Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study

BACKGROUND

The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners.

OBJECTIVE

This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework.

METHODS

A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model.

RESULTS

On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=-.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms.

CONCLUSIONS

This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.

Physicians' perceptions of electronic prescribing of controlled medications in the West Bank, Palestine: A pre-implementation assessment

BACKGROUND

In Palestine, prescribing controlled medications is still done on paper. Despite valuable regulatory efforts, there is a high risk of undetected abuse and "doctor shopping". These problems can be addressed with electronic prescribing of controlled medicines (EPCM). User adoption is essential to the successful implementation of any technology. Therefore, it is crucial to determine the perception of end users at an early stage. This topic has never been addressed in Palestine. Our study aims to investigate the perception of Palestinian physicians towards the introduction of EPCM.

METHODS

This cross-sectional study was conducted among Palestinian physicians in the West Bank who are familiar with controlled medications prescribing. Data were collected using a self-administered questionnaire based on the Unified Theory of User Acceptance and Use of Technology (UTAUT) from a convenience sample of 300 physicians. Data were analyzed using SPSS version 26. Bivariate analysis and binary and multivariate logistic regression were performed to identify factors associated with physicians' perceptions of ECPM.

RESULTS

Most physicians expressed their willingness to use EPCM, with an acceptance rate of 85%. This perception was significantly affected by performance expectancy, effort expectancy and trust. None was moderated by age, gender, or experience with electronic prescribing. Age and specialization level were independent factors significantly influencing the intention to use EPCM. The level of current workflow challenges did not correlate with the intent to use EPCM.

CONCLUSION

Palestinian physicians will accept EPCM. Based on the results of this study, it is recommended that the following be considered: ensuring maximum efficiency of the system, selecting user-friendly interfaces and high-security measures to prevent system breaches.

Factors influencing the adoption of internet banking: An integration of ISSM and UTAUT with price value and perceived risk

The investigation of users' satisfactions and intentions in using the services provided by commercial banks needs to be focused on internet banking, since this is the widely used banking service. This paper analyzed the satisfactions and behavioral intentions of Malaysian customers in using Internet Banking, applying the Information System Success Model (ISSM) by the integration of adoption and application technology (UTAUT) theory. Some criteria, which were taken into consideration, are as follows: perceived Risk (PR), facilitating Conditions (FC), Price (PV), Performance expectancy (PE), Information Quality (IQ), Service Quality (SEQ), and System Quality (SQ). These aspects are important to measure customers' satisfaction and behavior toward Internet and Online Banking. A sample of 362 valid responses, consisting of Malaysian customers who used E-Banking, was used for the purpose of data collection. The relationship between customers' satisfaction and factors influencing their contentment in using Online Banking was investigated. In order to evaluate this, a model called “Structural Equation Model (SEM)” was developed and used. Findings showed that most of the Online Banking users were satisfied with the system. Hence, it proves that Online Banking System was generally accepted in the Malaysian community. However, this current research is solely focused on the Malaysian community. Therefore, it may provide the necessary grounds for the study of internet banking accreditation, some useful information for the practitioners, policy makers, and the researchers to improve the system of online banking in Malaysia only. For a future study, a more well-structured research, which can accommodate the global need, would be required.

Factors Influencing Continued Usage Behavior on Mobile Health Applications

(1) Background: As people pay more attention to health, mobile health applications (mHealth apps) are becoming popular. These apps offer health services that run on mobile devices to help improve users’ health behaviors. However, few studies explore what motivates users to continue to use these apps. This study proposes antecedents influencing users’ electronic satisfaction (e-satisfaction) and their continued behaviors of using mHealth apps. Based on the extended Unified Theory of Acceptance and Use of Technology (UTAUT2), this study constructs a research model including perceived reliability and online review to predict the continued usage behavior on mHealth apps in China; (2) Methods: We conduct an online survey to collect data from participants who have used mHealth apps. This study receives 327 valid responses and tests the research model using the partial least squares structural equation model approach; (3) Results: Our results find that antecedents positively affect continued usage intention through the mediation role of e-satisfaction with mHealth apps. Interestingly, this study reveals that habit positively affects the continued usage behavior and moderates the effect of e-satisfaction and continued intention of using mHealth apps; (4) Conclusions: This study presents theoretical implications on the extended UTAUT2 and provides practical implications understanding of managing mHealth apps in China.

Technology Acceptance in Healthcare: A Systematic Review

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.

Acceptance and usage of mHealth technologies amid COVID-19 pandemic in a developing country: the UTAUT combined with situational constraint and health consciousness

Purpose

The COVID-19 pandemic has created a devastating effect on public health. As “social distance” is a highly effective preventive measure of this pandemic, close contact between a patient and physician is strongly discouraged where possible. Consequently, mobile health (mHealth) technology is taking its momentum to fulfil this gap. The purpose of this study is, therefore, to empirically investigate the moderating as well as the direct role of situational constraint and health consciousness in the unified theory of acceptance and use of technology (UTAUT) constructs to understand the adoption and use behavior of mHealth care services amid pandemic.

