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Mirabootalebi N, Meidani Z, Akbari H, Rangraz Jeddi F, Tagharrobi Z, Swoboda W, Holl F. Design and Psychometric Evaluation of Nurses' Mobile Health Device Acceptance Scale (NMHDA-Scale): Application of the Expectation-Confirmation Theory. JMIR Hum Factors 2024; 11:e55324. [PMID: 39288375 PMCID: PMC11445626 DOI: 10.2196/55324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 05/18/2024] [Accepted: 07/02/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND The use of mobile tools in nursing care is indispensable. Given the importance of nurses' acceptance of these tools in delivering effective care, this issue requires greater attention. OBJECTIVE This study aims to design the Mobile Health Tool Acceptance Scale for Nurses based on the Expectation-Confirmation Theory and to evaluate it psychometrically. METHODS Using a Waltz-based approach grounded in existing tools and the constructs of the Expectation-Confirmation Theory, the initial version of the scale was designed and evaluated for face and content validity. Construct validity was examined through exploratory factor analysis, concurrent validity, and known-group comparison. Reliability was assessed using measures of internal consistency and stability. RESULTS The initial version of the scale consisted of 33 items. During the qualitative and quantitative content validity stage, 1 item was added and 1 item was removed. Exploratory factor analysis, retaining 33 items, identified 5 factors that explained 70.53% of the variance. A significant positive correlation was found between the scores of the designed tool and nurses' attitudes toward using mobile-based apps in nursing care (r=0.655, P<.001). The intraclass correlation coefficient, Cronbach α, and ω coefficient were 0.938, 0.953, and 0.907, respectively. CONCLUSIONS The 33-item scale developed is a valid and reliable instrument for measuring nurses' acceptance of mobile health tools.
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Affiliation(s)
- Narjes Mirabootalebi
- Health Information Management Research Center (HIMRC), Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Meidani
- Health Information Management Research Center (HIMRC), Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, Allied Medical Sciences Faculty, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Akbari
- Social Determinants of Health Research Center, Kashan, Iran
| | - Fatemeh Rangraz Jeddi
- Health Information Management Research Center (HIMRC), Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, Allied Medical Sciences Faculty, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Tagharrobi
- Trauma Nursing Research Centre, Kashan University of Medical Sciences, Kashan, Iran
| | - Walter Swoboda
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Felix Holl
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
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Hawrysz L, Kludacz-Alessandri M, Walczak R. Predictive Factors of Physicians' Satisfaction and Quality of Work Under Teleconsultation Conditions: Structural Equation Analysis. JMIR Hum Factors 2024; 11:e47810. [PMID: 38857081 PMCID: PMC11216023 DOI: 10.2196/47810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 12/18/2023] [Accepted: 03/20/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic contributed to an increase in teleconsultation adoption in the Polish primary health care system. It is expected that in the long run, teleconsultations will successfully replace a significant part of face-to-face visits. Therefore, a significant challenge facing primary health care facilities (PHCs) is the acceptance of teleconsultations by their users, especially physicians. OBJECTIVE This study aimed to explore physicians' acceptance of teleconsultations during the COVID-19 pandemic in Poland. METHODS A representative survey was conducted among 361 physicians of PHCs across Poland in 2021. For the purposes of the study, we developed a modified Technology Acceptance Model (TAM) model. Based on the modified TAM, we analyzed the impact of perceived usefulness (PU), perceived ease of use (PEU), and intention to use teleconsultation (INT) on physicians' satisfaction (SAT) and quality of work (Q). The psychometric properties of the research instrument were examined using exploratory factor analysis. Finally, structural equation modeling was used for data analysis. RESULTS The results indicated a generally high level of PU (mean 3.85-4.36, SD 0.87-1.18), PEU (mean 3.81-4.60, SD 0.60-1.42), INT (mean 3.87-4.22, SD 0.89-1.12), and SAT (mean 3.55-4.13, SD 0.88-1.16); the lowest rated dimension in TAM was Q (mean 3.28-3.73, SD 1.06-1.26). The most important independent variable was PU. The influence of PU on INT (estimate=0.63, critical ratio [CR]=15.84, P<.001) and of PU on SAT (estimate=0.44, CR= 9.53, P<.001) was strong. INT was also a key factor influencing SAT (estimate=0.4, CR=8.57, P<.001). A weaker relationship was noted in the effect of PEU on INT (estimate=0.17, CR=4.31, P<.001). In turn, Q was positively influenced by INT (estimate=0.179, CR=3.64, P<.001), PU (estimate=0.246, CR=4.79, P<.001), PEU (estimate=0.18, CR=4.93, P<.001), and SAT (estimate=0.357, CR=6.97, P<.001). All paths between the constructs (PU, PEU, INT, SAT, and Q) were statistically significant, which highlights the multifaceted nature of the adoption of teleconsultations among physicians. CONCLUSIONS Our findings provide strong empirical support for the hypothesized relationships in TAM. The findings suggest that the PU and PEU of teleconsultation have a significant impact on the intention of physicians to adopt teleconsultation. This results in an improvement in the satisfaction of Polish physicians with the use of teleconsultation and an increase in Q. The study contributes to both theory and practice by identifying important prognostic factors affecting physicians' acceptance of teleconsultation systems.
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Affiliation(s)
- Liliana Hawrysz
- Faculty of Management, Wrocław University of Science and Technology, Wroclaw, Poland
| | | | - Renata Walczak
- Faculty of Civil Engineering, Mechanics and Petrochemistry, Warsaw University of Technology, Plock, Poland
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Ackerhans S, Huynh T, Kaiser C, Schultz C. Exploring the role of professional identity in the implementation of clinical decision support systems-a narrative review. Implement Sci 2024; 19:11. [PMID: 38347525 PMCID: PMC10860285 DOI: 10.1186/s13012-024-01339-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Clinical decision support systems (CDSSs) have the potential to improve quality of care, patient safety, and efficiency because of their ability to perform medical tasks in a more data-driven, evidence-based, and semi-autonomous way. However, CDSSs may also affect the professional identity of health professionals. Some professionals might experience these systems as a threat to their professional identity, as CDSSs could partially substitute clinical competencies, autonomy, or control over the care process. Other professionals may experience an empowerment of the role in the medical system. The purpose of this study is to uncover the role of professional identity in CDSS implementation and to identify core human, technological, and organizational factors that may determine the effect of CDSSs on professional identity. METHODS We conducted a systematic literature review and included peer-reviewed empirical studies from two electronic databases (PubMed, Web of Science) that reported on key factors to CDSS implementation and were published between 2010 and 2023. Our explorative, inductive thematic analysis assessed the antecedents of professional identity-related mechanisms from the perspective of different health care professionals (i.e., physicians, residents, nurse practitioners, pharmacists). RESULTS One hundred thirty-one qualitative, quantitative, or mixed-method studies from over 60 journals were included in this review. The thematic analysis found three dimensions of professional identity-related mechanisms that influence CDSS implementation success: perceived threat or enhancement of professional control and autonomy, perceived threat or enhancement of professional skills and expertise, and perceived loss or gain of control over patient relationships. At the technological level, the most common issues were the system's ability to fit into existing clinical workflows and organizational structures, and its ability to meet user needs. At the organizational level, time pressure and tension, as well as internal communication and involvement of end users were most frequently reported. At the human level, individual attitudes and emotional responses, as well as familiarity with the system, most often influenced the CDSS implementation. Our results show that professional identity-related mechanisms are driven by these factors and influence CDSS implementation success. The perception of the change of professional identity is influenced by the user's professional status and expertise and is improved over the course of implementation. CONCLUSION This review highlights the need for health care managers to evaluate perceived professional identity threats to health care professionals across all implementation phases when introducing a CDSS and to consider their varying manifestations among different health care professionals. Moreover, it highlights the importance of innovation and change management approaches, such as involving health professionals in the design and implementation process to mitigate threat perceptions. We provide future areas of research for the evaluation of the professional identity construct within health care.
