An appraisal of Nursing Informatics Research and the Influence of the Unified Theory of Acceptance and Use of Technology

Abstract The study recognized the importance of healthcare informatics in today’s dynamic health systems, and narrows down to how nursing informatics, a component of healthcare informatics, can provide efficient and effective healthcare delivery. Hence, underpinned by the unified theory of acceptance and use of technology (UTAUT), the study aimed at situating research activities on nursing informatics within existing studies that have applied the theory to investigate healthcare informatics in general. The study adopted a systematic review of literature to explored online databases: Google Scholar and Ebscohost from 2014 to 2019. The search returned a total of 205 articles for the specified period. However, only 8 eligible studies were found to be related specifically to nursing informatics. The study also revealed that performance expectancy and effort expectancy (respectively), both being constructs of the UTAUT, are the dominating factors influencing the acceptance/adoption/use of nursing informatics among the papers under review. The study recommends that researchers should further explore the use of nursing informatics technologies in healthcare. In addition; nursing informatics system designers should factor in the effectiveness and ease of use of the technologies for easy usage. On the other hand, the stakeholders in medical field are called upon to provide the enabling infrastructure to enhance the use of nursing informatics technologies

Investigating Evaluation Frameworks for Electronic Health Record: A Literature Review

BACKGROUND: There are various electronic health records (EHRs) evaluation frameworks with multiple dimensions and numerous sets of evaluation measures, while the coverage rate of evaluation measures in a common framework varies in different studies. AIM: This study provides a literature review of the current EHR evaluation frameworks and a model for measuring the coverage rate of evaluation measures in EHR frameworks. METHODS: The current study was a comprehensive literature review and a critical appraisal study. The study was conducted in three phases. In Phase 1, a literature review of EHR evaluation frameworks was conducted. In Phase 2, a three-level hierarchical structure was developed, which includes three aspects, 12 dimensions, and 110 evaluation measures. Subsequently, evaluation measures in the identified studies were categorized based on the hierarchical structure. In Phase 3, relative frequency (RF) of evaluation measures in different dimensions and aspects for each of the identified studies were determined and categorized as follows: Appropriate, moderate, and low coverage. RESULTS: Out of a total of 8276 retrieved articles, 62 studies were considered relevant. The RF range in the second and third level of the hierarchical structure was between 8.6%–91.94% and 0.2%–61%, respectively. “Ease of use” and “system quality” were the most frequent evaluation measure and dimension. Our results indicate that identified studies cover at least one and at most nine evaluation dimensions and current evaluation frameworks focus more on the technology aspect. Almost in all identified studies, evaluation measures related to the technology aspect were covered. However, evaluation measures related to human and organization aspects were covered in 68% and 84% of the identified studies, respectively. CONCLUSION: In this study, we systematically reviewed all literature presenting any type of EHR evaluation framework and analyzed and discussed their aspects and features. We believe that the findings of this study can help researchers to review and adopt the EHR evaluation frameworks for their own particular field of usage

Factors influencing nurses' acceptance of hospital information systems in Iran: application of the Unified Theory of Acceptance and Use of Technology

Abstract User acceptance is a precondition for successful implementation of hospital information systems (HISs). Increasing investment in information technology by healthcare organisations internationally has made user acceptance an important issue in technology implementation and management. Despite the increased focus on hospital information systems, there continues to be user resistance. The present study aimed to investigate the factors affecting hospital information systems nurse-user acceptance of HISs, based on the Unified Theory of Acceptance and Use of Technology (UTAUT), in the Shiraz University of Medical Sciences teaching hospitals. A descriptive-analytical research design was employed to study nurses' adoption and use of HISs. Data collection was undertaken using a cross-sectional survey of nurses (n=303). The research model was examined using the LISREL path confirmatory modeling. The results demonstrated that the nurses' behavioural intention (BI) to use hospital information systems was predicted by Performance Expectancy (PE) (β= 2.34, p<0.01), Effort Expectancy (EE) (β= 2.21, p<0.01), Social Influence (SI) (β= 2.63, p<0.01) and Facilitating Conditions (FC) (β= 2.84, p<0.01). The effects of these antecedents of BI explained 72.8% of the variance in nurses' intention to use hospital information systems (R 2 = 0.728). Application of the research model suggested that nurses' acceptance of HISs was influenced by performance expectancy, effort expectancy, social influence and facilitating conditions, with performance expectancy having the strongest effect on user intention

