ADOPTION OF TELEHEALTH BY HEALTHCARE PROFESSIONALS: AN OVERVIEW OF THEORETICAL MODELS AND THEIR APPLICATION

It has long been advocated that Information and Communication Technology (ICT) offers a huge potential to answer many of the challenges that the healthcare sector is facing. Therefore, information technology applications are abundantly present in healthcare sector. ICT applications promise efficient tools to collect, store, process and communicate health-related data and information. In that respect, it is believed that ICT could improve safety, quality, and costefficiency of healthcare services. For this reason, the integration of ICT into the health system constitutes a priority for many countries given regional disparities in the availability of health care services and in the distribution of health care human resources. However, telehealth adoption by healthcare professionals still represents a challenge. Indeed, the recognition of the utility of telemedicine by managers will not justify its adoption by physicians if they are reluctant to its use. In that sense, physicians’ lack of acceptance of the technology represents one of the main reasons why telemedicine implementation projects have failed. This paper presents an overview of the theoretical models that have been applied to the study of ICT adoption in the specific sector of healthcare, presents a synthesis of actual knowledge on factors involved in ICT adoption among healthcare professionals, and identifies key elements to design strategies aimed at optimizing the use of telehealth in healthcare settings

The Interplay of Facilitating Conditions and Organizational Settings in the Acceptance of Teleconsultation Technology in Public Hospitals in Malaysia

This research explores users’ intention to use teleconsultation technology. The study also explores the influence of facilitating conditions on the acceptance of the technology in the health care environment in Malaysia. Further, the study compares the level of user acceptance in two organizational settings: (1) between emergency and non-emergency environment, and (2) between referring and referral hospital. This research presumes on the basis of exploratory and descriptive study engaging a survey of healthcare providers who practice in public hospitals in Malaysia. The study reports a high level of acceptance and acceptable extent of facilitating conditions of teleconsultation technology. Thus, some facilitating conditions demonstrate significant correlations with the acceptance of teleconsultation. Interestingly, the study exhibits valuable insights concerning the acceptance of teleconsultation technology in the respective settings being compared. Overall, the findings provide useful insights for both practitioners and future researchers of health information technology adoption studies in the relevant context

Exploring Factors That Affect Teleconsultation Adoption: In The Case Of Malaysia

This study identifies the factors that could affect the adoption of teleconsultation technology in public hospitals in Malaysia from the qualitative standpoint. Based on theory-driven and prior-research approach, a conceptual framework was developed and used to facilitate the data collection and analysis processes. The underlying framework derived from a consideration of integrated model of established technology acceptance and diffusion theories and also findings of published telemedicine studies. Semi-structured interviews involving twenty eight key informants coupled with reviews of relevant documents were conducted within eleven participating hospitals to examine the key issues addressed in the framework which subsequently entailed thematic analysis. A summary of six themes and sub-themes drawn upon a priori issues appeared from the patterning of the responses were found to be of great importance in describing teleconsultation adoption phenomenon in Malaysia. Most respondents perceived teleconsultation as beneficial and useful for delivering health services. However the central issues appeared to be more focused on the actual need for the technology, perceived trust in technology and subsistence of facilitating conditions in explaining the way teleconsultation is utilized, suggesting more rigorous research should be conducted to uncover and acknowledge the actionable factors that potentially influence teleconsultation and health information technology adoption

Multi-level analysis of electronic health record adoption by health care professionals: A study protocol

<p>Abstract</p> <p>Background</p> <p>The electronic health record (EHR) is an important application of information and communication technologies to the healthcare sector. EHR implementation is expected to produce benefits for patients, professionals, organisations, and the population as a whole. These benefits cannot be achieved without the adoption of EHR by healthcare professionals. Nevertheless, the influence of individual and organisational factors in determining EHR adoption is still unclear. This study aims to assess the unique contribution of individual and organisational factors on EHR adoption in healthcare settings, as well as possible interrelations between these factors.</p> <p>Methods</p> <p>A prospective study will be conducted. A stratified random sampling method will be used to select 50 healthcare organisations in the Quebec City Health Region (Canada). At the individual level, a sample of 15 to 30 health professionals will be chosen within each organisation depending on its size. A semi-structured questionnaire will be administered to two key informants in each organisation to collect organisational data. A composite adoption score of EHR adoption will be developed based on a Delphi process and will be used as the outcome variable. Twelve to eighteen months after the first contact, depending on the pace of EHR implementation, key informants and clinicians will be contacted once again to monitor the evolution of EHR adoption. A multilevel regression model will be applied to identify the organisational and individual determinants of EHR adoption in clinical settings. Alternative analytical models would be applied if necessary.</p> <p>Results</p> <p>The study will assess the contribution of organisational and individual factors, as well as their interactions, to the implementation of EHR in clinical settings.</p> <p>Conclusions</p> <p>These results will be very relevant for decision makers and managers who are facing the challenge of implementing EHR in the healthcare system. In addition, this research constitutes a major contribution to the field of knowledge transfer and implementation science.</p

Nurses' and community support workers' experience of telehealth: A longitudinal case study