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Affiliation(s)
- Sophia Ackerhans
- Kiel Institute for Responsible Innovation, University of Kiel, Westring 425, 24118, Kiel, Germany.
| | - Thomas Huynh
- Kiel Institute for Responsible Innovation, University of Kiel, Westring 425, 24118, Kiel, Germany
| | - Carsten Kaiser
- Kiel Institute for Responsible Innovation, University of Kiel, Westring 425, 24118, Kiel, Germany
| | - Carsten Schultz
- Kiel Institute for Responsible Innovation, University of Kiel, Westring 425, 24118, Kiel, Germany
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Fernando M, Abell B, Tyack Z, Donovan T, McPhail SM, Naicker S. Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review. J Med Internet Res 2023; 25:e45163. [PMID: 37851492 PMCID: PMC10620641 DOI: 10.2196/45163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 08/18/2023] [Accepted: 09/14/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Computerized clinical decision support systems (CDSSs) are essential components of modern health system service delivery, particularly within acute care settings such as hospitals. Theories, models, and frameworks may assist in facilitating the implementation processes associated with CDSS innovation and its use within these care settings. These processes include context assessments to identify key determinants, implementation plans for adoption, promoting ongoing uptake, adherence, and long-term evaluation. However, there has been no prior review synthesizing the literature regarding the theories, models, and frameworks that have informed the implementation and adoption of CDSSs within hospitals. OBJECTIVE This scoping review aims to identify the theory, model, and framework approaches that have been used to facilitate the implementation and adoption of CDSSs in tertiary health care settings, including hospitals. The rationales reported for selecting these approaches, including the limitations and strengths, are described. METHODS A total of 5 electronic databases were searched (CINAHL via EBSCOhost, PubMed, Scopus, PsycINFO, and Embase) to identify studies that implemented or adopted a CDSS in a tertiary health care setting using an implementation theory, model, or framework. No date or language limits were applied. A narrative synthesis was conducted using full-text publications and abstracts. Implementation phases were classified according to the "Active Implementation Framework stages": exploration (feasibility and organizational readiness), installation (organizational preparation), initial implementation (initiating implementation, ie, training), full implementation (sustainment), and nontranslational effectiveness studies. RESULTS A total of 81 records (42 full text and 39 abstracts) were included. Full-text studies and abstracts are reported separately. For full-text studies, models (18/42, 43%), followed by determinants frameworks (14/42,33%), were most frequently used to guide adoption and evaluation strategies. Most studies (36/42, 86%) did not list the limitations associated with applying a specific theory, model, or framework. CONCLUSIONS Models and related quality improvement methods were most frequently used to inform CDSS adoption. Models were not typically combined with each other or with theory to inform full-cycle implementation strategies. The findings highlight a gap in the application of implementation methods including theories, models, and frameworks to facilitate full-cycle implementation strategies for hospital CDSSs.
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Affiliation(s)
- Manasha Fernando
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Bridget Abell
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Zephanie Tyack
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Thomasina Donovan
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Steven M McPhail
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
- Digital Health and Informatics Directorate, Metro South Health, Brisbane, Australia
| | - Sundresan Naicker
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Karkonasasi K, Cheah YN, Vadiveloo M, Mousavi SA. Acceptance of a Text Messaging Vaccination Reminder and Recall System in Malaysia's Healthcare Sector: Extending the Technology Acceptance Model. Vaccines (Basel) 2023; 11:1331. [PMID: 37631899 PMCID: PMC10458098 DOI: 10.3390/vaccines11081331] [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: 06/21/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Malaysian healthcare institutions still use ineffective paper-based vaccination systems to manage childhood immunization schedules. This may lead to missed appointments, incomplete vaccinations, and outbreaks of preventable diseases among infants. To address this issue, a text messaging vaccination reminder and recall system named Virtual Health Connect (VHC) was studied. VHC simplifies and accelerates immunization administration for nurses, which may result in improving the completion and timeliness of immunizations among infants. Considering the limited research on the acceptance of these systems in the healthcare sector, we examined the factors influencing nurses' attitudes and intentions to use VHC using the extended technology acceptance model (TAM). The novelty of the conceptual model is the incorporation of new predictors of attitude, namely, perceived compatibility and perceived privacy and security issues. We conducted a survey among 121 nurses in Malaysian government hospitals and clinics to test the model. We analyzed the collected data using partial least squares structural equation modeling (PLS-SEM) to examine the significant factors influencing nurses' attitudes and intentions to use VHC. Moreover, we applied an artificial neural network (ANN) to determine the most significant factors of acceptance with higher accuracy. Therefore, we could offer more accurate insights to decision-makers in the healthcare sector for the advancement of health services. Our results highlighted that the compatibility of VHC with the current work setting of nurses developed their positive perspectives on the system. Moreover, the nurses felt optimistic about the system when they considered it useful and easy to use in the workplace. Finally, their attitude toward using VHC played a pivotal role in increasing their intention to use it. Based on the ANN models, we also found that perceived compatibility was the most significant factor influencing nurses' attitudes towards using VHC, followed by perceived ease of use and perceived usefulness.
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Affiliation(s)
- Kamal Karkonasasi
- School of Computer Sciences, Universiti Sains Malaysia, USM Penang 11800, Malaysia;
| | - Yu-N Cheah
- School of Computer Sciences, Universiti Sains Malaysia, USM Penang 11800, Malaysia;
| | - Mogana Vadiveloo
- Faculty of Information and Communication Technology, Universiti Tunku Abdul Rahman, Kampar 31900, Malaysia;
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Kleine AK, Kokje E, Lermer E, Gaube S. Attitudes Toward the Adoption of 2 Artificial Intelligence-Enabled Mental Health Tools Among Prospective Psychotherapists: Cross-sectional Study. JMIR Hum Factors 2023; 10:e46859. [PMID: 37436801 PMCID: PMC10372564 DOI: 10.2196/46859] [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: 02/28/2023] [Revised: 05/08/2023] [Accepted: 05/14/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Despite growing efforts to develop user-friendly artificial intelligence (AI) applications for clinical care, their adoption remains limited because of the barriers at individual, organizational, and system levels. There is limited research on the intention to use AI systems in mental health care. OBJECTIVE This study aimed to address this gap by examining the predictors of psychology students' and early practitioners' intention to use 2 specific AI-enabled mental health tools based on the Unified Theory of Acceptance and Use of Technology. METHODS This cross-sectional study included 206 psychology students and psychotherapists in training to examine the predictors of their intention to use 2 AI-enabled mental health care tools. The first tool provides feedback to the psychotherapist on their adherence to motivational interviewing techniques. The second tool uses patient voice samples to derive mood scores that the therapists may use for treatment decisions. Participants were presented with graphic depictions of the tools' functioning mechanisms before measuring the variables of the extended Unified Theory of Acceptance and Use of Technology. In total, 2 structural equation models (1 for each tool) were specified, which included direct and mediated paths for predicting tool use intentions. RESULTS Perceived usefulness and social influence had a positive effect on the intention to use the feedback tool (P<.001) and the treatment recommendation tool (perceived usefulness, P=.01 and social influence, P<.001). However, trust was unrelated to use intentions for both the tools. Moreover, perceived ease of use was unrelated (feedback tool) and even negatively related (treatment recommendation tool) to use intentions when considering all predictors (P=.004). In addition, a positive relationship between cognitive technology readiness (P=.02) and the intention to use the feedback tool and a negative relationship between AI anxiety and the intention to use the feedback tool (P=.001) and the treatment recommendation tool (P<.001) were observed. CONCLUSIONS The results shed light on the general and tool-dependent drivers of AI technology adoption in mental health care. Future research may explore the technological and user group characteristics that influence the adoption of AI-enabled tools in mental health care.
