Factors affecting general practitioners' readiness to accept and use an electronic health record system in the republic of north Macedonia: a national survey of general practitioners

Background: Electronic health records (EHRs) represent an important aspect of digital health care, and to promote their use further, we need to better understand the drivers of their acceptance among health care professionals. EHRs are not simple computer applications; they should be considered as a highly integrated set of systems. Technology acceptance theories can be used to better understand users' intentions to use EHRs. It is recommended to assess factors that determine the future acceptance of a system before it is implemented. Objective: This study uses a modified version of the Unified Theory of Acceptance and Use of Technology with the aim of examining the factors associated with intentions to use an EHR application among general practitioners (GPs) in the Republic of North Macedonia, a country that has been underrepresented in extant literature. More specifically, this study aims to assess the role of technology acceptance predictors such as performance expectancy, effort expectancy, social influence, facilitating conditions, job relevance, descriptive norms, and satisfaction with existing eHealth systems already implemented in the country. Methods: A web-based invitation was sent to 1174 GPs, of whom 458 completed the questionnaire (response rate=40.2%). The research instrument assessed performance expectancy, effort expectancy, facilitating conditions, and social influence in relation to the GPs' intentions to use future EHR systems. Job relevance, descriptive norms, satisfaction with currently used eHealth systems in the country, and computer/internet use were also measured. Results: Hierarchical linear regression analysis showed that effort expectancy, descriptive norms, social influence, facilitating conditions, and job relevance were significantly associated with intentions to use the future EHR system, but performance expectance was not. Multiple mediation modeling analyses further showed that social influence (z=2.64; P<.001), facilitating conditions (z=4.54; P<.001), descriptive norms (z=4.91; P<.001), and effort expectancy (z=5.81; P=.008) mediated the association between job relevance and intentions. Finally, moderated regression analysis showed that the association between social influence and usage intention was significantly moderated (P=.02) by experience (Bexperience×social influence=.005; 95% CI 0.001 to 0.010; β=.080). In addition, the association between social influence and intentions was significantly moderated (P=.02) by age (Bage×social influence=.005; 95% CI 0.001 to 0.010; β=.077). Conclusions: Expectations of less effort in using EHRs and perceptions on supportive infrastructures for enabling EHR use were significantly associated with the greater acceptance of EHRs among GPs. Social norms were also associated with intentions, even more so among older GPs and those with less work experience. The theoretical and practical implications of these findings are also discussed

The Trajectory of IT in Healthcare at HICSS: A Literature Review, Analysis, and Future Directions

Research has extensively demonstrated that healthcare industry has rapidly implemented and adopted information technology in recent years. Research in health information technology (HIT), which represents a major component of the Hawaii International Conference on System Sciences, demonstrates similar findings. In this paper, review the literature to better understand the work on HIT that researchers have conducted in HICSS from 2008 to 2017. In doing so, we identify themes, methods, technology types, research populations, context, and emerged research gaps from the reviewed literature. With much change and development in the HIT field and varying levels of adoption, this review uncovers, catalogs, and analyzes the research in HIT at HICSS in this ten-year period and provides future directions for research in the field

Technology validation for e-trial systems

This research study presents a Hypothesised Model, developed on the basis of the Unified Theory of Acceptance and Use of Technology (UTAUT). Its aim is to evaluate innovative Health Information Technology (HIT) at the early stages of projects. It is contended that this practice would support system developers at the design and implementation phases, and reduce the risk of underutilisation or rejection. The performance of the model was tested in three studies within the Clinical Trial Management Systems framework. The Hypothesised Model approaches Behavioural Intention from a socio-technical point of view, taking into consideration the complexity and need of HIT to achieve joint optimisation. Moreover, it simplifies and extends UTAUT so that it may fit soundly within the healthcare context. Hence, it excludes the moderators and adds three core constructs, including: System-Specific Features, Technology Anxiety, and Adaptation Timeline. However, the model is easily adjustable to fit specific situations, especially given that this research study posits the non-existence of a single model that suits all situations. This approach appears to have improved the final outcome and outperformed the use of generic models within the healthcare context. The total explained variance reported from the three studies is: (76%), (86%), and (87%) respectively

A COMPREHENSIVE MODEL TO EXPLAINING USERS’ ACCEPTANCE AND INTENTION TO USE ELECTRONIC HEALTH RECORDS(EHR)IN REHABILITATION FACILITIES IN SAUDI ARABIA

This study provided a literature-based model that was developed by using a general and cumulative approach to explain user attitudes toward EHR. The model embodies the Theory of Reasoned Action (TRA), the Technology Acceptance Model (TAM), and the barriers that hinder users from proper use of the EHR system. Dimensions related to Human, Technological, Organizational, Professional, Legal, and Financial sources of influence were identified and tested in a special care setting. Because rehabilitation care facilities require an interdisciplinary (interactive) and multidisciplinary (additive) care approach, they pose an extra challenge. The current situation of the Saudi healthcare system demands a transition to a more connected and integrated system among different facilities of a single provider and across different providers. This situation underscores the need to have EHR in place and demands that particular attention be paid to user acceptance of the system. Thus, current and potential users of EHR in Saudi Arabia were targeted and asked to rate the importance of each source of influence on their attitudes toward EHR. The sample size was 319, comprising respondents from more than 20 hospitals and rehabilitation care facilities, and 263 responses were eligible for statistical analysis. Examining the model revealed that human, technological, organizational, and professional dimensions are the necessary and sufficient predictors for users in the tested settings. This calls for raising awareness of EHR and its anticipated benefits and difficulties. Continuous learning and ongoing training sessions are key aspects in attaining users’ acceptance of EHR. The findings of this study also call for developing policies and legal procedures to regulate the use of EHR in Saudi Arabia by establishing a national regulator and enforcement bodies to oversee issues related to system security and patient privacy. Furthermore, it is worth proposing an act or policy (stimuli) to promote the adoption and meaningful use of EHR and to keep costs of EHR low, especially for the private sector. Regarding future directions, the proposed model is to be taken to different levels and examined in different care settings, geographic areas, and with different technologies, including but not limited to mHealth, cloud computing, and telehealth