1
|
Nabelsi V, Lévesque-Chouinard A. Successful Electronic Consultation Service Initiative in Quebec, Canada With Primary Care Physicians' and Specialists' Experiences on Acceptance and Use of Technological Innovation: Cross-Sectional Exploratory Study. JMIR Form Res 2024; 8:e52921. [PMID: 38814689 PMCID: PMC11176886 DOI: 10.2196/52921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 04/10/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Electronic consultation (eConsult) is an eHealth service that allows primary care providers (PCPs) to electronically consult specialists regarding their patients' medical issues. Many studies have demonstrated that eConsult services improve timely access to specialist care; prevent unnecessary referrals; improve PCPs', specialists', and patients' satisfaction; and therefore have a large impact on costs. However, no studies have evaluated PCPs' and specialists' acceptance of eConsult services in Quebec, Canada, and worldwide. OBJECTIVE This exploratory study aims to identify factors affecting eConsult service acceptance by PCPs and specialists in urban and rural primary care clinics across 3 regions in the province of Quebec, Canada, by integrating the Unified Theory of Acceptance and Use of Technology and Task-Technology Fit (TTF) models and user satisfaction. This research was designed to broaden and assist in scaling up this effective eHealth service innovation across the province. METHODS A cross-sectional web-based survey was sent to all PCPs (n=263) and specialists (n=62) who used the eConsult Quebec Service between July 2017 and May 2021. We proposed a unified model integrating the Unified Theory of Acceptance and Use of Technology model and TTF model and user satisfaction by endorsing 11 hypotheses. The partial least squares was used to investigate factors influencing the acceptance of the eConsult Quebec Service. RESULTS Of the 325 end users, 136 (41.8%) users responded (PCPs: 101/263, 38.4%; specialists: 35/62, 57%). The results of the analysis with partial least squares method indicate that 9 of our 11 hypotheses are supported. The direct relationships uniting the various constructs of the model highlighted the importance of several key constructs and predominant correlations. The results suggest that satisfaction is the key driver behind the use of the eConsult Quebec Service. Performance expectancy (P<.001) and effort expectancy (P=.03) can have a positive impact on behavioral intention (BI), and BI (P<.001) can impact adoption. TTF has an influence on performance expectancy (P<.001), adoption (P=.02), and satisfaction (P<.001). However, the results show that there is no direct effect between social influence (P=.38) and BI or between facilitating conditions (P=.17) and adoption. CONCLUSIONS This study provides a better understanding of the factors influencing PCPs' and specialists' intention to adopt the eConsult Quebec Service. Furthermore, this study tests a research model and a technology that have never been explored in Quebec until now. On the basis of the results, the service is a good fit to meet the users' need to improve access to specialized medical advice. Therefore, the results of our study have made a valuable contribution to the implementation of the service by policy makers in order to maximize acceptance, use, adoption, and success across the province of Quebec. Moreover, after 4 successful years, the eConsult Quebec pilot project is now the Conseil Numérique digital consultation service.
Collapse
Affiliation(s)
- Véronique Nabelsi
- Department of Administrative Sciences, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Annabelle Lévesque-Chouinard
- GMF-U de la Haute-Ville du Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, Sainte-Foy, QC, Canada
| |
Collapse
|
2
|
Park J, Rho MJ. Factors Influencing the Acceptance of Distributed Research Networks in Korea: Data Accessibility and Data Security Risk. Healthc Inform Res 2023; 29:334-342. [PMID: 37964455 PMCID: PMC10651399 DOI: 10.4258/hir.2023.29.4.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVES Distributed research networks (DRNs) facilitate multicenter research by enabling the use of multicenter data; therefore, they are increasingly utilized in healthcare fields. Despite the numerous advantages of DRNs, it is crucial to understand researchers' acceptance of these networks to ensure their effective application in multicenter research. In this study, we sought to identify the factors influencing the adoption of DRNs among researchers in Korea. METHODS We used snowball sampling to collect data from 149 researchers between July 7 and August 28, 2020. Five factors were used to formulate the hypotheses and research model: data accessibility, usefulness, ease of use, data security risk, and intention to use DRNs. We applied a structural equation model to identify relationships within the research model. RESULTS Data accessibility and data security were critical to the acceptance and use of DRNs. The usefulness of DRNs partially mediated the relationship between data accessibility and the intention to use DRNs. Interestingly, ease of use did not influence the intention to use DRNs, but it was affected by data accessibility. Furthermore, ease of use impacted the perceived usefulness of DRNs. CONCLUSIONS This study highlighted major factors that can promote the broader adoption and utilization of DRNs. Consequently, these findings can contribute to the expansion of active multicenter research using DRNs in the field of healthcare research.
Collapse
Affiliation(s)
- Jihwan Park
- College of Liberal Arts, Dankook University, Cheonan,
Korea
| | - Mi Jung Rho
- College of Health Science, Dankook University, Cheonan,
Korea
| |
Collapse
|
3
|
Kaihlanen AM, Elovainio M, Virtanen L, Kinnunen UM, Vehko T, Saranto K, Heponiemi T. Nursing informatics competence profiles and perceptions of health information system usefulness among registered nurses: A latent profile analysis. J Adv Nurs 2023; 79:4022-4033. [PMID: 37243421 DOI: 10.1111/jan.15718] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/27/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
AIMS To identify different nursing informatics competence (NIC) profiles in nurses, examine the factors associated with profile memberships and examine the associations of the derived profiles with the nurses' perception of the usefulness of a health information system (HIS). DESIGN A cross-sectional study. METHODS A sample of 3610 registered nurses responded to a nationwide survey in March 2020. A latent profile analysis was performed to identify NIC profiles based on three competence areas: nursing documentation, working in digital environment, and ethics and data protection. A multinomial logistic regression was carried out to examine the associations of demographic and background variables with the profile membership. Linear regression analyses were carried out to examine the association between the profile membership and perceived HIS usefulness. RESULTS Three NIC profiles were identified and labelled as low, moderate and high competence groups. A younger age, recent graduation year, sufficient orientation and high-rated proficiency as an HIS user were associated with nurses belonging to a high or moderate competence group relative to a low competence group. Competence group membership was associated with perceived HIS usefulness. The high competence group consistently expressed the highest usefulness of the HIS and the low competence group the lowest. CONCLUSION Tailored training and support should be provided for nurses with different levels of informatics competence, thereby facilitating their ability to respond to increasingly digitalized work. This could contribute to higher usefulness of the HIS in terms of supporting the nurses' work tasks and promoting the quality of care. IMPACT This was the first study exploring latent profiles of informatics competence in nurses. Insights from this study are useful for nursing management to identify different competence profiles of their employees, provide support and training to meet their needs, and promote the successful use of an HIS.
Collapse
Affiliation(s)
| | - Marko Elovainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Lotta Virtanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ulla-Mari Kinnunen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Tuulikki Vehko
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kaija Saranto
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | | |
Collapse
|
4
|
Digital transformation of healthcare during the COVID-19 pandemic: Patients’ teleconsultation acceptance and trusting beliefs. TECHNOVATION 2023; 120. [PMCID: PMC9108035 DOI: 10.1016/j.technovation.2022.102547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The COVID-19 pandemic boosted the digital transformation of many services, including healthcare, and access to medical care using teleconsultation has increased rapidly. Thus, a growing number of online platforms have been developed to accommodate patients’ needs. This paper examines the factors that predict the intention to use medical teleconsultation by extending the unified theory of acceptance and use of technology (UTAUT2) with the three dimensions of trusting beliefs and self-efficacy. A survey was administered to patients who had used a teleconsultation platform during the pandemic period. As one of the largest studies to date, a sample of 1233 respondents was collected and analyzed using a partial least squares approach, often mobilized in the information systems (IS) domain. Furthermore, a deep analysis using all recommended metrics was performed. The results highlight the significance of trusting beliefs, and self-efficacy in the adoption of digital healthcare services. These findings contribute to both theory and practice in COVID-19 research.