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Affiliation(s)
- Anne-Kathrin Kleine
- Department of Psychology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Eesha Kokje
- Department of Psychology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Eva Lermer
- Department of Psychology, Ludwig Maximilian University of Munich, Munich, Germany
- Technical University of Applied Sciences Augsburg, Augsburg, Germany
| | - Susanne Gaube
- Department of Psychology, Ludwig Maximilian University of Munich, Munich, Germany
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Alfuqaha O, Rabay'ah M, Al. khashashneh O, Alsalaht M. Technology acceptance model among nurses and other healthcare providers during the 2019 Coronavirus pandemic: a comparative cross-sectional study. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2022. [DOI: 10.15452/cejnm.2022.13.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Yang JY, Shu KH, Peng YS, Hsu SP, Chiu YL, Pai MF, Wu HY, Tsai WC, Tung KT, Kuo RN. Physician Compliance with Computerized Clinical Decision Support System is a Complete Intermediate Factor in the Anemia Management of Patients with End-Stage Kidney Disease on Hemodialysis: A Retrospective Electronic Health Record Observational Study (Preprint). JMIR Form Res 2022; 7:e44373. [PMID: 37133912 DOI: 10.2196/44373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Previous studies on clinical decision support systems (CDSSs) for the management of renal anemia in patients with end-stage kidney disease undergoing hemodialysis have previously focused solely on the effects of the CDSS. However, the role of physician compliance in the efficacy of the CDSS remains ill-defined. OBJECTIVE We aimed to investigate whether physician compliance was an intermediate variable between the CDSS and the management outcomes of renal anemia. METHODS We extracted the electronic health records of patients with end-stage kidney disease on hemodialysis at the Far Eastern Memorial Hospital Hemodialysis Center (FEMHHC) from 2016 to 2020. FEMHHC implemented a rule-based CDSS for the management of renal anemia in 2019. We compared the clinical outcomes of renal anemia between the pre- and post-CDSS periods using random intercept models. Hemoglobin levels of 10 to 12 g/dL were defined as the on-target range. Physician compliance was defined as the concordance of adjustments of the erythropoietin-stimulating agent (ESA) between the CDSS recommendations and the actual physician prescriptions. RESULTS We included 717 eligible patients on hemodialysis (mean age 62.9, SD 11.6 years; male n=430, 59.9%) with a total of 36,091 hemoglobin measurements (average hemoglobin and on-target rate were 11.1, SD 1.4, g/dL and 59.9%, respectively). The on-target rate decreased from 61.3% (pre-CDSS) to 56.2% (post-CDSS) owing to a high hemoglobin percentage of >12 g/dL (pre: 21.5%; post: 29%). The failure rate (hemoglobin <10 g/dL) decreased from 17.2% (pre-CDSS) to 14.8% (post-CDSS). The average weekly ESA use of 5848 (SD 4211) units per week did not differ between phases. The overall concordance between CDSS recommendations and physician prescriptions was 62.3%. The CDSS concordance increased from 56.2% to 78.6%. In the adjusted random intercept model, the post-CDSS phase showed increased hemoglobin by 0.17 (95% CI 0.14-0.21) g/dL, weekly ESA by 264 (95% CI 158-371) units per week, and 3.4-fold (95% CI 3.1-3.6) increased concordance rate. However, the on-target rate (29%; odds ratio 0.71, 95% CI 0.66-0.75) and failure rate (16%; odds ratio 0.84, 95% CI 0.76-0.92) were reduced. After additional adjustments for concordance in the full models, increased hemoglobin and decreased on-target rate tended toward attenuation (from 0.17 to 0.13 g/dL and 0.71 to 0.73 g/dL, respectively). Increased ESA and decreased failure rate were completely mediated by physician compliance (from 264 to 50 units and 0.84 to 0.97, respectively). CONCLUSIONS Our results confirmed that physician compliance was a complete intermediate factor accounting for the efficacy of the CDSS. The CDSS reduced failure rates of anemia management through physician compliance. Our study highlights the importance of optimizing physician compliance in the design and implementation of CDSSs to improve patient outcomes.
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Affiliation(s)
- Ju-Yeh Yang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Center for General Education, Lee-Ming Institute of Technology, New Taipei City, Taiwan
| | - Kai-Hsiang Shu
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yu-Sen Peng
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Shih-Ping Hsu
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yen-Ling Chiu
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
- Graduate Program in Biomedical Informatics, Yuan Ze University, Taoyuan, Taiwan
| | - Mei-Fen Pai
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hon-Yen Wu
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wan-Chuan Tsai
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Kuei-Ting Tung
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Raymond N Kuo
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
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Liu Y, Hao H, Sharma MM, Harris Y, Scofi J, Trepp R, Farmer B, Ancker JS, Zhang Y. Clinician Acceptance of Order Sets for Pain Management: A Survey in Two Urban Hospitals. Appl Clin Inform 2022; 13:447-455. [PMID: 35477148 PMCID: PMC9045963 DOI: 10.1055/s-0042-1745828] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/18/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Order sets are a clinical decision support (CDS) tool in computerized provider order entry systems. Order set use has been associated with improved quality of care. Particularly related to opioids and pain management, order sets have been shown to standardize and reduce the prescription of opioids. However, clinician-level barriers often limit the uptake of this CDS modality. OBJECTIVE To identify the barriers to order sets adoption, we surveyed clinicians on their training, knowledge, and perceptions related to order sets for pain management. METHODS We distributed a cross-sectional survey between October 2020 and April 2021 to clinicians eligible to place orders at two campuses of a major academic medical center. Survey questions were adapted from the widely used framework of Unified Theory of Acceptance and Use of Technology. We hypothesize that performance expectancy (PE) and facilitating conditions (FC) are associated with order set use. Survey responses were analyzed using logistic regression. RESULTS The intention to use order sets for pain management was associated with PE to existing order sets, social influence (SI) by leadership and peers, and FC for electronic health record (EHR) training and function integration. Intention to use did not significantly differ by gender or clinician role. Moderate differences were observed in the perception of the effort of, and FC for, order set use across gender and roles of clinicians, particularly emergency medicine and internal medicine departments. CONCLUSION This study attempts to identify barriers to the adoption of order sets for pain management and suggests future directions in designing and implementing CDS systems that can improve order sets adoption by clinicians. Study findings imply the importance of order set effectiveness, peer influence, and EHR integration in determining the acceptability of the order sets.
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Affiliation(s)
- Yifan Liu
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
| | - Haijing Hao
- Department of Computer Information Systems, Bentley University, Waltham, Massachusetts, United States
| | - Mohit M. Sharma
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
| | - Yonaka Harris
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
| | - Jean Scofi
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Richard Trepp
- Department of Emergency Medicine, Columbia University, New York, New York, United States
| | - Brenna Farmer
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Jessica S. Ancker
- Department of Biomedical Informatics, Vanderbilt University Medical Center, New York, New York, United States
| | - Yiye Zhang
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, United States
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Abujaber AA, Nashwan AJ, Fadlalla A. Enabling the adoption of machine learning in clinical decision support: A Total Interpretive Structural Modeling Approach. INFORMATICS IN MEDICINE UNLOCKED 2022. [DOI: 10.1016/j.imu.2022.101090] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Mahla M, Talati S, Gupta AK, Agarwal R, Tripathi S, Bhattacharya S. The acceptance level of Hospital Information Management System (HIMS) among the nursing officials working in a teaching hospital. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:452. [PMID: 35233399 PMCID: PMC8826790 DOI: 10.4103/jehp.jehp_1410_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 04/24/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The acceptability of hospital staff in the use of hospital information management system (HIMS) is an emerging research area it can explain the fate of any HIMS development and implementation project in hospitals. The aim of this study was to observe the level of acceptance of HMIS among nursing officials working at a teaching hospital. MATERIALS AND METHODS This cross-sectional study was conducted for 1 year in a teaching hospital of northern India by using a pretested questionnaire. Our study participants were nursing officers who were not under the probation period and we used a purposive sampling (10% nurses from each ward). Our sample size was 256. RESULTS We have observed that majority of 174 (67.96%) participants had good acceptability to the HIMS system. Our study revealed that most of the participants were aware of HIMS. Among all participants, nearly half of them had good acceptability to the HIMS system. This is may be due to their job profiles, distribution of their working places, and their past experiences with HMIS. The bottlenecks such as connectivity problem, error prevention, and lack of training can be addressed by the hospital management by proper measures. CONCLUSION The acceptance level of HIMS among the nursing officials working in a teaching hospital was good.