Copyright © 2014 Sharma and Clarke; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.This article has been made available through the Brunel Open Access Publishing Fund.Background - Introduction of telehealth into the healthcare setting has been recognised as a service that might be experienced as disruptive. This paper explores how this disruption is experienced. Methods - In a longitudinal qualitative study, we conducted focus group discussions prior to and semi structured interviews post introduction of a telehealth service in Nottingham, U.K. with the community matrons, congestive heart failure nurses, chronic obstructive pulmonary disease nurses and community support workers that would be involved in order to elicit their preconceptions and reactions to the implementation. Results - Users experienced disruption due to the implementation of telehealth as threatening. Three main factors add to the experience of threat and affect the decision to use the technology: change in clinical routines and increased workload; change in interactions with patients and fundamentals of face-to-face nursing work; and change in skills required with marginalisation of clinical expertise. Conclusion - Since the introduction of telehealth can be experienced as threatening, managers and service providers should aim at minimising the disruption caused by taking the above factors on board. This can be achieved by employing simple yet effective measures such as: providing timely, appropriate and context specific training; provision of adequate technical support; and procedures that allow a balance between the use of telehealth and personal visit by nurses delivering care to their patients

The relevance of telehealth across the digital divided the transfer of knowledge over distance

This paper explores the concept of Relevance as an explanatory factor to the diffusion of ITuse, or, in this paper particularly, the use of Telehealth. Relevance is the net value of performance expectancy and effort expectancy and contains both micro-relevance (i.e. here-and-now) and macro-relevance (i.e. actual goals) Following the case-study approach, two Telehealth situations were studied in Rwanda and The Netherlands. In the comparison, two more existing studies in Canada and Tanzania were included. The conclusion is that Relevance is the explanatory factor, whereas particularly micro-relevance is crucial. Without the micro-relevant occasions that initiate use, there will be no use on longer term In the cases studied the micro-relevance of knowledge-transfer was crucial. Furthermore distance determined Telehealth relevance. Practical conclusions to cases were drawn

From recommendation to action: psychosocial factors influencing physician intention to use Health Technology Assessment (HTA) recommendations

BACKGROUND: Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy-makers. Using a psychosocial theoretical framework, this study aimed at exploring the factors affecting physician intention to adopt HTA recommendations. The selected recommendations were prioritisation systems for patients on waiting lists for two surgical procedures: hip and knee replacement and cataract surgery. METHODS: Determinants of physician intention to use HTA recommendations for patient prioritisation were assessed by a questionnaire based upon the Theory of Interpersonal Behaviour. A total of 96 physicians from two medical specialties (ophthalmology and orthopaedic surgery) responded to the questionnaire (response rate 44.2%). A multiple analysis of variance (MANOVA) was performed to assess differences between medical specialties on the set of theoretical variables. Given the main effect difference between specialties, two regression models were tested separately to assess the psychosocial determinants of physician intention to use HTA recommendations for the prioritisation of patients on waiting lists for surgical procedures. RESULTS: Factors influencing physician intention to use HTA recommendations differ between groups of specialists. Intention to use the prioritisation system for patients on waiting lists for cataract surgery among ophthalmologists was related to attitude towards the behaviour, social norms, as well as personal normative beliefs. Intention to use HTA recommendations for patient prioritisation for hip and knee replacement among orthopaedic surgeons was explained by: perception of conditions that facilitated the realisation of the behaviour, personal normative beliefs, and habit of using HTA recommendations in clinical work. CONCLUSION: This study offers a model to assess factors influencing the intention to adopt recommendations from health technology assessment into professional practice. Results identify determinant factors that should be considered in the elaboration of strategies to support the implementation of evidence-based practice, with respect to emerging health technologies and modalities of practice. However, it is important to emphasise that behavioural determinants of evidence-based practice vary according to the specific technology considered. Evidence-based implementation of HTA recommendations, as well as other evidence-based practices, should build on a theoretical understanding of the complex forces that shape the practice of healthcare professionals

Telemedicine Adoption and Sustainability in Extreme Resource Poor Countries

The value and importance of telemedicine and adoption in developed countries is growing, especially due to an increase in m-health applications. In resource poor communities and developing countries often telemedicine is adopted because it is the only available option. The scarcity of medical professionals and equipment, distances between care centers, and the high cost for obtaining medical care makes telmedicine an increasingly attractive solution. This paper reports on the need for a new model for telemedicine adoption in extreme resource poor countries. The authors made several service and research trips to Haiti between 2014 and 2015. We observed that the adoption theories used in developed countries like the US do not adequately describe the adoption process in Haiti. Based on our findings and experience in Haiti we propose a new adoption model for extreme resource poor countries

Understanding the Impact of the Cultural Factors on Hospital Information System Acceptance: A Literature Review and Proposal of a New Model

The behavioural intention to accept information system technologies remains an interesting research field for information system management specialists and researchers. However, the cultural dimension has rarely been treated by researchers in the healthcare context. This paper focuses on identifying the impact of national culture on users’ intention to accept the Hospital Information System in public healthcare establishments in Morocco. Thus, we propose a research model which is based on a strong literature review, taking into consideration the previous studies’ recommendations and limitations. The proposed model was developed through the extension of the Technology Acceptance Model (TAM) (Davis, 1989), by Hofstede’s cultural dimensions

Assessing hospital physicians' acceptance of clinical information systems : a review of the relevant literature

In view, of the tremendous potential benefits of clinical information systems (CIS) for the quality of patient care; it is hard to understand why not every CIS is embraced by its targeted users, the physicians. The aim of this study is to propose a framework for assessing hospital physicians' CIS-acceptance that can serve as a guidance for future research into this area. Hereto, a review of the relevant literature was performed in the ISI Web-of-Science database. Eleven studies were withheld from an initial dataset of 797 articles. Results show that just as in business settings, there are four core groups of variables that influence physicians' acceptance of a CIS: its usefulness and ease of use social norms, and factors in the working environment that facilitate use of the CIS (such as providing computers/workstations, compatibility between the new and existing system...). We also identified some additional variables as predictors of CIS-acceptance