Collapse
|
5
|
Ebnehoseini Z, Tabesh H, Deghatipour A, Tara M. Development an extended-information success system model (ISSM) based on nurses' point of view for hospital EHRs: a combined framework and questionnaire. BMC Med Inform Decis Mak 2022; 22:71. [PMID: 35317784 PMCID: PMC8939199 DOI: 10.1186/s12911-022-01800-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 03/04/2022] [Indexed: 11/27/2022] Open
Abstract
Background Understanding the hospital EHR success rate has great benefits for hospitals. The present study aimed to 1-Propose an extended-ISSM framework and a questionnaire in a systematic manner for EHR evaluation based on nurses’ perspectives, 2-Determine the EHR success rate, and 3-Explore the effective factors contributing to EHR success. Methods The proposed framework was developed using ISSM, TAM3, TTF, HOT-FIT, and literature review in seven steps. A self-administrated structured 65-items questionnaire was developed with CVI: 90.27% and CVR: 94.34%. Construct validity was conducted using EFA and CFA. Eleven factors were identified, collectively accounting for 71.4% of the total variance. In the EFA step, 15 questions and two questions in EFA were excluded. Finally, 48 items remained in the framework including dimensions of technology, human, organization, ease of use, usefulness, and net benefits. The overall Cronbach’s alpha value was 93.4%. In addition, the hospital EHR success rate was determined and categorized. In addition, effective factors on EHR success were explored. Results In total, 86 nurses participated in the study. On average, the “total hospital EHR success rate” was moderate. The total EHR success rates was ranging from 47.09 to 74.96%. The results of the Kruskal–Wallis test showed that there was a significant relationship between “gender” and “self-efficacy” (p-value: 0.042). A reverse relation between “years of experience using computers” and “training” (p-value: 0.012) was observed. “Years of experience using EHR” as well as “education level” (p-value: 0.001) and “ease of use” had a reverse relationship (p-value: 0.034). Conclusions Our findings underscore the EHR success based on nurses’ viewpoint in a developing country. Our results provide an instrument for comparison of EHR success rates in various hospitals. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-022-01800-1.
Collapse
Affiliation(s)
- Zahra Ebnehoseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Tabesh
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Deghatipour
- Ibn-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmood Tara
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
6
|
Chen RF, Hsiao JL. Health Professionals' Perspectives on Electronic Medical Record Infusion and Individual Performance: Model Development and Questionnaire Survey Study. JMIR Med Inform 2021; 9:e32180. [PMID: 34851297 PMCID: PMC8672292 DOI: 10.2196/32180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/07/2021] [Accepted: 10/17/2021] [Indexed: 12/05/2022] Open
Abstract
Background Electronic medical records (EMRs) are integrated information sources generated by health care professionals (HCPs) from various health care information systems. EMRs play crucial roles in improving the quality of care and medical decision-making and in facilitating cross-hospital health information exchange. Although many hospitals have invested considerable resources and efforts to develop EMRs for several years, the factors affecting the long-term success of EMRs, particularly in the EMR infusion stage, remain unclear. Objective The aim of this study was to investigate the effects of technology, user, and task characteristics on EMR infusion to determine the factors that largely affect EMR infusion. In addition, we examined the effect of EMR infusion on individual HCP performance. Methods A questionnaire survey was used to collect data from HCPs with >6 months experience in using EMRs in a Taiwanese teaching hospital. A total of 316 questionnaires were distributed and 211 complete copies were returned, yielding a valid response rate of 66.8%. The collected data were further analyzed using WarpPLS 5.0. Results EMR infusion (R2=0.771) was mainly affected by user habits (β=.411), portability (β=.217), personal innovativeness (β=.198), technostress (β=.169), and time criticality (β=.168), and individual performance (R2=0.541) was affected by EMR infusion (β=.735). This finding indicated that user (habit, personal innovativeness, and technostress), technology (portability), and task (mobility and time criticality) characteristics have major effects on EMR infusion. Furthermore, the results indicated that EMR infusion positively affects individual performance. Conclusions The factors identified in this study can extend information systems infusion theory and provide useful insights for the further improvement of EMR development in hospitals and by the government, specifically in its infusion stage. In addition, the developed instrument can be used as an assessment tool to identify the key factors for EMR infusion, and to evaluate the extent of EMR infusion and the individual performance of hospitals that have implemented EMR systems. Moreover, the results can help governments to understand the urgent needs of hospitals in implementing EMR systems, provide sufficient resources and support to improve the incentives of EMR development, and develop adequate EMR policies for the meaningful use of electronic health records among hospitals and clinics.
Collapse
Affiliation(s)
- Rai-Fu Chen
- Department of Information Management, Chia-Nan University of Pharmacy and Science, Tainan City, Taiwan
| | - Ju-Ling Hsiao
- Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan City, Taiwan
| |
Collapse
|
7
|
Baudier P, Kondrateva G, Ammi C, Chang V, Schiavone F. Patients' perceptions of teleconsultation during COVID-19: A cross-national study. TECHNOLOGICAL FORECASTING AND SOCIAL CHANGE 2021; 163:120510. [PMID: 33318716 PMCID: PMC7720768 DOI: 10.1016/j.techfore.2020.120510] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 05/08/2023]
Abstract
In recent months, humanity has had to deal with a worldwide pandemic called COVID-19, which has caused the death of hundreds of thousands of people and paralyzed the global economy. Struggling to cure infected patients while continuing to care for patients with other pathologies, health authorities have faced the lack of medical staff and infrastructure. This study aimed to investigate the acceptance of teleconsultation solutions by patients, which help to avoid the spread of the disease during this pandemic period. The model was built using some constructs of the technology acceptance model UTAUT2, Personal traits, Availability, and Perceived Risks. A new scale on Contamination Avoidance was developed by the authors. The questionnaire was disseminated in several countries in Europe and Asia and a total sample of 386 respondents was collected. The results emphasize the huge impact of Performance Expectancy, the negative influence of Perceived Risk, and the positive influence of Contamination Avoidance on the adoption of teleconsultation solutions. The findings highlight the moderating effects of Age, Gender, and Country.
Collapse
Affiliation(s)
| | | | - Chantal Ammi
- Institut Mines-Télécom Business School, Evry, France
| | - Victor Chang
- Artificial Intelligence and Information Systems Research Group, School of Computing, Engineering and Digital Technologies, Teesside University, Middlesbrough, United Kingdom
| | - Francesco Schiavone
- Parthenope University of Naples, Italy, Department of Management Studies & Quantitative Methods and Paris School of Business, France
| |
Collapse
|
8
|
Ebnehoseini Z, Jangi M, Tara M, Tabesh H. Investigation the success rate of hospital information system (HIS): Development of a questionnaire and case study. J Healthc Qual Res 2021; 36:103-112. [PMID: 33495115 DOI: 10.1016/j.jhqr.2020.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 02/21/2020] [Accepted: 03/02/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND OBJECTIVES The implantation of hospital information systems (HISs) has grown dramatically in recent years. Understanding the success rate of HIS is key in health organizations. In this study, a validated questionnaire for HISs evaluation based on the Information System Success Model (ISSM) has been provided. In addition, the HIS success rate was determined. MATERIALS AND METHODS The current study was conducted at one of the largest teaching hospitals in eastern Iran. The 44-items questionnaire was developed for data gathering. The questionnaire covered ISSM dimensions, which include analysis of quality system, quality of information, quality service, system use, usefulness, satisfaction, and net benefits. Content validity, constructs validity, and reliability of the ISSM questionnaire was measured. HIS success rate has been determined and categorized based on users' perspective as follows: appropriate (75%≤HIS success rate), moderate (50%≤HIS success rate<75%), low coverage (25%≤HIS success rate<50%), and poor (coverage rate<25%). RESULTS In total, 253 users participated in the study. The ISSM questionnaire was validated by an expert panel with CVI: 85.12% and CVR: 88.22%. The overall Cronbach's alpha value of the instrument was determined as 92.2%. Nine factors with eigenvalues greater than 1.00 were identified, jointly accounting for 66.91% of the total variance. The value of KMO was.866 showed that the sample size was adequate for factor analysis. The highly significant Bartlett's test (p<0.000) indicated that variables were correlated and the factor analysis was appropriate. Our results demonstrated that the total mean of HIS success was "moderate" base on the users' point of view. CONCLUSIONS The findings of the current study, provide valuable scientific evidence for key affecting factors on hospital EHR in Iran as a developing country.
Collapse
Affiliation(s)
- Z Ebnehoseini
- Medical Informatics, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Jangi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M Tara
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - H Tabesh
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
9
|
Ebnehoseini Z, Tabesh H, Jangi MJ, Deldar K, Mostafavi SM, Tara M. Investigating Evaluation Frameworks for Electronic Health Record: A Literature Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.3421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: There are various electronic health records (EHRs) evaluation frameworks with multiple dimensions and numerous sets of evaluation measures, while the coverage rate of evaluation measures in a common framework varies in different studies.
AIM: This study provides a literature review of the current EHR evaluation frameworks and a model for measuring the coverage rate of evaluation measures in EHR frameworks.
METHODS: The current study was a comprehensive literature review and a critical appraisal study. The study was conducted in three phases. In Phase 1, a literature review of EHR evaluation frameworks was conducted. In Phase 2, a three-level hierarchical structure was developed, which includes three aspects, 12 dimensions, and 110 evaluation measures. Subsequently, evaluation measures in the identified studies were categorized based on the hierarchical structure. In Phase 3, relative frequency (RF) of evaluation measures in different dimensions and aspects for each of the identified studies were determined and categorized as follows: Appropriate, moderate, and low coverage.