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Affiliation(s)
- Mahesh Mahla
- Department of Hospital Administration, PGIMS, Rohtak, Haryana, India
| | - Shweta Talati
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | - Anil Kumar Gupta
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, PGIMER, Chandigarh, India
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12
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Singh H, Tahsin F, Nie JX, McKinstry B, Thavorn K, Upshur R, Harvey S, Wodchis WP, Gray CS. Exploring the perspectives of primary care providers on use of the electronic Patient Reported Outcomes tool to support goal-oriented care: a qualitative study. BMC Med Inform Decis Mak 2021; 21:366. [PMID: 34965860 PMCID: PMC8714873 DOI: 10.1186/s12911-021-01734-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Digital health technologies can support primary care delivery, but clinical uptake in primary care is limited. This study explores enablers and barriers experienced by primary care providers when adopting new digital health technologies, using the example of the electronic Patient Reported Outcome (ePRO) tool; a mobile application and web portal designed to support goal-oriented care. To better understand implementation drivers and barriers primary care providers' usage behaviours are compared to their perspectives on ePRO utility and fit to support care for patients with complex care needs. METHODS This qualitative sub-analysis was part of a larger trial evaluating the use of the ePRO tool in primary care. Qualitative interviews were conducted with providers at the midpoint (i.e. 4.5-6 months after ePRO implementation) and end-point (i.e. 9-12 months after ePRO implementation) of the trial. Interviews explored providers' experiences and perceptions of integrating the tool within their clinical practice. Interview data were analyzed using a hybrid thematic analysis and guided by the Technology Acceptance Model. Data from thirteen providers from three distinct primary care sites were included in the presented study. RESULTS Three core themes were identified: (1) Perceived usefulness: perceptions of the tool's alignment with providers' typical approach to care, impact and value and fit with existing workflows influenced providers' intention to use the tool and usage behaviour; (2) Behavioural intention: providers had a high or low behavioural intention, and for some, it changed over time; and (3) Improving usage behaviour: enabling external factors and enhancing the tool's perceived ease of use may improve usage behaviour. CONCLUSIONS Multiple refinements/iterations of the ePRO tool (e.g. enhancing the tool's alignment with provider workflows and functions) may be needed to enhance providers' usage behaviour, perceived usefulness and behavioural intention. Enabling external factors, such as organizational and IT support, are also necessary to increase providers' usage behaviour. Lessons from this study advance knowledge of technology implementation in primary care. TRIAL REGISTRATION Clinicaltrials.gov Identified NCT02917954. Registered September 2016, https://www.clinicaltrials.gov/ct2/show/study/NCT02917954.
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Affiliation(s)
- Hardeep Singh
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, Canada.
- March of Dimes Canada, Toronto, Canada.
| | - Farah Tahsin
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M6, Canada
| | - Jason Xin Nie
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, L5B 1B8, Canada
| | - Brian McKinstry
- Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, Ottawa, ON, K1Y 4E9, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Ross Upshur
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M6, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sarah Harvey
- Logibec Inc., 1751, Richardson Street, Suite 1.060, Montréal, QC, H3K 1G6, Canada
| | - Walter P Wodchis
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M6, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, L5B 1B8, Canada
| | - Carolyn Steele Gray
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M6, Canada
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Grammatikopoulou MG, Vassilakou T, Goulis DG, Theodoridis X, Nigdelis MP, Petalidou A, Gkiouras K, Poulimeneas D, Alexatou O, Tsiroukidou K, Marakis G, Daniil Z, Bogdanos DP. Standards of Nutritional Care for Patients with Cystic Fibrosis: A Methodological Primer and AGREE II Analysis of Guidelines. CHILDREN (BASEL, SWITZERLAND) 2021; 8:1180. [PMID: 34943375 PMCID: PMC8699992 DOI: 10.3390/children8121180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/25/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022]
Abstract
Although many Clinical Practice Guidelines (CPGs) have been published for the care of patients with Cystic Fibrosis (CF), including a variety of nutrition recommendations, the quality of these CPGs has never been evaluated. The aim of this study was to compare, review, and critically appraise CPGs for the nutritional management of CF, throughout the lifespan. We searched PubMed, Guidelines International Network (GIN), ECRI Institute, and Guidelines Central for CPGs, with information on the nutritional management of CF. Retrieved CPGs were appraised by three independent reviewers, using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument and checklist. A total of 22 CPGs (seven solely nutrition oriented), by 14 different publishers, were retrieved. The Thoracic Society of Australia and New Zealand CPGs scored the highest overall quality (94.4%), while the Paediatric Gastroenterology Society/Dietitians Association of Australia CPGs had the lowest score (27.8%). Great variation in AGREE II domain-specific scores was observed in all CPGs, suggesting the existence of different strengths and weaknesses. Despite the availability of several CPGs, many appear outdated, lacking rigor, transparency, applicability, and efficiency, while incorporating bias. Considering that CPGs adherence is associated with better outcomes and the need for improving life expectancy in patients with CF, the development of CPGs of better quality is deemed necessary.
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Affiliation(s)
- Maria G. Grammatikopoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, 57400 Thessaloniki, Greece;
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (K.G.); (A.P.)
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece; (D.G.G.); (M.P.N.)
- 3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens University Campus, 11521 Athens, Greece;
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece; (D.G.G.); (M.P.N.)
| | - Xenophon Theodoridis
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Meletios P. Nigdelis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece; (D.G.G.); (M.P.N.)
| | - Arianna Petalidou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (K.G.); (A.P.)
| | - Konstantinos Gkiouras
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (K.G.); (A.P.)
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Dimitrios Poulimeneas
- Department of Nutrition & Dietetics, Harokopio University, 17676 Athens, Greece; (D.P.); (O.A.)
| | - Olga Alexatou
- Department of Nutrition & Dietetics, Harokopio University, 17676 Athens, Greece; (D.P.); (O.A.)
| | - Kyriaki Tsiroukidou
- 3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Georgios Marakis
- Nutrition and Food Standards Unit, Risk Assessment and Nutrition Directorate, Hellenic Food Authority, 11526 Athens, Greece;
| | - Zoe Daniil
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece;
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (K.G.); (A.P.)
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Abstract
Understanding the factors affecting the use of healthcare technologies is a crucial topic that has been extensively studied, specifically during the last decade. These factors were studied using different technology acceptance models and theories. However, a systematic review that offers extensive understanding into what affects healthcare technologies and services and covers distinctive trends in large-scale research remains lacking. Therefore, this review aims to systematically review the articles published on technology acceptance in healthcare. From a yield of 1768 studies collected, 142 empirical studies have met the eligibility criteria and were extensively analyzed. The key findings confirmed that TAM and UTAUT are the most prevailing models in explaining what affects the acceptance of various healthcare technologies through different user groups, settings, and countries. Apart from the core constructs of TAM and UTAUT, the results showed that anxiety, computer self-efficacy, innovativeness, and trust are the most influential factors affecting various healthcare technologies. The results also revealed that Taiwan and the USA are leading the research of technology acceptance in healthcare, with a remarkable increase in studies focusing on telemedicine and electronic medical records solutions. This review is believed to enhance our understanding through a number of theoretical contributions and practical implications by unveiling the full potential of technology acceptance in healthcare and opening the door for further research opportunities.
