Transformational leadership and physician acceptance of computerized physician order entry systems and electronic medical records and the role of Chief Medical Information Officers in the United States

Researchers, industry analysts and the broader medical fraternity generally agree that physician adoption of healthcare technology is vital to the advancement of healthcare outcomes and cost effectiveness. Accordingly, there is a vast body of research into technology design, implementation process methodology, total cost of ownership and many other technical factors. However, there is minimal research into the humanistic socio-medical components such as leadership, particularly transformational leadership. In general ‘leadership is one of the most observed and least understood phenomena on earth’ (Burns, 1978). The entrenched rigid hierarchical structure of the medical fraternity sets forth legitimized power and authoritative leadership by decree to the members of this complex web. This research has a focus on the efficacy of transformational leadership mediated by trust in relation to the adoption of electronic medical record technology. The purpose of this research is twofold. First, it examines the perceptions of transformational leadership by senior management in healthcare. Secondly, it explores if and how the practice of transformational leadership, mediated by trust, improves the adoption of electronic medical recording equipment by the physician community. This dissertation presents a review beginning with parent, intermediate and specific literature of transformational leadership, across a range of organizations and industries in various stages of development. The chapter then identifies gaps in the extant literature and develops a theoretical framework to guide the research and close the gaps. This research adopts a principally interpretive social science methodology. It involves a nixed-methods approach incorporating semi-structured interview protocol, augmented by a quantitative capstone survey. The research setting was across five geographic regions of the United States of America. The respondents were Chief Information Officers (CIO) of major teaching hospitals and large central hospitals, integrated delivery networks and single facility institutions. The transcripts from the interviews were analysed using NVivo 9 and Microsoft Excel to identify patterns and themes in the responses.