RESULTS: Out of a total of 8276 retrieved articles, 62 studies were considered relevant. The RF range in the second and third level of the hierarchical structure was between 8.6%–91.94% and 0.2%–61%, respectively. “Ease of use” and “system quality” were the most frequent evaluation measure and dimension. Our results indicate that identified studies cover at least one and at most nine evaluation dimensions and current evaluation frameworks focus more on the technology aspect. Almost in all identified studies, evaluation measures related to the technology aspect were covered. However, evaluation measures related to human and organization aspects were covered in 68% and 84% of the identified studies, respectively.
CONCLUSION: In this study, we systematically reviewed all literature presenting any type of EHR evaluation framework and analyzed and discussed their aspects and features. We believe that the findings of this study can help researchers to review and adopt the EHR evaluation frameworks for their own particular field of usage.
Collapse
|
10
|
Ebnehoseini Z, Tara M, Tabesh H, Dindar FH, Hasibian S. Understanding key factors affecting on hospital electronic health record (EHR) adoption. J Family Med Prim Care 2020; 9:4348-4352. [PMID: 33110858 PMCID: PMC7586526 DOI: 10.4103/jfmpc.jfmpc_109_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/12/2020] [Accepted: 03/26/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction: This study investigated the factors affecting the acceptance of hospital electronic health record (EHR) adoption by users based on Technology Acceptance Model3 (TAM3). Methods: The self-administered TAM3 questionnaire was used for data gathering. Content validity and reliability of the TAM3 questionnaire were measured. The relation between dependent, independent, and mediator variables was analyzed using multiple regression analysis. Results: The results from 224 users indicated that subjective norm, job relevance, output quality, voluntariness, computer experience have significant impacts on perceived usefulness. Also, perceptions of external control and computer anxiety were identified as having significant impacts on perceived ease of use. Perceived usefulness did not have a mediator role between result demonstrability and behavioral intention. Perceived ease of use was not found to be a mediating factor in the relationship between computer self- efficacy and behavioral intention, as well as perceived enjoyment. Conclusions: The findings of the current study, provide valuable scientific evidence for key affecting factors on hospital EHR in Iran as a developing country. Our results showed the main constructs and relationships depicted in the TAM3 were found to be applicable to assess the adoption of hospital EHR.
Collapse
Affiliation(s)
- Zahra Ebnehoseini
- Ph.D. Medical Informatics, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmood Tara
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Tabesh
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Hami Dindar
- Bachelor Degree of Medical Record, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sepideh Hasibian
- Department of Biology, Mashhad Islamic Azad University, Mashhad, Iran
| |
Collapse
|
11
|
Huang HY, Lee TT, Hsu TC, Mills ME, Tzeng IS. Evaluation of the Pressure Injury Prevention Information System. Comput Inform Nurs 2020; 38:625-632. [PMID: 32467444 DOI: 10.1097/cin.0000000000000627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Clinical decision support systems provide empirical guidance to improve the quality of nursing care. This study aimed to evaluate the outcomes of implementation of decision support functions into the preventive care system as regards nurses' acceptance of technology, documentation completeness, and incidence of hospital-acquired pressure injury. The researchers performed data collection in a regional hospital in northern Taiwan. The study used the Davis Science and Technology Acceptance Model scale to investigate nurses' technology acceptance before and after the introduction of a clinical decision support system and compared documentation compliance of preventive records with the incidence of hospital-acquired pressure injuries. Results showed that nurses' acceptance of the technology was significantly improved, and the completion rate of the pressure injury preventive care record significantly increased from 88.9% to 99.9%. Meanwhile, the incidence of hospital-acquired pressure injury decreased significantly from 0.057% to 0.021%. Therefore, it was concluded that the clinical decision support system provides evidenced-based support to nurses and is effective in identifying patient-specific prevention nursing plans of care.
Collapse
Affiliation(s)
- Hsiu-Yen Huang
- Author Affiliations: Department of Nursing, Taiwan Adventist Hospital (Ms Huang); School of Nursing, National Yang-Ming University (Dr Lee); and Taiwan Adventist Hospital (Dr Hsu), Taipei, Taiwan; School of Nursing, University of Maryland (Dr Mills), Baltimore; and Department of Research, Taipei Tzu Chi Hospital (Dr Tzeng), Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | | | | | | | | |
Collapse
|
12
|
Farzandipour M, Nadi-Ravandi S, Gilasi H, Soleimani N. Iranian Health Information Technology Acceptance Model (IHITAM) from Users' Views. Acta Inform Med 2020; 27:245-252. [PMID: 32055091 PMCID: PMC7004288 DOI: 10.5455/aim.2019.27.245-252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction Information technology (IT) is an important component of medical informatics. Information needs to be accepted by users to function effectively. At different ages and from different views, several models have been proposed and used to show factors affecting users' IT acceptance. However, such models are in need of frequent revision and development due to variable conditions. Aim The present research aims to design a new health IT acceptance model from Iranian users' views. The research aims both to design a model for status quo by reviewing previous models and consider features of Iranian users. Methods This is a correlative, cross-sectional study. Firstly, the primary model was presented by studying important IT acceptance models. Then, a structured questionnaire was designed and, after confirmation of validity and reliability of the questionnaire, it was given to users of information and health IT systems in different wards of hospitals in Iran. Data were analyzed by SPSS and Lisrel and the final model was designed by structural equations. Results The model showed that there are six key factors which are effective on attitude and use intention including performance expectancy, observability, effort expectancy, facilitating conditions, empowerment and subjective norms via three interface factors of perceived usefulness, perceived ease of use, self-efficacy. The size of technology use is an important factor in technology acceptance and application as well. Conclusion The present model has more details compared to the other models and can show a new image of important factors in technology acceptance and their relationships.
Collapse
Affiliation(s)
- Mehrdad Farzandipour
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Somayyeh Nadi-Ravandi
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamidreza Gilasi
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Nabiallah Soleimani
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
| |
Collapse
|
13
|
Zhou LL, Owusu-Marfo J, Asante Antwi H, Antwi MO, Kachie ADT, Ampon-Wireko S. "Assessment of the social influence and facilitating conditions that support nurses' adoption of hospital electronic information management systems (HEIMS) in Ghana using the unified theory of acceptance and use of technology (UTAUT) model". BMC Med Inform Decis Mak 2019; 19:230. [PMID: 31752840 PMCID: PMC6873399 DOI: 10.1186/s12911-019-0956-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/31/2019] [Indexed: 11/30/2022] Open
Abstract
Background Hospital electronic information management systems (HEIMS) are widely used in Ghana, and hence its performance must be carefully assessed. Nurses as clinical health personnel are the largest cluster of hospital staff and are the pillar of healthcare delivery. Therefore, they play a crucial role in the adoption and assessment of HEIMSs in Ghana. This report sought to assess the “Social Influence” (SI) and “Facilitating Conditions” (FC) that support Nurses’ Acceptance of HEIMS in Ghana using the “Unified Theory of Acceptance and Use of Technology” (UTAUT) model. Methods This study applied a non-experimental survey design. An electronic platform questionnaire on smartphones was used to collect data on 660 nurses. Statistically, AMOS Structural Equation Modelling (SEM) version 22.0 was employed to examine the research model. Results “Behavioral Intention” (BI) to HEIMS use was significantly predicted by SI and FC (p < 0.001). Notably, both SI and FC had an influence on nurses’ use behavior (UB) with behavioral intention (BI) as the mediator, which explains a total of 42.1% variance in the intention of nurses to use HEIMS. Likewise, UB of HEIMS was also significantly predicted by SI (R2 = 43.2) and BI (R2 = 0.39.6) with both constructs explaining a total of 51.7% of the variance in nurses’ acceptance to use HEIMS. Conclusion Nurses’ adoption of HEIMS in terms of the UB was influenced by SI and BI, whiles SI and FC had the strongest influence on BI (serving as mediator) of UB to adopt and use HEIMS among the nurses in Ghanaian hospitals.