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15
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Physicians' Attitude towards Electronic Medical Record Systems: An Input for Future Implementers. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5523787. [PMID: 34493979 PMCID: PMC8418928 DOI: 10.1155/2021/5523787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/23/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022]
Abstract
Background Electronic medical record (EMR) systems offer the potential to improve health care quality by allowing physicians real-time access to patient healthcare information. The endorsement and usage of EMRs by physicians have a significant influence on other user groups in the healthcare system. As a result, the purpose of this study was to examine physicians' attitudes regarding EMRs and identify the elements that may influence their attitudes. Method An institutional-based cross-sectional study design supplemented with a qualitative study was conducted from March 1 to April 30, 2018, among a total of 403 physicians. A self-administered questionnaire was used to collect quantitative data. The validity of the prediction bounds for the dependent variable and the validity of the confidence intervals and P values for the parameters were measured with a value of less than 0.05 and 95 percent of confidence interval. For the supplementary qualitative study, data were collected using semistructured in-depth interviews from 11 key informants, and the data were analyzed using thematic analysis. Result Physicians' computer literacy (CI: 0.264, 0.713; P: 0001) and computer access at work (CI: 0.141, 0.533, P: 0.001) were shown to be favorable predictors of their attitude towards EMR system adoption. Another conclusion from this study was the inverse relationship between physicians' prior EMR experience and their attitude about the system (CI: -0.517, -0.121; P: 0.002). Conclusion According to the findings of this study, physicians' attitudes regarding EMR were found moderate in the studied region. There was a favorable relationship between computer ownership, computer literacy, lack of EMR experience, participation in EMR training, and attitude towards EMR. Improving the aforementioned elements is critical to improving physicians' attitudes regarding EMR.
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16
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Acceptance of clinical decision support systems in Saudi healthcare organisations. INFORMATION DEVELOPMENT 2021. [DOI: 10.1177/02666669211025076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Applications of clinical decision support systems (CDSS) have become essential for physicians seeking to make appropriate decisions. The implementation of CDSS, however, is complicated if the factors affecting physician’s acceptance are not recognised. This study aims to explore the various factors that may influence the acceptance of CDSS in Saudi Arabia. A qualitative method was used to collect data from interviews with 54 GPs, with interviews conducted in three stages. The study then integrated the Unified Theory of Acceptance and Use of Technology (UTAUT) and Task-Technology Fit (TTF) models to communicate the findings. It is suggested that all factors of both UTAUT and TTF influence acceptance of CDSS by GPs, with the sole exception of the social influence factor. Some additional factors were also discovered by means of in-depth interviews, including accessibility, patient satisfaction, informativeness (increased knowledge), connectedness (informing patients), communication and shared knowledge, privacy and security, and perceived risk (functional performance risk and time risk). The study thus offers a new insight of the factors influencing GPs’ acceptance of CDSS.
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17
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Heinsch M, Wyllie J, Carlson J, Wells H, Tickner C, Kay-Lambkin F. Theories Informing eHealth Implementation: Systematic Review and Typology Classification. J Med Internet Res 2021; 23:e18500. [PMID: 34057427 PMCID: PMC8204232 DOI: 10.2196/18500] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 10/22/2020] [Accepted: 04/15/2021] [Indexed: 01/23/2023] Open
Abstract
Background Theory-guided approaches to implementation science have informed translation efforts and the acceptance of eHealth (digital health) interventions in clinical care. However, there is scarce evidence on which theories are best suited to addressing the inherent complexity of eHealth implementation. Objective The objectives of this systematic review are to identify theories that inform and explain eHealth implementation and to classify these theories using the typology by Sovacool and Hess for theories of sociotechnical change. Methods An electronic search was conducted in the PsycINFO, MEDLINE, Embase, CINAHL, Scopus, Sociological Source Ultimate, Web of Science, ABI/INFORM, EBSCO, and ProQuest databases in June 2019. Studies were included if they were published between 2009 and June 2019; were written in English; reported on empirical research, regardless of study or publication type; reported on one or more theories in the context of eHealth implementation; and were published in a peer-reviewed journal. A total of 2 reviewers independently assessed the titles, abstracts, and full texts. Theories identified were classified using a typology for theories of sociotechnical change, which was considered a useful tool for ordering and analyzing the diverse theoretical approaches as a basis for future theory building. Results Of the 13,101 potentially relevant titles, 119 studies were included. The review identified 36 theories used to explain implementation approaches in eHealth. The most commonly used approaches were the Technology Acceptance Model (TAM) (n=33) and the Unified Theory of Acceptance and Use of Technology (UTAUT) (n=32). These theories were primarily concerned with individual and interpersonal elements of eHealth acceptance. Less common were theories that reflect the various disorderly social processes and structural dimensions of implementation, such as the normalization process theory (n=17) and the structuration theory (n=6). Conclusions Theories currently informing the implementation of eHealth interventions predominantly focus on predicting or explaining end-user acceptance. Theoretical perspectives that capture the dense and intricate relationships and structures required to enact sustainable change are less well represented in the eHealth literature. Given the growing acknowledgment of the inherent complexity of eHealth implementation, future research should develop and test models that recognize and reflect the multidimensional, dynamic, and relational nature of this process.
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Affiliation(s)
- Milena Heinsch
- Centre for Brain and Mental Health Priority Research Centre, The University of Newcastle, Callaghan, Australia.,School of Humanities and Social Science, The University of Newcastle, Callaghan, Australia
| | - Jessica Wyllie
- Newcastle Business School, The University of Newcastle, Callaghan, Australia
| | - Jamie Carlson
- Newcastle Business School, The University of Newcastle, Callaghan, Australia
| | - Hannah Wells
- Centre for Brain and Mental Health Priority Research Centre, The University of Newcastle, Callaghan, Australia
| | - Campbell Tickner
- Centre for Brain and Mental Health Priority Research Centre, The University of Newcastle, Callaghan, Australia
| | - Frances Kay-Lambkin
- Centre for Brain and Mental Health Priority Research Centre, The University of Newcastle, Callaghan, Australia
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18
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McKinley KW, Chamberlain JM, Doan Q, Berkowitz D. Reducing Pediatric ED Length of Stay by Reducing Diagnostic Testing: A Discrete Event Simulation Model. Pediatr Qual Saf 2021; 6:e396. [PMID: 33718751 PMCID: PMC7952107 DOI: 10.1097/pq9.0000000000000396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 10/16/2020] [Indexed: 11/25/2022] Open
Abstract
Supplemental Digital Content is available in the text. Quality improvement efforts can require significant investment before the system impact of those efforts can be evaluated. We used discrete event simulation (DES) modeling to test the theoretical impact of a proposed initiative to reduce diagnostic testing for low-acuity pediatric emergency department (ED) patients.
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Affiliation(s)
- Kenneth W McKinley
- Emergency Medicine Section of Data Analytics, Children's National, Washington, D.C
| | - James M Chamberlain
- Emergency Medicine Section of Data Analytics, Children's National, Washington, D.C
| | - Quynh Doan
- Division of Emergency Medicine, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Deena Berkowitz
- Emergency Medicine Section of Data Analytics, Children's National, Washington, D.C
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19
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Hogan J, Grant G, Kelly F, O'Hare J. Factors influencing acceptance of robotics in hospital pharmacy: a longitudinal study using the Extended Technology Acceptance Model. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2020; 28:483-490. [PMID: 32430998 DOI: 10.1111/ijpp.12637] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To explore factors influencing hospital pharmacy staff acceptance of a pharmacy robotic dispensing system during implementation and over time. METHODS A single centred, prospective, longitudinal cohort quantitative study was conducted in an Australian tertiary public hospital using the Extended Technology Acceptance Model (ETAM). Staff were surveyed during the implementation of a pharmacy dispensing robot (May 2016) and again after working with the system for fifteen months (August 2017). Fishers exact test and correlation analysis of paired responses were used to identify significant factors influencing use of the system between the two time points. KEY FINDINGS Sixty four respondents completed surveys during implementation (n=64) and 34-paired surveys were collected fifteen months later. Respondents were predominantly young, female with a tertiary qualification. Initial perceptions did not change over time, with the exception of reliability. Departmental leaders had greatest influence on technology acceptance during implementation and over time. Other key factors correlating with acceptance included: how useful the robot was perceived to be; ease of use and how relevant the robot was for an individual role. Higher levels of education had a negative association with usage during implementation and age was not a factor. CONCLUSION This study identified critical insights influencing staff acceptance of pharmacy robots that will help inform future implementation. The influence of pharmacy leaders emerged as key influence on technology acceptance. Leveraging on this influence a communication strategy prior to implementation should include information on useful functions and known benefits of the system customised for individual roles.
