Digitizing healthcare is a major aim of healthcare policy, with efforts aimed at increasing adoption of electronic health records (EHRs). We study the capability use for EHRs through the lens of normalisation process theory to assess whether these barriers to adoption also remain barriers to sustained use. We focus on health information exchange (HIE), which is one of the most challenging capabilities identified in the literature. We analyse the National Electronic Health Records Survey data, in which physicians were asked whether known HIE adoption barriers remain in place, and how frequently they use HIE capabilities. Though we expect that adoption barriers reported to be less problematic will be associated with greater capability use, we found that adoption barriers perceived to be more (less) problematic were not necessarily those that predicted less (greater) capability use. This study contributes through a critical examination of the process of normalization of EHR capabilities.

医疗保健数字化是医疗保健政策的一个主要目标，旨在提高电子健康记录 (EHR) 的采用率。我们通过标准化过程理论的视角研究电子病历的能力使用，以评估这些采用障碍是否仍然是持续使用的障碍。我们专注于健康信息交换（HIE），这是文献中确定的最具挑战性的功能之一。我们分析了国家电子健康记录调查数据，其中医生被问及已知的 HIE 采用障碍是否仍然存在，以及他们使用 HIE 功能的频率。尽管我们预计问题较少的采用障碍将与更多的能力使用相关，但我们发现被认为问题较多（较少）的采用障碍不一定是那些预测较少（较多）能力使用的障碍。这项研究通过对电子病历能力正常化过程的严格审查做出了贡献。