Collapse
Affiliation(s)
- Lu Lin Zhou
- Center for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu, 212013, People's Republic of China
| | - Joseph Owusu-Marfo
- Center for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu, 212013, People's Republic of China. .,Department of Health Informatics/Health Information Management, College of Health and Well-Being, Kintampo Bono East, Ghana.
| | - Henry Asante Antwi
- Center for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu, 212013, People's Republic of China
| | - Maxwell Opuni Antwi
- Center for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu, 212013, People's Republic of China
| | - Arielle Doris Tetgoum Kachie
- Center for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu, 212013, People's Republic of China
| | - Sabina Ampon-Wireko
- Center for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu, 212013, People's Republic of China
| |
Collapse
|
14
|
Alipour J, Mehdipour Y, Karimi A. Factors Affecting Acceptance of Hospital Information Systems in Public Hospitals of Zahedan University of Medical Sciences: A Cross-Sectional Study. J Med Life 2019; 12:403-410. [PMID: 32025259 PMCID: PMC6993299 DOI: 10.25122/jml-2019-0064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 10/02/2019] [Indexed: 11/17/2022] Open
Abstract
A hospital information system is used to support a wide range of operations and activities in the hospital. This study was conducted to determine the factors affecting hospital information system acceptance by users. A cross-sectional, descriptive, analytic study was performed in 2018. The study population included 550 users of the system. The data were collected using a questionnaire and analyzed using the SPSS software. A significant moderate positive correlation was found between hospital information system acceptance and perceived usefulness (r = 0.54, P < 0.01), perceived ease of use (r = 0.41, P < 0.01), human factors (r = 0.46, P < 0.01) and technological factors (r = 0.54, P < 0.01). A significant weak positive correlation was detected between the acceptance of the hospital information system and organizational factors (r = 0.35, P < 0.01). Perceived usefulness of the system, social influence, system quality, perceived ease of use of the system, and top managers' supports had the most substantial influence on the users' intention to accept a hospital information system. User education, preparation of guidelines suited to the user specialty or department, incorporating users' work needs into the capabilities of the hospital information system, and improving the system to an ideal level are important considerations.
Collapse
Affiliation(s)
- Jahanpour Alipour
- Department of Health Information Technology, Paramedical School, Zahedan University of Medical Sciences, Zahedan, Iran
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Yousef Mehdipour
- Department of Health Information Technology, Paramedical School, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Afsaneh Karimi
- Department of Health Information Technology, Paramedical School, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
15
|
Ho KF, Ho CH, Chung MH. Theoretical integration of user satisfaction and technology acceptance of the nursing process information system. PLoS One 2019; 14:e0217622. [PMID: 31163076 PMCID: PMC6548361 DOI: 10.1371/journal.pone.0217622] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 05/15/2019] [Indexed: 12/01/2022] Open
Abstract
Background The nursing process system (NPS) is used to establish the nursing process involving assessment, diagnosis, planning, intervention, and evaluation in solving the health problems of patients. Objectives The factors influencing the use of the NPS by nurses were analyzed based on user satisfaction and technology acceptance within the 3Q (service quality, information quality, and system quality) model. Methods In this cross-sectional quantitative study, the valid responses of 222 nurses to a questionnaire were obtained; these nurses worked at eight hospitals affiliated with public organizations in Taiwan. Structural equation modeling was used to analyze information quality, system quality, service quality, user satisfaction, perceived usefulness, perceived ease of use, perceived enjoyment, behavioral attitude, and intention after the nurses had used the NPS system for more than 1 month. Results Information quality, service quality, and system quality influenced user satisfaction. User satisfaction affected perceived usefulness, perceived ease of use, and perceived enjoyment and had the highest explanatory power (R2 = 0.75). Furthermore, perceived usefulness, perceived ease of use, and perceived enjoyment influenced behavioral attitude and intention to use the system. The proposed model explained 53% of the variance in the intention to use the NPS. Conclusions The relationships between the variables of the 3Q model were successfully used to examine the intention of nurses toward using the NPS. Using the findings of this study, designers and programmers can comprehensively understand the perceptions of nurses and further improve the performance of the NPS.
Collapse
Affiliation(s)
- Kuei-Fang Ho
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Hsun Ho
- Graduate Institute of Information Management, National Taipei University, New Taipei City, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- * E-mail:
| |
Collapse
|
16
|
Shahzad K, Jianqiu Z, Sardar T, Hafeez M, Shaheen A, Wang L. Hospital information-system (HIS) acceptance: A physician’s stance. HUMAN SYSTEMS MANAGEMENT 2019. [DOI: 10.3233/hsm-180415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Khuram Shahzad
- School of Economics and Management, Beijing University of Posts and Telecommunications, People’s Republic of China
| | - Zeng Jianqiu
- School of Economics and Management, Beijing University of Posts and Telecommunications, People’s Republic of China
| | - Taiba Sardar
- School of Economics and Management, Beijing University of Posts and Telecommunications, People’s Republic of China
| | - Muhammad Hafeez
- School of Economics and Management, Beijing University of Posts and Telecommunications, People’s Republic of China
| | - Aliya Shaheen
- School of Economics and Management, Beijing University of Posts and Telecommunications, People’s Republic of China
| | - Lei Wang
- School of Economics and Management, Beijing University of Posts and Telecommunications, People’s Republic of China
| |
Collapse
|
17
|
Zozus MN, Penning M, Hammond WE. Factors impacting physician use of information charted by others. JAMIA Open 2019; 2:107-114. [PMID: 30976757 PMCID: PMC6447025 DOI: 10.1093/jamiaopen/ooy041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 07/30/2018] [Accepted: 10/01/2018] [Indexed: 11/26/2022] Open
Abstract
Objectives To identify factors impacting physician use of information charted by others. Materials and methods A 4-round Delphi process was conducted with physicians and non-physicians publishing in the healthcare data quality literature to identify and characterize factors impacting physician use of information charted by others (other people or devices), either within or external to their organization. Factors with high average importance and reliability were categorized according to similarity of topic. Results Thirty-nine factors were ultimately identified as impacting physician use of information charted by others. Five categories of factors included aspects of: the information source, the information itself, the information user, the information system, and aspects of healthcare as an institution. In addition, 4 themes were identified: (1) value of narrative text in providing context, (2) importance of mental models and personal heuristics in deciding whether, and how to use information, (3) loss of confidence in, and decreased use of information due to errors encountered, and (4) existence of a trust hierarchy potentially influencing information use. Discussion Five similarly focused studies have recently probed clinician willingness to use information in decision-making. Our results mostly confirmed factors identified by prior studies, and uniquely identified aspects of the information user as important. Conclusion According to the participants in this study, information quality is prominent among factors impacting physician use of information charted by others. Based on this and similar studies, it appears that despite concerns about information quality, physicians use information charted by others.
Collapse
Affiliation(s)
- Meredith N Zozus
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Melody Penning
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - William E Hammond
- Duke University Center for Health Informatics, Durham, North Carolina, USA
| |
Collapse
|
18
|
Kujala S, Hörhammer I, Heponiemi T, Josefsson K. The Role of Frontline Leaders in Building Health Professional Support for a New Patient Portal: Survey Study. J Med Internet Res 2019; 21:e11413. [PMID: 30901003 PMCID: PMC6450477 DOI: 10.2196/11413] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/20/2018] [Accepted: 12/29/2018] [Indexed: 11/30/2022] Open
Abstract
Background Effective leadership and change management are thought to contribute to the successful implementation of health information technology innovations. However, limited attention has been paid to the role of frontline leaders in building health professional support for new technical innovations. Objective First, we examined whether frontline leaders’ positive expectations of a patient portal and perceptions of its implementation were associated with their support for the portal. Second, we explored whether leaders’ positive perceptions influenced the same unit’s health professional support for the portal. Methods Data were collected through an online survey of 2067 health professionals and 401 frontline leaders working in 44 units from 14 health organizations in Finland. The participating organizations run a joint self-care and digital value services project developing a new patient portal for self-management. The survey was conducted before the piloting and implementation of the patient portal. Results The frontline leaders’ perception of vision clarity had the strongest association with their own support for the portal (ß=.40, P<.001). Results also showed an association between leaders’ view of organizational readiness and their support (ß=.15, P=.04). The leaders’ positive perceptions of the quality of informing about the patient portal was associated with both leaders’ own (ß=.16, P=.02) and subordinate health professionals’ support for the portal (ß=.08, P<.001). Furthermore, professional participation in the planning of the portal was positively associated with their support (ß=.57, P<.001). Conclusions Findings suggest that assuring good informing, communicating a clear vision to frontline leaders, and acknowledging organizational readiness for change can increase health professional support for electronic health (eHealth) services in the pre-implementation phase. Results highlight the role of frontline leaders in engaging professionals in the planning and implementation of eHealth services and in building health professionals’ positive attitudes toward the implementation of eHealth services.