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Affiliation(s)
- Jane Hogan
- School of Pharmacy and Pharmacology, Griffith University, Southport, Qld, Australia.,Pharmacy Department, Gold Coast Hospital and Health Service, GCUH, Southport, Qld, Australia
| | - Gary Grant
- School of Pharmacy and Pharmacology, Griffith University, Southport, Qld, Australia
| | - Fiona Kelly
- School of Pharmacy and Pharmacology, Griffith University, Southport, Qld, Australia
| | - Jennie O'Hare
- Pharmacy Department, Gold Coast Hospital and Health Service, GCUH, Southport, Qld, Australia
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20
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Deng Q, Liu W. Utilization of clinical practice guideline on antimicrobial in China: an exploratory survey on multilevel determinants. BMC Health Serv Res 2020; 20:282. [PMID: 32252756 PMCID: PMC7137508 DOI: 10.1186/s12913-020-05171-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nowadays, irrational use of antimicrobials has threatened public health. It's necessary to expand the use of clinical practice guideline (CPG) on antimicrobial for facilitating the proper use of antimicrobial. However, the utilization status of CPG on antimicrobial and the influencing factors, especially the ones at the organizational level, remain largely unknown. METHODS A cross-sectional questionnaire survey was conducted on a sample among physicians from 16 public hospitals in the eastern, central and western parts of China. A multilevel regression model was employed to examine factors associated with physicians' utilization of CPG on antimicrobial. RESULTS A total of 815 physicians were included in this study. About 80% of the surveyed physicians reported their adherence to the CPG on antimicrobial. Dimensions of "subjective norm", "perceived risk" and "behavioral intention" from the domain of physician belief, a dimension of "ease of use" from the domain of CPG traits, and dimensions of "top management support" and "organization & implementation" from the domain of hospital practice were significantly associated with physicians' utilization of CPG on antimicrobial. And except for working department, most demographics characteristics of the physician were not found to be significantly related to the CPG use. In addition, it also showed that region is a significant factor affecting physicians' CPG use. CONCLUSIONS This study depicted the current status of CPG on antimicrobial and comprehensively identified its potential determinants not only from the three domains at the individual level, such as physician belief, but also from the location region at the organizational level. The results will provide a direct reference for the implementation of CPG on antimicrobial.
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Affiliation(s)
- Qingwen Deng
- Department of Health Management, School of Public Health, Fujian Medical University, Room 108 in the Building for School of Public Health, 1 Xuefubei Road, Minhou District, Fuzhou, 350122, China
| | - Wenbin Liu
- Department of Health Management, School of Public Health, Fujian Medical University, Room 108 in the Building for School of Public Health, 1 Xuefubei Road, Minhou District, Fuzhou, 350122, China.
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Chérrez-Ojeda I, Felix M, Mata VL, Vanegas E, Simancas-Racines D, Aguilar M, Gavilanes AWD, Chedraui P, Vera C. Use and Perceptions of Information and Communication Technologies Among Ecuadorian Nurses: A Cross-sectional Study. Open Nurs J 2020. [DOI: 10.2174/1874434602014010001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Nurses represent a key group for the implementation of Information and Communication Technologies (ICTs), however, few studies have explored the current use of these technologies among healthcare professionals in developing countries. Our study aims to achieve a better understanding of how Ecuadorian nurses perceive the theoretical advantages and limitations of ICTs, as well as to explore the current use of these technologies in the setting of the professional nursing practice.
Methods:
We conducted an anonymous survey-based cross-sectional study where 191 nurses rated their frequency of use and level of agreement to specific statements on perceptions related to ICTs. For the statistical analyses, adjusted binomial logistic regressions and the chi-squared test for association were applied.
Results:
In general, 96.3% of nurses reported the use of ICTs to communicate with colleagues, and 80.1% reported the use of ICTs to communicate with patients. More than 70% of participants agreed that ICTs can be useful to promote professional services, help in the search for new job opportunities and/or professional development, foster health promotion, and improve the workflow with colleagues. Meanwhile, 78.6% of nurses had privacy or security concerns about personal and/or patient information, and 60.6% reported not having enough time neither to learn how to use ICTs nor to use them.
Conclusion:
High use of ICTs was found among Ecuadorian nurses for communicating with both colleagues and patients. Most of the participants had a positive perception of the use of ICTs in the healthcare practice, particularly among younger nurses. Finally, the major reservations perceived were related to privacy and patient confidentiality, and lack of time to learn how to use, or use ICTs.
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Chérrez-Ojeda I, Felix M, Mata VL, Vanegas E, Simancas-Racines D, Aguilar M, Gavilanes AWD, Chedraui P, Vera C. Use and Perceptions of Information and Communication Technologies Among Ecuadorian Nurses: A Cross-sectional Study. Open Nurs J 2020. [DOI: 10.2174/1874434602014010008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Nurses represent a key group for the implementation of Information and Communication Technologies (ICTs), however, few studies have explored the current use of these technologies among healthcare professionals in developing countries. Our study aims to achieve a better understanding of how Ecuadorian nurses perceive the theoretical advantages and limitations of ICTs, as well as to explore the current use of these technologies in the setting of the professional nursing practice.
Methods:
We conducted an anonymous survey-based cross-sectional study where 191 nurses rated their frequency of use and level of agreement to specific statements on perceptions related to ICTs. For the statistical analyses, adjusted binomial logistic regressions and the chi-squared test for association were applied.
Results:
In general, 96.3% of nurses reported the use of ICTs to communicate with colleagues, and 80.1% reported the use of ICTs to communicate with patients. More than 70% of participants agreed that ICTs can be useful to promote professional services, help in the search for new job opportunities and/or professional development, foster health promotion, and improve the workflow with colleagues. Meanwhile, 78.6% of nurses had privacy or security concerns about personal and/or patient information, and 60.6% reported not having enough time neither to learn how to use ICTs nor to use them.
Conclusion:
High use of ICTs was found among Ecuadorian nurses for communicating with both colleagues and patients. Most of the participants had a positive perception of the use of ICTs in the healthcare practice, particularly among younger nurses. Finally, the major reservations perceived were related to privacy and patient confidentiality, and lack of time to learn how to use, or use ICTs.