Design/methodology/approach

Data were collected from existing mHealth users using an online survey questionnaire in Bangladesh. SmartPLS 3.0 and SPSS 23.0 were used for partial least squares-structural equation modeling.

Findings

Situational constraint and health consciousness both have strong direct positive effects on both behavioral intention (in all models) and use behavior (in Models 2 and 3). Further, this study revealed that effort expectancy remains insignificant in both direct and interaction effects whereas social influence becomes insignificant in interaction effects from direct significant effect (Models 1 and 2). Besides, the study reported that the relationship between behavioral intention and use behavior is moderated by situational constraint.

Originality/value

To the best of the authors’ knowledge, this study is the first in terms of mHealth empirical investigation considering the current pandemic situation. The incorporation of the situational constraint and health consciousness into the UTAUT model provides a holistic framework to understand the influence of the adoption and use behavior of mHealth amid pandemic.

The impact of technological alignment and advancement on firms’ project performance with mediating role of technology acceptance model

BACKGROUND: Nowadays, technology has become a vital capability for the organizations. It plays an essential role for all business operations and performances consequently it is crucial to uncover technological influence with respect to project performance. OBJECTIVES: This study examines the linkage of technological alignment (TAL) and technological advancement (TAD) on organizational project performance (OPP) with mediating influence of Technology Acceptance Model (TAM) considering two TAM attributes—perceived ease of use (PEOU) and perceived usefulness (PU) —. METHODS: Data were collected using a convenience sampling approach from the respondents associated with different business projects in China and analyzed using structural equation modeling and factor analysis. RESULTS: The findings affirmed the positive relationships of TAL and TAD on OPP. The study revealed the mediating influence of PEOU between TAL and OPP. The study further affirmed a positive mediation of PU between TAD and OPP, respectively. CONCLUSION: This study provides insights into how incorporation of technological and TAM tools—TAL, TAD, PEOU, and PU—may improve OPP of the organizations in today’s digital era. In addition, the study provides implications for the management and future opportunities for the researchers.

Doctors' Perceptions of E-Prescribing upon Its Mandatory Adoption in Poland, Using the Unified Theory of Acceptance and Use of Technology Method

Background: E-prescribing is the most important achievement in the automation of the healthcare sector in Poland. Obligatory electronic prescribing came into force on 8 January 2020. This innovation significantly changes the work of doctors. Therefore, it is useful to identify the factors that have an impact on doctors’ acceptance levels for the new technology. Methods: This study employs a survey based on the Unified Theory of Acceptance and Use of Technology (UTAUT) method. Our questionnaire was completed by 144 family doctors in Poland during the technology implementation phase and the initial period of obligatory e-prescribing, between 1 December 2019 and 1 March 2020. Results: The results of the survey indicate that doctors do not believe that e-prescribing improves the effectiveness of their work. In addition, this attitude does not depend on the age of the respondent. We also found, regarding the influence of societal attitudes, that doctors only rarely consider the opinions of others in relation to their job. Conclusions: The implementation of new technologies in the healthcare system must be accompanied by consideration of how user-friendly the technologies are, and whether the users will have appropriate technical and financial support.

Critical Factors Influencing the Intention to Adopt m-Government Services by the Elderly

While the elderly population is growing rapidly, acceptance and use of m-government services by them are far below expectation. Previous studies on acceptance and use of m-government services have predominantly focused on younger citizens with skills and experience of information technologies. Drawing upon the dual factor model, this study investigates the enablers and inhibitors of the elderly's m-government service adoption behavior. Four constructs from the unified theory of acceptance and use of technology (UTAUT), namely, performance expectancy, effort expectancy, facilitating conditions, social influence; and self-actualization are treated as enablers, while user resistance to change, technology anxiety, and declining physiological conditions are regarded as inhibitors. Results show that adoption of m-government by the elderly is significantly influenced by all tested enablers and inhibitors, except for social influence. This study contributes by providing an integrative model of technology acceptance for the elderly along with practical implications for policy makers.

Measuring the Effects of Risk and Cultural Dimensions on the Adoption of Online Stock Trading

Online stock trading (OST) is a growing phenomenon across countries, yet there is a sparse literature focusing on the negative utilities (risks) that causing the low adoption. Drawing from perceived risk theory, this article attempts to fill the gap by identifying the influential risk factors that impede the acceptance of OST in a developing country, Pakistan. The study also applies the Hofstede cultural theory to ascertain the effects of cultural moderators on investors' usage behavior (UB). Based on structured questionnaire, 443 valid responses were received from current and potential investors. The model was tested using structural equation modeling through Smart-PLS. The results validate a negative and significant relationship between risk dimensions and investors' behavioral intentions (BI) to use OST. Especially time, financial, performance, privacy and opportunity cost risks are found having a negative impact on investors' BI. Moreover, the study finds that cultural dimensions, collectivism, and uncertainty avoidance, moderate the relationship between BI and UB.