Collapse
Affiliation(s)
- Sari Kujala
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Iiris Hörhammer
- Department of Industrial Engineering and Management, Aalto University, Espoo, Finland
| | - Tarja Heponiemi
- National Institute for Health and Welfare, Helsinki, Finland
| | - Kim Josefsson
- National Institute for Health and Welfare, Helsinki, Finland
| |
Collapse
|
19
|
Hsiao JL, Chen RF. Understanding Determinants of Health Care Professionals' Perspectives on Mobile Health Continuance and Performance. JMIR Med Inform 2019; 7:e12350. [PMID: 30882353 PMCID: PMC6441862 DOI: 10.2196/12350] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/16/2018] [Accepted: 12/31/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND With the widespread use of mobile technologies, mobile information systems have become crucial tools in health care operations. Although the appropriate use of mobile health (mHealth) may result in major advances in expanding health care coverage (increasing decision-making speeds, managing chronic conditions, and providing suitable health care in emergencies), previous studies have argued that current mHealth research does not adequately evaluate mHealth interventions, and it does not provide sufficient evidence regarding the effects on health. OBJECTIVE The aim of this study was to facilitate the widespread use of mHealth systems; an accurate evaluation of the systems from the users' perspective is essential after the implementation and use of the system in daily health care practices. This study extends the expectation-confirmation model by using characteristics of individuals, technology, and tasks to identify critical factors affecting mHealth continuance and performance from the perspective of health care professionals (HCPs). METHODS A questionnaire survey was used to collect data from HCPs who were experienced in using mHealth systems of a Taiwanese teaching hospital. In total, 282 questionnaires were distributed, and 201 complete and valid questionnaires were returned, thus indicating a valid response rate of 71.3% (201/282). The collected data were analyzed using WarpPLS version 5.0 (ScriptWarp Systems). RESULTS The results revealed that mHealth continuance (R2=0.522) was mainly affected by perceived usefulness, technology maturity, individual habits, task mobility, and user satisfaction, whereas individual performance (R2=0.492) was affected by mHealth continuance. In addition, user satisfaction (R2=0.548) was affected by confirmation and perceived usefulness of mHealth, whereas perceived usefulness (R2=0.521) was affected by confirmation. This implied that confirmation played a key role in affecting perceived usefulness and user satisfaction. Furthermore, the results showed that mHealth continuance positively affected individual performance. CONCLUSIONS The identified critical factors influencing mHealth continuance and performance can be used as a useful assessment tool by hospitals that have implemented mHealth systems to facilitate the use and infusion of the systems. Furthermore, the results can help health care institutions that intend to introduce or develop mHealth applications to identify critical issues and effectively allocate limited resources to mHealth systems.
Collapse
Affiliation(s)
- Ju-Ling Hsiao
- Department of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science, Tainan City, Taiwan
| | - Rai-Fu Chen
- Department of Information Management, Chia-Nan University of Pharmacy and Science, Tainan City, Taiwan
| |
Collapse
|
20
|
Yu MH, Lee TT, Mills ME. The Effect of Barcode Technology Use on Pathology Specimen Labeling Errors. AORN J 2019; 109:183-191. [PMID: 30694536 DOI: 10.1002/aorn.12585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pathology specimen labeling errors occur for a variety of reasons. We investigated the use of barcode technology as a method to improve the accuracy of pathology specimen labeling and patient safety. We also assessed nurses' perceptions of system quality, information quality, service quality, user satisfaction, and net benefits. Sixty-eight perioperative nurses who work in a teaching hospital in Taiwan completed the survey. Nurses scored net benefits as highly contributing to their satisfaction, whereas system quality contributed most to dissatisfaction. Further, we analyzed pathology specimen records before and after implementing the barcode system and found that specimen management errors significantly decreased. The use of a reliable barcode system could improve specimen labeling accuracy and enhance nurses' satisfaction with this technology.
Collapse
|
21
|
Barzekar H, Ebrahimzadeh F, Luo J, Karami M, Robati Z, Goodarzi P. Adoption of Hospital Information System Among Nurses: a Technology Acceptance Model Approach. Acta Inform Med 2019; 27:305-310. [PMID: 32210497 PMCID: PMC7085343 DOI: 10.5455/aim.2019.27.305-310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: The successful implementation of Hospital Information Systems (HIS) depends on user acceptance. Nurses are the largest group of HIS users in hospitals. This study aims to evaluate some factors may affect the utilization of the Hospital Information System. Aim: To explore factors that contribute to using of Hospital Information System. Methods: In this cross-sectional study, 325 nurses from training Hospitals affiliated with Lorestan University of Medical Sciences (LUMS) were chosen. A valid and reliable structured questionnaire based on Technology Acceptance Model 1&2 and Unified Theory of Acceptance and Use of Technology was used as the data collection tool. Descriptive statistics, Correlations analysis, multiple regression analysis, path analysis technique, Structure Equation Model using AMOS software was used to examine factors that influenced the Adoption of Hospital Information System. Results: The findings indicate a significant direct relationship between Management Support and Perceived Usefulness of HIS. Perceived Usefulness has a significant effect on attitudes. While there was no significant effect of perceived ease of use on attitude. Attitude has a significant effect on behavioral intention. Conclusion: This research provides a tool to realize what factors undertake the behavioral intention of healthcare professionals to use hospital information system and how this may affect future use.
Collapse
Affiliation(s)
- Hosein Barzekar
- Department of Computer Sciences, Biomedical and Health Informatics, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Farzad Ebrahimzadeh
- Department of Biostatistics and Epidemiology, School of Allied Medical Sciences, Lorestan University of Medical Sciences, Lorestan, Iran
| | - Jake Luo
- Department of Health Informatics and Administration, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Mahtab Karami
- Department of Health Information Technology and Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Robati
- Department of Health Information Technology, Lorestan University of Medical Sciences, Lorestan, Iran
| | - Parvin Goodarzi
- Department of Health Information Technology, Lorestan University of Medical Sciences, Lorestan, Iran
| |
Collapse
|
22
|
Ileri YY, Arik O. Investigation of Resistance, Perception and Attitudes of Employees against Change in Information Systems Using Change Management Approach: A Study in a University Hospital. JOURNAL OF INFORMATION & KNOWLEDGE MANAGEMENT 2018. [DOI: 10.1142/s0219649218500387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The need for change in the rapidly developing health sector is essential for the provision of quality health care services. In this study, the technological change experienced in the process of transition from the old hospital information management system used in a university hospital to the new hospital information management system was discussed and employees’ resistance, perceptions and attitudes to change have been examined through a change management approach. In this study, we aimed to examine the level of usage of the change management tools and change management phases in a university hospital through a change management approach in the transition phase to the new HIS. We also aim to discuss faced problems encountered in the change process, help to create consciousness for management of change, examine behavioural reasons of resistance of healthcare professionals and present our experiences and propose solutions in the view of adoption and acceptance management tools against change in Hospital Information Systems (HIS) for healthcare managers. In the research, it has been observed that in the transition to the new information system, the change management tools are applied partially whereas change management phases have been implemented to a large extent. University hospital employees are resistant to Hospital Information Management System replacement. The most resistant groups are doctors and nurses and the least resistant employees are administrative staff. The rise in hospital revenues following the change is noteworthy.
Collapse
Affiliation(s)
- Yusuf Yalcin Ileri
- Health Informatics Department, Necmettin Erbakan University, Konya, Turkey
| | - Ozer Arik
- Necmettin Erbakan University, Medical Faculty Hospital, Konya, Turkey
| |
Collapse
|
23
|
Factors Affecting Consumer Acceptance of an Online Health Information Portal Among Young Internet Users. Comput Inform Nurs 2018; 36:530-539. [PMID: 30074918 DOI: 10.1097/cin.0000000000000467] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite the proliferation of health and nursing informatics applications in the past decade, factors influencing consumer acceptance of the applications are not well understood. This study was conducted to investigate factors affecting acceptance of a consumer-used nursing informatics application (ie, online health information portal) within the framework of the Technology Acceptance Model. A cross-sectional study was conducted in which 201 Chinese young adults were invited to participate in usability testing with a typical health information portal and to complete a self-report questionnaire measuring the model's constructs and five hypothesized variables drawn from consumer and portal characteristics. Hierarchical regression analyses were used to test research hypotheses. Fifteen of the 22 research hypotheses were supported. Perceived ease of use and perceived usefulness predicted satisfaction and behavioral intention, respectively, over and above the portal and consumer characteristics examined in the study. All portal and consumer characteristics had significant, although varied, impacts on the original model constructs. This study demonstrated that an adapted Technology Acceptance Model, extended with portal and consumer characteristics, provides an effective means to understand consumer acceptance of health portals. The findings hold important implications for design and implementation strategies to increase the likelihood of acceptance of consumer-used nursing informatics applications.