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Villarosa AR, Maneze D, Ramjan LM, Srinivas R, Camilleri M, George A. The effectiveness of guideline implementation strategies in the dental setting: a systematic review. Implement Sci 2019; 14:106. [PMID: 31847876 PMCID: PMC6918615 DOI: 10.1186/s13012-019-0954-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 11/25/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Guideline implementation has been an ongoing challenge in the dental practice setting. Despite this, there are no reviews summarising the existing evidence regarding effective guideline implementation strategies in this setting. In order to address this, this systematic review examines the effectiveness of guideline implementation strategies in the dental practice setting. METHODS A systematic search was undertaken according to the PRISMA statement across nine electronic databases, targeting randomised controlled trials and quasi-experimental studies which evaluated the effectiveness of guideline implementation strategies in improving guideline adherence in the dental setting. All records were independently examined for relevance and appraised for study quality by two authors, with consensus achieved by a third author. Data were extracted from included studies using a standardised data extraction pro forma. RESULTS A total of 15 records were eligible for inclusion in this review, which focused on the effects of audit and feedback, reminders, education, patient-mediated interventions, pay for performance and multifaceted interventions. Although there were some conflicting evidence, studies within each category of implementation strategy indicated a positive effect on guideline adherence. CONCLUSIONS This study has identified education, reminders and multifaceted interventions as effective implementation strategies for the dental practice setting. Although this is similar to research findings from other health sectors, there is some evidence to suggest patient-mediated interventions may be less effective and pay for performance may be more effective in the dental setting. These findings can inform policy makers, professional associations, colleges and organisations in the future adoption of clinical guidelines in the dental practice setting. TRIAL REGISTRATION This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration ID CRD42018093023.
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Affiliation(s)
- Amy R Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871, Australia. .,Western Sydney University, Penrith, 2751, Australia. .,South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia. .,Ingham Institute for Applied Medical Research, Liverpool, 1871, Australia.
| | - Della Maneze
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871, Australia.,Western Sydney University, Penrith, 2751, Australia.,South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,Ingham Institute for Applied Medical Research, Liverpool, 1871, Australia
| | - Lucie M Ramjan
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871, Australia.,Western Sydney University, Penrith, 2751, Australia.,Ingham Institute for Applied Medical Research, Liverpool, 1871, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, 2751, Australia
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871, Australia.,Western Sydney University, Penrith, 2751, Australia.,South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,Ingham Institute for Applied Medical Research, Liverpool, 1871, Australia.,University of Sydney, Camperdown, 2050, Australia
| | - Michelle Camilleri
- South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871, Australia.,Western Sydney University, Penrith, 2751, Australia.,South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,Ingham Institute for Applied Medical Research, Liverpool, 1871, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, 2751, Australia.,University of Sydney, Camperdown, 2050, Australia
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Darby AB, Su Y, Reynolds RB, Madlock-Brown C. A Survey-based Study of Pharmacist Acceptance and Resistance to Health Information Technology. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2019; 16:1a. [PMID: 31019433 PMCID: PMC6462883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Because user acceptance and resistance to the use of health information technology (HIT) affects system utilization and previous studies in this area have typically excluded pharmacists, this study specifically addresses the response of institutional pharmacists to HIT. METHODS A survey investigating pharmacists' responses to electronic medical record (EMR) system use was developed using questions modified from previously validated research. The survey was distributed electronically to the mailing list for pharmacy preceptors for the University of Tennessee College of Pharmacy. Descriptive statistics and univariate and multivariate analyses were used to analyze the collected data based on a previously validated dual-factor model. RESULTS Of the 96 responses from institutional pharmacists, 64 responses (66.7 percent) were complete and usable. Of the acceptance and resistance constructs evaluated, only attitude and perceived behavior control were found to be significantly associated with acceptance of use (p = .036 and p = .025, respectively), and only transition cost was found to be significantly associated with resistance to use (p = .018). System vendor and interface integration were also significantly associated with acceptance of use. These findings suggest that attitude, perceived behavior control, and transition costs may have the most impact on pharmacists' responses to the use of EMR systems. CONCLUSION It is reasonable for hospitals to focus efforts on specific factors influencing acceptance of and resistance to EMR use and, before a system is selected, to consider the effects of vendor selection and level of interface integration on acceptance of use.
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Affiliation(s)
| | - Yin Su
- The University of Tennessee Health Science Center in Memphis, TN
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25
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Developing Sustainable Healthcare Systems in Developing Countries: Examining the Role of Barriers, Enablers and Drivers on Knowledge Management Adoption. SUSTAINABILITY 2019. [DOI: 10.3390/su11040954] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Knowledge management (KM) adoption is crucial to integrating sustainable development within the healthcare sector. Different barriers, enablers, and drivers affect KM adoption. Identifying these barriers, enablers, and drivers and their role in KM adoption is the core of successful KM adoption. However, there is scarcity of studies applying quantitative models and combing barriers, enablers and drivers to check their effect on KM adoption, especially form a developing country’s perspective such as Pakistan. Therefore, this study explores the role of barriers, enablers and drivers on KM adoption in Pakistan. Healthcare professionals participated in the data collection process, and results were analyzed using structural equation modeling. The findings described that: (1) organizational and strategic barriers have significant negative association with KM adoption; (2) government related enablers have significant positive association with KM adoption; (3) healthcare related drivers, and performance-based drivers have significant positive association with KM adoption. This study concludes that government intervention to promote KM adoption is necessary especially in developing countries. These findings will be helpful for the healthcare professionals and policy makers to promote KM adoption in healthcare sector. Current study contributes to the healthcare literature and body of knowledge by providing the empirical evidence of checking the quantitative effect of barriers, enablers and drivers on KM adoption.
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26
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Lee SJ, Choi MJ, Rho MJ, Kim DJ, Choi IY. Factors Affecting User Acceptance in Overuse of Smartphones in Mobile Health Services: An Empirical Study Testing a Modified Integrated Model in South Korea. Front Psychiatry 2018; 9:658. [PMID: 30631283 PMCID: PMC6315168 DOI: 10.3389/fpsyt.2018.00658] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/19/2018] [Indexed: 11/13/2022] Open
Abstract
Smartphones have become crucial in people's everyday lives, including in the medical field. However, as people become close to their smartphones, this leads easily to overuse. Overuse leads to fatigue due to lack of sleep, depressive symptoms, and social relationship failure, and in the case of adolescents, it hinders academic achievement. Self-control solutions are needed, and effective tools can be developed through behavioral analysis. Therefore, the aim of this study was to investigate the determinants of users' intentions to use m-Health for smartphone overuse interventions. A research model was based on TAM and UTAUT, which were modified to be applied to the case of smartphone overuse. The studied population consisted of 400 randomly selected smartphone users aged from 19 to 60 years in South Korea. Structural equation modeling was conducted between variables to test the hypotheses using a 95% confidence interval. Perceived ease of use had a very strong direct positive association with perceived usefulness, and perceived usefulness had a very strong direct positive association with behavioral intention to use. Resistance to change had a direct positive association with behavioral intention to use and, lastly, social norm had a very strong direct positive association with behavioral intention to use. The findings that perceived ease of use influenced perceived usefulness, that perceived usefulness influenced behavioral intention to use, and social norm influenced behavioral intention to use were in accordance with prior related research. Other results that were not consistent with previous research imply that these are unique behavioral findings regarding smartphone overuse. This research identifies the critical factors that need to be considered when implementing systems or solutions in the future for tackling the issue of smartphone overuse.
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Affiliation(s)
- Seo-Joon Lee
- Research Institute of Health Science, Korea University, Seoul, South Korea
| | - Mun Joo Choi
- Department of Medical Informatics, The Catholic University of Seoul, Seoul, South Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Mi Jung Rho
- Department of Medical Informatics, The Catholic University of Seoul, Seoul, South Korea
- Catholic Institute for Healthcare Management and Graduate School of Healthcare Management and Policy, The Catholic University of Korea, Seoul, South Korea
| | - Dai-Jin Kim
- Department of Psychiatry, Addiction Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - In Young Choi
- Department of Medical Informatics, The Catholic University of Seoul, Seoul, South Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- Catholic Institute for Healthcare Management and Graduate School of Healthcare Management and Policy, The Catholic University of Korea, Seoul, South Korea
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Abstract
Knowledge management (KM) is the source for creating a sustainable competitive advantage, and it helps the organizations to retain, develop, organize and utilize their knowledge. Due to globalization, the organizations must maintain their knowledge assets to survive. Many organizations have realized the potential of KM and are applying it. Since the healthcare industry is growing significantly, it is continuously generating a wealth of knowledge. This knowledge can be recorded, communicated and used by many health care professionals with the help of KM. There is a wealth of research on KM in healthcare of developed countries, but very few studies regarding KM implementation can be found in developing countries i.e., Pakistan. Pakistan is now looking towards the implementation of KM; it is in its initial stages. The implementation of KM in the healthcare of Pakistan is affected by different barriers. In this study, the barriers will be identified and analyzed. An interrelationship between the barriers will be determined, and how the different barriers support each other (driving power), and how they influence each other (dependence power). The results of interpretive structural modeling (ISM) and MICMAC (Matrice d’Impacts croises-multipication appliqué an classment i.e., cross-impact matrix multiplication applied to classification) approach show that lack of support from top management, insufficient strategic planning and lack of support from organizational structure are the main barriers to KM adoption in the healthcare of Pakistan. This study provides a solution in determining the main barriers that need to be solved first, and to ensure effective implementation of KM in the healthcare of Pakistan.
