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Table 1 Micro, meso and macro level dimensions and categories of the Clinical Adoption Framework

From: Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework

Dimension Category
Micro level Health Information System (HIS) quality, which refers to the accuracy, completeness and availability of the clinical information content; features, performance and security of the system; and responsiveness of the support services.
Usage quality which refers to HIS usage intention/pattern and user satisfaction in terms of usefulness, ease of use and competency.
Net benefits, which refer to the change in care quality, access and productivity as a result of HIS adoption by clinicians. Care quality includes patient safety, appropriateness/ effectiveness, and health outcomes. Access refers to provider/patient participation and availability/access to services. Productivity covers care coordination, efficiency and net cost.
Meso level People meaning the individuals/groups involved, their personal characteristics and expectations, and their roles and responsibilities with the HIS.
Organization which refers to how the HIS fits with the organization’s strategy, culture, structure/processes, info−/infrastructure, and return on value.
Implementation which involves the HIS adoption stages, project management approaches and the extent of the HIS’s fit for the practice.
Macro level Healthcare standards in terms of the types of HISs organizational performance and professional practice standards in place.
Funding and incentives which refer to the added values, remunerations and incentive programs.
Legislation/policy and governance in terms of the influence of legislative acts, regulations/policies and governance bodies, such as professional associations/colleges and advocacy groups, and their attitudes toward HIS.
Societal, political and economic trends which include public expectations and the overall socio-political and economic climates with regards to technologies healthcare and HIS.