Collapse
|
24
|
Rahimi B, Nadri H, Lotfnezhad Afshar H, Timpka T. A Systematic Review of the Technology Acceptance Model in Health Informatics. Appl Clin Inform 2018; 9:604-634. [PMID: 30112741 PMCID: PMC6094026 DOI: 10.1055/s-0038-1668091] [Citation(s) in RCA: 207] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/24/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND One common model utilized to understand clinical staff and patients' technology adoption is the technology acceptance model (TAM). OBJECTIVE This article reviews published research on TAM use in health information systems development and implementation with regard to application areas and model extensions after its initial introduction. METHOD An electronic literature search supplemented by citation searching was conducted on February 2017 of the Web of Science, PubMed, and Scopus databases, yielding a total of 492 references. Upon eliminating duplicates and applying inclusion and exclusion criteria, 134 articles were retained. These articles were appraised and divided into three categories according to research topic: studies using the original TAM, studies using an extended TAM, and acceptance model comparisons including the TAM. RESULTS The review identified three main information and communication technology (ICT) application areas for the TAM in health services: telemedicine, electronic health records, and mobile applications. The original TAM was found to have been extended to fit dynamic health service environments by integration of components from theoretical frameworks such as the theory of planned behavior and unified theory of acceptance and use of technology, as well as by adding variables in specific contextual settings. These variables frequently reflected the concepts subjective norm and self-efficacy, but also compatibility, experience, training, anxiety, habit, and facilitators were considered. CONCLUSION Telemedicine applications were between 1999 and 2017, the ICT application area most frequently studied using the TAM, implying that acceptance of this technology was a major challenge when exploiting ICT to develop health service organizations during this period. A majority of the reviewed articles reported extensions of the original TAM, suggesting that no optimal TAM version for use in health services has been established. Although the review results indicate a continuous progress, there are still areas that can be expanded and improved to increase the predictive performance of the TAM.
Collapse
Affiliation(s)
- Bahlol Rahimi
- Department of Health Information Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran
| | - Hamed Nadri
- Department of Health Information Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran
| | - Hadi Lotfnezhad Afshar
- Department of Health Information Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran
| | - Toomas Timpka
- Department of Computer and Information Sciences, Linköping University, Linköping, Sweden
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
25
|
Nadri H, Rahimi B, Lotfnezhad Afshar H, Samadbeik M, Garavand A. Factors Affecting Acceptance of Hospital Information Systems Based on Extended Technology Acceptance Model: A Case Study in Three Paraclinical Departments. Appl Clin Inform 2018; 9:238-247. [PMID: 29618139 DOI: 10.1055/s-0038-1641595] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Regardless of the acceptance of users, information and communication systems can be considered as a health intervention designed to improve the care delivered to patients. This study aimed to determine the adoption and use of the extended Technology Acceptance Model (TAM2) by the users of hospital information system (HIS) in paraclinical departments including laboratory, radiology, and nutrition and to investigate the key factors of adoption and use of these systems. MATERIALS AND METHODS A standard questionnaire was used to collect the data from nearly 253 users of these systems in paraclinical departments of eight university hospitals in two different cities of Iran. A total of 202 questionnaires including valid responses were used in this study (105 in Urmia and 97 in Khorramabad). The data were processed using LISREL and SPSS software and statistical analysis technique was based on the structural equation modeling (SEM). RESULTS It was found that the original TAM constructs had a significant impact on the staffs' behavioral intention to adopt HIS in paraclinical departments. The results of this study indicated that cognitive instrumental processes (job relevance, output quality, result demonstrability, and perceived ease of use), except for result demonstrability, were significant predictors of intention to use, whereas the result revealed no significant relationship between social influence processes (subjective norm, voluntariness, and image) and the users' behavioral intention to use the system. CONCLUSION The results confirmed that several factors in the TAM2 that were important in previous studies were not significant in paraclinical departments and in government-owned hospitals. The users' behavior factors are essential for successful usage of the system and should be considered. It provides valuable information for hospital system providers and policy makers in understanding the adoption challenges as well as practical guidance for the successful implementation of information systems in paraclinical departments.
Collapse
Affiliation(s)
- Hamed Nadri
- Department of Health Information Technology, Urmia University of Medical Sciences, School of Allied Medical Sciences, Urmia, Iran
| | - Bahlol Rahimi
- Department of Health Information Technology, Urmia University of Medical Sciences, School of Allied Medical Sciences, Urmia, Iran
| | - Hadi Lotfnezhad Afshar
- Department of Health Information Technology, Urmia University of Medical Sciences, School of Allied Medical Sciences, Urmia, Iran
| | - Mahnaz Samadbeik
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Garavand
- Department of Management and Health Information Technology, Shaheed Beheshti University of Medical Sciences, School of Allied Medical Sciences, Tehran, Iran
| |
Collapse
|
26
|
Examining the Relationship Between Nursing Informatics Competency and the Quality of Information Processing. Comput Inform Nurs 2018. [PMID: 29522423 DOI: 10.1097/cin.0000000000000379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to examine nursing informatics competency and the quality of information processing among nurses in Jordan. The study was conducted in a large hospital with 380 registered nurses. The hospital introduced the electronic health record in 2010. The measures used in this study were personal and job characteristics, self-efficacy, Self-Assessment Nursing Informatics Competencies, and Health Information System Monitoring Questionnaire. The convenience sample consisted of 99 nurses who used the electronic health record for at least 3 months. The analysis showed that nine predictors explained 22% of the variance in the quality of information processing, whereas the statistically significant predictors were nursing informatics competency, clinical specialty, and years of nursing experience. There is a need for policies that advocate for every nurse to be educated in nursing informatics and the quality of information processing.
Collapse
|
27
|
Tubaishat A. Perceived usefulness and perceived ease of use of electronic health records among nurses: Application of Technology Acceptance Model. Inform Health Soc Care 2017; 43:379-389. [PMID: 28920708 DOI: 10.1080/17538157.2017.1363761] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Electronic health records (EHRs) are increasingly being implemented in healthcare organizations but little attention has been paid to the degree to which nurses as end-users will accept these systems and subsequently use them. OBJECTIVES To explore nurses' perceptions of usefulness and ease-of-use of EHRs. The relationship between these constructs was examined, and its predictors were studied. METHOD A national exploratory study was conducted with 1539 nurses from 15 randomly selected hospitals, representative of different regions and healthcare sectors in Jordan. Data were collected using a self-administered questionnaire, which was based on the Technology Acceptance Model. Correlations and linear multiple regression were utilized to analyze the data. RESULTS Jordanian nurses demonstrated a positive perception of the usefulness and ease-of-use of EHRs, and subsequently accepted the technology. Significant positive correlations were found between these two constructs. The variables that predict usefulness were the gender, professional rank, EHR experience, and computer skills of the nurses. The perceived ease-of-use was affected by nursing and EHR experience, and computers skills. CONCLUSION This study adds to the growing body of knowledge on issues related to the acceptance of technology in the health informatics field, focusing on nurses' acceptance of EHRs.
Collapse
Affiliation(s)
- Ahmad Tubaishat
- a Adult Health Nursing Department, Faculty of Nursing , AL AL-Bayt University , Mafraq , Jordan
| |
Collapse
|
28
|
Yen PY, McAlearney AS, Sieck CJ, Hefner JL, Huerta TR. Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation. JMIR Med Inform 2017; 5:e28. [PMID: 28882812 PMCID: PMC5608986 DOI: 10.2196/medinform.7476] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/04/2017] [Accepted: 08/04/2017] [Indexed: 11/26/2022] Open
Abstract
In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer.
Collapse
Affiliation(s)
- Po-Yin Yen
- Washington University in St Louis, Institute for Informatics, St Louis, MO, United States.,Goldfarb School of Nursing, BJC Healthcare, St Louis, MO, United States
| | - Ann Scheck McAlearney
- The Ohio State University, Department of Family Medicine, Columbus, OH, United States
| | - Cynthia J Sieck
- The Ohio State University, Department of Family Medicine, Columbus, OH, United States
| | - Jennifer L Hefner
- The Ohio State University, Department of Family Medicine, Columbus, OH, United States
| | - Timothy R Huerta
- The Ohio State University, Department of Family Medicine, Columbus, OH, United States
| |
Collapse
|
29
|
Chauhan S, Jaiswal M. A meta-analysis of e-health applications acceptance. JOURNAL OF ENTERPRISE INFORMATION MANAGEMENT 2017. [DOI: 10.1108/jeim-08-2015-0078] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The increasing importance of electronic health (e-health) has raised the significance of exploring the factors influencing the users’ acceptance of e-health applications. There has been an extensive usage of the technology acceptance model (TAM) in e-health applications acceptance research. However, not all TAM relationships are borne out in all the studies. There is a variation in predicted effects in several studies with different user type and application type. The purpose of this paper is to bridge a research gap by providing a holistic view of the e-health applications acceptance research by integrating the findings of existing relevant literature.
Design/methodology/approach
A statistical meta-analysis of the effect size of causal relationships between common TAM constructs was conducted on 111 peer-reviewed academic studies published in various journals.
Findings
The results confirm the validity and robustness of the TAM in e-health applications acceptance research. Further, a moderator analysis based on user type and e-health application type demonstrated that the effect size of causal relationships between TAM constructs majorly depends on the user type, but not on e-health application type.
Research limitations/implications
This research provides a ready reference of the existing studies on e-health applications acceptance to the researchers. Further, if researchers or practitioners want to learn more about the particular user or application type, they may find the results valuable.
Practical implications
This research suggests that the general public can be used as the surrogates for patients in e-health applications acceptance research. The implementation strategy found successful for medical staff may not work for general public and patients. This research also suggests ways to enhance acceptance of e-health applications among different user groups.