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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.
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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
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30
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Al-Jumaili AA, Al-Rekabi MD, Alsawad OS, Allela OQ, Carnahan R, Saaed H, Naqishbandi A, Kadhim DJ, Sorofman B. Exploring Electronic Communication Modes Between Iraqi Faculty and Students of Pharmacy Schools Using the Technology Acceptance Model. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2017; 81:89. [PMID: 28720917 PMCID: PMC5508088 DOI: 10.5688/ajpe81589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/22/2016] [Indexed: 06/07/2023]
Abstract
Objective. To explore for the first time the extent to which Iraqi pharmacy students and faculty use Facebook and university email for academic communications, and to examine factors influencing utilization within the framework of the Technology Acceptance Model (TAM). Methods. An electronic survey was administered to convenience samples of students and faculty of six Iraqi public schools and colleges of pharmacy in 2015. Results. Responses included 489 student and 128 faculty usable surveys. Both students and faculty use Facebook more than university email for academic communications. Less than a third of the faculty used university email. Students used Facebook for academic purposes twice as much as faculty. Conclusion. Absence of university email in Iraqi schools and colleges of pharmacy makes Facebook essential for faculty-student communications. The majority (71.1% to 82%) of respondents perceived that Facebook was easy to use. Three TAM variables (intention to use, attitude toward use and perceived usefulness) had significant positive associations with actual use of both Facebook messaging and university email.
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Affiliation(s)
- Ali Azeez Al-Jumaili
- University of Iowa College of Pharmacy, Iowa City, Iowa
- University of Baghdad College of Pharmacy, Baghdad, Iraq
| | | | | | | | - Ryan Carnahan
- University of Iowa College of Public Health, Iowa City, Iowa
| | - Hiwa Saaed
- University of Sulaimani College of Pharmacy, Sulaymaniyah, Kurdistan, Iraq
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Brandt L, Vandvik PO, Alonso-Coello P, Akl EA, Thornton J, Rigau D, Adams K, O'Connor P, Guyatt G, Kristiansen A. Multilayered and digitally structured presentation formats of trustworthy recommendations: a combined survey and randomised trial. BMJ Open 2017; 7:e011569. [PMID: 28188149 PMCID: PMC5306518 DOI: 10.1136/bmjopen-2016-011569] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To investigate practicing physicians' preferences, perceived usefulness and understanding of a new multilayered guideline presentation format-compared to a standard format-as well as conceptual understanding of trustworthy guideline concepts. DESIGN Participants attended a standardised lecture in which they were presented with a clinical scenario and randomised to view a guideline recommendation in a multilayered format or standard format after which they answered multiple-choice questions using clickers. Both groups were also presented and asked about guideline concepts. SETTING Mandatory educational lectures in 7 non-academic and academic hospitals, and 2 settings involving primary care in Lebanon, Norway, Spain and the UK. PARTICIPANTS 181 practicing physicians in internal medicine (156) and general practice (25). INTERVENTIONS A new digitally structured, multilayered guideline presentation format and a standard narrative presentation format currently in widespread use. PRIMARY AND SECONDARY OUTCOME MEASURES Our primary outcome was preference for presentation format. Understanding, perceived usefulness and perception of absolute effects were secondary outcomes. RESULTS 72% (95% CI 65 to 79) of participants preferred the multilayered format and 16% (95% CI 10 to 22) preferred the standard format. A majority agreed that recommendations (multilayered 86% vs standard 91%, p value=0.31) and evidence summaries (79% vs 77%, p value=0.76) were useful in the context of the clinical scenario. 72% of participants randomised to the multilayered format vs 58% for standard formats reported correct understanding of the recommendations (p value=0.06). Most participants elected an appropriate clinical action after viewing the recommendations (98% vs 92%, p value=0.10). 82% of the participants considered absolute effect estimates in evidence summaries helpful or crucial. CONCLUSIONS Clinicians clearly preferred a novel multilayered presentation format to the standard format. Whether the preferred format improves decision-making and has an impact on patient important outcomes merits further investigation.
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Affiliation(s)
- Linn Brandt
- Department of Internal Medicine, Sykehuset Innlandet Hospital Trust, Gjøvik, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Per Olav Vandvik
- Department of Internal Medicine, Sykehuset Innlandet Hospital Trust, Gjøvik, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute (IIB Sant Pau-CIBERESP), Barcelona, Spain
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Elie A Akl
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Judith Thornton
- National Institute for Health and Care Excellence, Manchester, UK
| | - David Rigau
- Iberoamerican Cochrane Centre, Biomedical Research Institute (IIB Sant Pau-CIBERESP), Barcelona, Spain
| | - Katie Adams
- National Institute for Health and Care Excellence, Manchester, UK
| | - Paul O'Connor
- National Institute for Health and Care Excellence, Manchester, UK
| | - Gordon Guyatt
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Annette Kristiansen
- Department of Internal Medicine, Sykehuset Innlandet Hospital Trust, Gjøvik, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Buabbas AJ, Al-Shamali DA, Sharma P, Haidar S, Al-Shawaf H. Users' Perspectives on a Picture Archiving and Communication System (PACS): An In-Depth Study in a Teaching Hospital in Kuwait. JMIR Med Inform 2016; 4:e21. [PMID: 27307046 PMCID: PMC4927806 DOI: 10.2196/medinform.5703] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 04/30/2016] [Accepted: 05/19/2016] [Indexed: 11/24/2022] Open
Abstract
Background Picture archiving and communication system (PACS) is a well-known imaging informatics application in health care organizations, specifically designed for the radiology department. Health care providers have exhibited willingness toward evaluating PACS in hospitals to ascertain the critical success and failure of the technology, considering that evaluation is a basic requirement. Objective This study aimed at evaluating the success of a PACS in a regional teaching hospital of Kuwait, from users’ perspectives, using information systems success criteria. Methods An in-depth study was conducted by using quantitative and qualitative methods. This mixed-method study was based on: (1) questionnaires, distributed to all radiologists and technologists and (2) interviews, conducted with PACS administrators. Results In all, 60 questionnaires were received from the respondents. These included 39 radiologists (75% response rate) and 21 technologists (62% response rate), with the results showing almost three-quarters (74%, 44 of 59) of the respondents rating PACS positively and as user friendly. This study’s findings revealed that the demographic data, including computer experience, was an insignificant factor, having no influence on the users’ responses. The findings were further substantiated by the administrators’ interview responses, which supported the benefits of PACS, indicating the need for developing a unified policy aimed at streamlining and improving the departmental workflow. Conclusions The PACS had a positive and productive impact on the radiologists’ and technologists’ work performance. They were endeavoring to resolve current problems while keeping abreast of advances in PACS technology, including teleradiology and mobile image viewer, which is steadily increasing in usage in the Kuwaiti health system.
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Affiliation(s)
- Ali Jassem Buabbas
- Faculty of Medicine, Community Medicine and Behavioral Sciences, Kuwait University, Hawally, Kuwait.
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