Understanding Continuance Intentions of Physicians with Electronic Medical Records (EMRS): An Expectancy-Confirmation Perspective

This thesis examines physicians’ satisfaction with electronic medical records (EMRs) in the post-adoption phase. More specifically, the study examines how physicians’ satisfaction with EMRs impacts on their intention to continue using as well as extend their adoption of additional functions of EMRs. Expectation-confirmation theory is used with the incorporation of perceived risk as the theoretical framework. The extended theoretical model is used to formulate eight hypotheses to aid in the understanding of physicians’ continuance intentions. A field survey of 135 Canadian physicians that utilize EMRs was performed to test the model empirically. The study found that physicians are willing to continue using and adopting additional components of EMRs. In addition, the empirical results suggest that physicians’ perceived usefulness and perceived risk impacts satisfaction, which in turn influences physicians’ continuance intentions. As well, perceived risk has an influence on physicians’ continuance intentions directly.

(A) Optimization of solid body phase synthesis of RNA using the Cpep chemistry. (B) Synthesis of BODIPY labeled oligonucleotides

(A) Solid phase synthesis of oligonucleotides are well documented and are extensively studied as the demands continue to rise with the development of antisense, anti-gene, RNA interference, and aptamers. Although synthesis of RNA sequences faces many challenges, most notably the choice of the 2' -hydroxy protecting group, modified 2' -O-Cpep protected ribonucleotides were synthesized as alternitive building blocks. Altering phosphitylation procedures to incorporate 3' -N,N-diethyl phosphoramidites enhanced the overall reactivity, thus, increased the coupling efficiency without loss of integrety. Furthermore, technical optimizations of solid phase synthesis cycles were carried out to allow for successful synthesis of a homo UIO sequences with a stepwise coupling efficiency reaching 99% and a final yield of 91 %. (B) Over the past few decades, dipyrrometheneboron difluoride (BODIPY) has gained recognition as one of the most versatile fluorophores. Currently, BODIPY labeling of oligonucleotides are carried out post-synthetically and to date, there lacks a method that allows for direct incorporation of BODIPY into oligonucleotides during solid phase synthesis. Therefore, synthesis of BODIPY derived phosphoramidites will provide an alternative method in obtaining fluorescently labelled oligonucleotides. A method for the synthesis and incorporation of the BODIPY analogues into oligonucleotides by phosphoramidite chemistry-based solid phase DNA synthesis is reported here. Using this approach, BODIPY-labeled TlO homopolymer and ISIS 5132 were successfully synthesized.