Originality/value
The research is original and is based on the existing literature and its interpretation.
Collapse
|
30
|
Handayani PW, Hidayanto AN, Pinem AA, Sandhyaduhita PI, Budi I. Hospital information system user acceptance factors: User group perspectives. Inform Health Soc Care 2017; 43:84-107. [PMID: 28140717 DOI: 10.1080/17538157.2016.1269109] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- P. W. Handayani
- Faculty of Computer Science, Universitas Indonesia, Jl. Kampus UI Depok, Depok, Indonesia
| | - A. N. Hidayanto
- Faculty of Computer Science, Universitas Indonesia, Jl. Kampus UI Depok, Depok, Indonesia
| | - A. A. Pinem
- Faculty of Computer Science, Universitas Indonesia, Jl. Kampus UI Depok, Depok, Indonesia
| | - P. I. Sandhyaduhita
- Faculty of Computer Science, Universitas Indonesia, Jl. Kampus UI Depok, Depok, Indonesia
| | - I. Budi
- Faculty of Computer Science, Universitas Indonesia, Jl. Kampus UI Depok, Depok, Indonesia
| |
Collapse
|
31
|
Ayatollahi H, Langarizadeh M, Chenani H. Confirmation of Expectations and Satisfaction with Hospital Information Systems: A Nursing Perspective. Healthc Inform Res 2016; 22:326-332. [PMID: 27895965 PMCID: PMC5116545 DOI: 10.4258/hir.2016.22.4.326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 07/25/2016] [Accepted: 07/27/2016] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This study aimed to compare nurses' satisfaction with, and expectations of, hospital information systems in two teaching hospitals. METHODS This was a survey study, which was completed in 2014. The potential participants were 267 nurses who worked in two teaching hospitals and used the same hospital information system. Data were collected using two questionnaires. Both questionnaires were examined in terms of content validity and reliability. RESULTS The results showed that, for a majority of nurses, their expectations of the system were not met in either hospital. Moreover, there was a significant association between the nurses' expectations and the perceived usefulness of the systems (p < 0.001), between the nurses' expectations and their satisfaction with the systems (p < 0.001), and between the perceived usefulness and nurses' satisfaction with the systems (p < 0.001). CONCLUSIONS The results suggested that, apart from the technical issues of implementing clinical information systems, non-technical factors should be taken into account. Among them, the nature of clinical tasks and the organizational culture require more attention to allow a successful system to be designed and implemented.
Collapse
Affiliation(s)
- Haleh Ayatollahi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Langarizadeh
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Habib Chenani
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
32
|
Farzianpour F, Shojaei S, Arab M, Foroushani AR. Accreditation of Management Communication and Information Systems in Public Hospitals of Sabzevar City, Iran. Acta Inform Med 2016; 24:124-9. [PMID: 27147805 PMCID: PMC4851504 DOI: 10.5455/aim.2016.24.124-129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/05/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Information systems are "computer systems that collect, store, process, retrieve, show, and provide timely information required in practice, education, management, and research". The purpose of these systems is to support hospital activities in practical, tactical, and strategic levels in order to provide better service to patients. This study aimed to evaluate the communication and information system (MCI) in public hospitals in Sabzevar city in 2014 from the perspective of human resources according to international standards of the Joint Commission Accreditation Hospital (JCAH). METHODS This study was a practical, descriptive, cross-sectional study. The study population consisted of Sabzevar nurses who used hospital information system. Sampling was done by classification method and in proportion to the number of nurses in each health care units in hospitals in 2014. The sample size was 200 and after referring to hospitals, 200 questionnaires were completed. Sample size was calculated by the formula n=Z(2)P (1-P)/d(2) with P=0.5, α=0.05, d=0.05, and Z=1.96. Data collection tool was the questionnaire of assessment of hospital information systems of JCAH, which has 124 specific questions, including 6 areas. To assess the effect of demographic variables with MCI standards of two questionnaires (feasibility and implementation), the following steps were taken. 1. Kolmogorov-Smirnov test was used to determine whether responses were normal or not. 2. In case of normal data, t-test was used for dual groups and one-way ANOVA test for groups of three or more. 3. If not normal, Mann-Whitney test was used for dual groups and Kruskal-Wallis test for groups of three or more. RESULTS Research findings show the mean results of feasibility and implementation of all 6 areas of international standards MCI have feasibility in three hospitals in Sabzevar in 20 sections (H1=105.01±10.468), (H1=196.31±4.662), (H2=104.26±9.099), (H2=195.33±3.778) (H3=106.48±11.545) and (H3=197.57±4.943), respectively. CONCLUSION The results showed that the mean feasibility and implementation of all six areas of MCI international standards is practical in three hospitals in Sabzevar in 20 wards. Also, 50% of users in clinical departments, physicians, and nurses agreed to appropriateness of the hospital information and communication systems for doing their duties.
Collapse
Affiliation(s)
- Fereshteh Farzianpour
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Shojaei
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Arab
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
33
|
Gonen A, Lev-Ari L. The relationship between work climate and nurse educators' use of information technology. NURSE EDUCATION TODAY 2016; 39:1-6. [PMID: 27006026 DOI: 10.1016/j.nedt.2016.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 01/06/2016] [Accepted: 01/21/2016] [Indexed: 06/05/2023]
Abstract
UNLABELLED Understanding organizational behavior and the attitudes of individuals in organizations is crucial for policymakers and managers. Work climate is a major part of these constructs. The main goal of this study was to examine the perceptions of academic nurse educators about their work climate, concerning the use of information technology (IT), including examining a number of variables such as self-efficacy, innovativeness, attitudes, intention to use, and actual use of information technology. METHOD This study used a quantitative research design, using written and online surveys submitted to 109 academic nurse educators working at ten different academic nursing schools in Israel. RESULTS The relationship between work climate and actual use of IT was mediated by personality characteristics such as attitude toward using IT, self-efficacy, and innovativeness. Work climate positively predicted both self-efficacy and attitudes toward IT, but did not directly predict innovativeness and did not predict actual use. CONCLUSION Policymakers and managers should consider work climate and personality characteristics as important factors in their efforts to promote IT use in nursing. As a result, nurse educators would become better acquainted with new technologies, and their acceptance of IT would improve. The organization would benefit from a better work environment and from enhanced performance.
Collapse
Affiliation(s)
- Ayala Gonen
- Nursing Department, School of Social and Community Sciences, Ruppin Academic Center, Emeq-Hefer, Israel.
| | - Lilac Lev-Ari
- Behavioral Sciences Department, School of Social and Community Sciences, Ruppin Academic Center, Emeq-Hefer, Israel.
| |
Collapse
|
34
|
Prioritizing factors influencing nurses' satisfaction with hospital information systems: a fuzzy analytic hierarchy process approach. Comput Inform Nurs 2015; 32:174-81. [PMID: 24469556 DOI: 10.1097/cin.0000000000000031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our aim was to use the fuzzy analytic hierarchy process approach to prioritize the factors that influence nurses' satisfaction with a hospital information system. First, we reviewed the related literature to identify and select possible factors. Second, we developed an analytic hierarchy process framework with three main factors (quality of services, of systems, and of information) and 22 subfactors. Third, we developed a questionnaire based on pairwise comparisons and invited 10 experienced nurses who were identified through snowball sampling to rate these factors. Finally, we used Chang's fuzzy extent analysis method to compute the weights of these factors and prioritize them. We found that information quality was the most important factor (58%), followed by service quality (22%) and then system quality (19%). In conclusion, although their weights were not similar, all factors were important and should be considered in evaluating nurses' satisfaction.
Collapse
|
35
|
Gartrell K, Trinkoff A, Storr C, Wilson M, Gurses A. Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health: A Cross-sectional Survey. Appl Clin Inform 2015; 6:224-47. [PMID: 26171072 PMCID: PMC4493327 DOI: 10.4338/aci-2014-11-ra-0107] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 02/24/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To our knowledge, no evidence is available on health care professionals' use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses' personal use of ePHRs using a modified technology acceptance model. OBJECTIVES To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses' own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers' use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use. METHODS A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect. RESULTS Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses' own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses. CONCLUSIONS Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their individual patients.
Collapse
Affiliation(s)
- K. Gartrell
- National Institutes of Health/National Library of Medicine/Lister Hill National Center for Biomedical Communications, Bethesda, MD
| | - A.M. Trinkoff
- University of Maryland School of Nursing, Baltimore, MD
| | - C.L. Storr
- University of Maryland School of Nursing, Baltimore, MD
| | - M.L. Wilson
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - A.P. Gurses
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, MD
| |
Collapse
|
36
|
Maillet É, Mathieu L, Sicotte C. Modeling factors explaining the acceptance, actual use and satisfaction of nurses using an Electronic Patient Record in acute care settings: an extension of the UTAUT. Int J Med Inform 2014; 84:36-47. [PMID: 25288192 DOI: 10.1016/j.ijmedinf.2014.09.004] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/04/2014] [Accepted: 09/15/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE End-user acceptance and satisfaction are considered critical factors for successful implementation of an Electronic Patient Record (EPR). The aim of this study was to explain the acceptance and actual use of an EPR and nurses' satisfaction by testing a theoretical model adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT). METHODS A multicenter cross-sectional study was conducted in the medical-surgical wards of four hospitals ranked at different EPR adoption stages. A randomized stratified sampling approach was used to recruit 616 nurses. Structural equation modeling techniques were applied. RESULTS Support was found for 13 of the model's 20 research hypotheses. The strongest effects are those between performance expectancy and actual use of the EPR (r=0.55, p=0.006), facilitating conditions and effort expectancy (r=0.45, p=0.009), compatibility and performance expectancy (r=0.39, p=0.002). The variables explained 33.6% of the variance of actual use, 54.9% of nurses' satisfaction, 50.2% of performance expectancy and 52.9% of effort expectancy. CONCLUSIONS Many results of this study support the conclusions of prior research, but some take exception, such as the non-significant relationship between the effort expectancy construct and actual use of the EPR. The results highlight the importance of the mediating effects of the effort expectancy and performance expectancy constructs. Compatibility of the EPR with preferred work style, existing work practices and the values of nurses were the most important factors explaining nurses' satisfaction. The results reveal the complexity of this change and suggest several avenues for future research and for the implementation of IT in healthcare.
Collapse
Affiliation(s)
- Éric Maillet
- University of Montreal Hospital Center, Quebec, Canada.
| | - Luc Mathieu
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada.
| | - Claude Sicotte
- Health Administration Department, School of Public Health, University of Montreal, Quebec, Canada.
| |
Collapse
|
37
|
Ingebrigtsen T, Georgiou A, Clay-Williams R, Magrabi F, Hordern A, Prgomet M, Li J, Westbrook J, Braithwaite J. The impact of clinical leadership on health information technology adoption: systematic review. Int J Med Inform 2014; 83:393-405. [PMID: 24656180 DOI: 10.1016/j.ijmedinf.2014.02.005] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 02/21/2014] [Accepted: 02/24/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To conduct a systematic review to examine evidence of associations between clinical leadership and successful information technology (IT) adoption in healthcare organisations. METHODS We searched Medline, Embase, Cinahl, and Business Source Premier for articles published between January 2000 to May 2013 with keywords and subject terms related to: (1) the setting--healthcare provider organisations; (2) the technology--health information technology; (3) the process--adoption; and (4) the intervention--leadership. We identified 3121 unique citations, of which 32 met our criteria and were included in the review. Data extracted from the included studies were assessed in light of two frameworks: Bassellier et al.'s IT competence framework; and Avgar et al.'s health IT adoption framework. RESULTS The results demonstrate important associations between the attributes of clinical leaders and IT adoption. Clinical leaders who have technical informatics skills and prior experience with IT project management are likely to develop a vision that comprises a long-term commitment to the use of IT. Leaders who possess such a vision believe in the value of IT, are motivated to adopt it, and can maintain confidence and stability through the adversities that IT adoptions often entail. This leads to proactive leadership behaviours and partnerships with IT professionals that are associated with successful organisational and clinical outcomes. CONCLUSIONS This review provides evidence that clinical leaders can positively contribute to successful IT adoption in healthcare organisations. Clinical leaders who aim for improvements in the processes and quality of care should cultivate the necessary IT competencies, establish mutual partnerships with IT professionals, and execute proactive IT behaviours to achieve successful IT adoption.
Collapse
Affiliation(s)
- Tor Ingebrigtsen
- Australian Institute of Health Innovation, The University of New South Wales, Sydney, Australia; Institute of Clinical Medicine, Faculty of Health Sciences, The University of Tromsø, Tromsø, Norway; CEO's Office, University Hospital of North Norway, Tromsø, Norway
| | - Andrew Georgiou
- Australian Institute of Health Innovation, The University of New South Wales, Sydney, Australia.
| | - Robyn Clay-Williams
- Australian Institute of Health Innovation, The University of New South Wales, Sydney, Australia
| | - Farah Magrabi
- Australian Institute of Health Innovation, The University of New South Wales, Sydney, Australia
| | - Antonia Hordern
- Australian Institute of Health Innovation, The University of New South Wales, Sydney, Australia
| | - Mirela Prgomet
- Australian Institute of Health Innovation, The University of New South Wales, Sydney, Australia
| | - Julie Li
- Australian Institute of Health Innovation, The University of New South Wales, Sydney, Australia
| | - Johanna Westbrook
- Australian Institute of Health Innovation, The University of New South Wales, Sydney, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, The University of New South Wales, Sydney, Australia
| |
Collapse
|
38
|
Koivunen M, Anttila M, Kuosmanen L, Katajisto J, Välimäki M. Team climate and attitudes toward information and communication technology among nurses on acute psychiatric wards. Inform Health Soc Care 2014; 40:79-90. [PMID: 24393065 DOI: 10.3109/17538157.2013.872112] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives: To describe the association of team climate with attitudes toward information and communication technology among nursing staff working on acute psychiatric wards. Background: Implementation of ICT applications in nursing practice brings new operating models to work environments, which may affect experienced team climate on hospital wards. Method: Descriptive survey was used as a study design. Team climate was measured by the Finnish modification of the Team Climate Inventory, and attitudes toward ICT by Burkes' questionnaire. The nursing staff (N = 181, n = 146) on nine acute psychiatric wards participated in the study. Results: It is not self-evident that experienced team climate associates with attitudes toward ICT, but there are some positive relationships between perceived team climate and ICT attitudes. The study showed that nurses' motivation to use ICT had statistically significant connections with experienced team climate, participative safety (p = 0.021), support for innovation (p = 0.042) and task orientation (p = 0.042). Conclusion: The results suggest that asserting team climate and supporting innovative operations may lead to more positive attitudes toward ICT. It is, in particular, possible to influence nurses' motivation to use ICT. More attention should be paid to psychosocial factors such as group education and co-operation at work when ICT applications are implemented in nursing.
Collapse
|
39
|
Lin HCK, Chuang TY, Lin IL, Chen HY. Elucidating the role of IT/IS assessment and resource allocation in IT/IS performance in hospitals. INFORMATION & MANAGEMENT 2014. [DOI: 10.1016/j.im.2013.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
40
|
Hsiao JL, Wu WC, Chen RF. Factors of accepting pain management decision support systems by nurse anesthetists. BMC Med Inform Decis Mak 2013; 13:16. [PMID: 23360305 PMCID: PMC3563435 DOI: 10.1186/1472-6947-13-16] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 01/25/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pain management is a critical but complex issue for the relief of acute pain, particularly for postoperative pain and severe pain in cancer patients. It also plays important roles in promoting quality of care. The introduction of pain management decision support systems (PM-DSS) is considered a potential solution for addressing the complex problems encountered in pain management. This study aims to investigate factors affecting acceptance of PM-DSS from a nurse anesthetist perspective. METHODS A questionnaire survey was conducted to collect data from nurse anesthetists in a case hospital. A total of 113 questionnaires were distributed, and 101 complete copies were returned, indicating a valid response rate of 89.3%. Collected data were analyzed by structure equation modeling using the partial least square tool. RESULTS The results show that perceived information quality (γ=.451, p<.001), computer self-efficacy (γ=.315, p<.01), and organizational structure (γ=.210, p<.05), both significantly impact nurse anesthetists' perceived usefulness of PM-DSS. Information quality (γ=.267, p<.05) significantly impacts nurse anesthetists' perceptions of PM-DSS ease of use. Furthermore, both perceived ease of use (β=.436, p<.001, R(2)=.487) and perceived usefulness (β=.443, p<.001, R(2)=.646) significantly affected nurse anesthetists' PM-DSS acceptance (R2=.640). Thus, the critical role of information quality in the development of clinical decision support system is demonstrated. CONCLUSIONS The findings of this study enable hospital managers to understand the important considerations for nurse anesthetists in accepting PM-DSS, particularly for the issues related to the improvement of information quality, perceived usefulness and perceived ease of use of the system. In addition, the results also provide useful suggestions for designers and implementers of PM-DSS in improving system development.
Collapse
Affiliation(s)
- Ju-Ling Hsiao
- Department of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan, Republic of China
| | - Wen-Chu Wu
- Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan, Republic of China
| | - Rai-Fu Chen
- Department of Information Management, Chia-Nan University of Pharmacy and Science, No.60, Sec. 1, Erren Rd., Rende Dist, Tainan City, 71710, , Taiwan, Republic of China
| |
Collapse
|