The Impacts of Role Overload and Role Conflict on Physicians\u27 Technology Adoption

Technology adoption is an important solution for physicians to increase work efficiency, and thus deal with role conflict among their multiple job roles. Prior studies have not investigated how multiple job roles and role conflict influence physicians’ technology adoption intentions. Based on role strain theory and role identity theory, we present a model of physicians’ technology adoption intentions to support their primary (clinical care) versus secondary (teaching or research) job roles. We test the model using surveys with 156 physicians at nine medical schools in Korea. The results of our data analysis largely support our hypotheses. Role overload in each of their job roles increases role conflict between any pair of associated roles. Furthermore, role conflict between a physician’s primary and secondary role is affected more by role overload in the secondary role than by overload in the primary role. Moreover, the impact of role conflict on technology adoption intentions is also influenced by the hierarchical relationship between two roles. This study contributes to technology adoption research by demonstrating how physicians’ job characteristics affect technology adoption

Using the UTAUT Model to Determine Factors Affecting Acceptance and Use of Mobile Health (mHealth) Services in Bangladesh

mHealth is one of the most promising technologies that has emerged in recent years and could prove to have considerable value to both health services providers and patients for achieving the sustainable development goals (SDGs). But, the adoption of mHealth faces many challenges and barriers, including cultural, technological, personal, organizational and social issues which must be addressed and treated carefully by mHealth services providers. The aim of this study is to identify the critical factors affecting the adoption of mHealth in healthcare system of Bangladesh by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) model to include perceived reliability and price value. A cross sectional survey questionnaire was used to collect data from 296 participants from different public and private hospitals in Dhaka city of Bangladesh. Result demonstrates that performance expectancy, effort expectancy, social influence, facilitating condition & perceived reliability had significant influence on the intention to adopt mHealth services in Bangladesh. Surprisingly, price value (p>0.05) had no significant influence on adoption of mHealth services. With the proposed model, it is possible to develop better mHealth services to meet the requirements of the common people based on widely available smartphone. The findings of this study will be beneficial for the government agencies, mobile phone operators, policy makers, healthcare providers and NGOs in developing countries

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

Social, Organizational, and Technological Factors Impacting Clinicians’ Adoption of Mobile Health Tools: A Systematic Literature Review

Background: There is a growing body of evidence highlighting the potential of mobile health (mHealth) in reducing health care costs, enhancing access, and improving the quality of patient care. However, user acceptance and adoption are key prerequisites to harness this potential; hence, a deeper understanding of the factors impacting this adoption is crucial for its success. Objective: The aim of this review was to systematically explore relevant published literature to synthesize the current understanding of the factors impacting clinicians’ adoption of mHealth tools, not only from a technological perspective but also from social and organizational perspectives. Methods: A structured search was carried out of MEDLINE, PubMed, the Cochrane Library, and the SAGE database for studies published between January 2008 and July 2018 in the English language, yielding 4993 results, of which 171 met the inclusion criteria. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and the Cochrane handbook were followed to ensure a systematic process. Results: The technological factors impacting clinicians’ adoption of mHealth tools were categorized into eight key themes: usefulness, ease of use, design, compatibility, technical issues, content, personalization, and convenience, which were in turn divided into 14 subthemes altogether. Social and organizational factors were much more prevalent and were categorized into eight key themes: workflow related, patient related, policy and regulations, culture or attitude or social influence, monetary factors, evidence base, awareness, and user engagement. These were divided into 41 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. Conclusions: The study results can help inform mHealth providers and policymakers regarding the key factors impacting mHealth adoption, guiding them into making educated decisions to foster this adoption and harness the potential benefits

Development of implementation models for hospital information system (HIS) in Malaysian public hospitals

Studies have shown that Hospital Information System (HIS) implementation improve hospital’s management and activities in terms of cost and time reductions. However, there are only 15.2% out of 138 Malaysian Public Hospitals implemented HIS. Literatures have further highlighted various issues and challenges with regards to its implementation. Therefore, this study aimed to explore the implementation of THIS, IHIS and BHIS’s hospitals as well as factors affecting them. This study employed a mixed methods approach to answer the research objectives. In the first phase of this study, semi-structured interviews were conducted with nine participants consisted of the hospital directors, Information Technology officers and HIS users. It is found that THIS’s hospital implementation phases differed from IHIS and BHIS’s hospitals, while IHIS and BHIS’s hospitals have similar phases based on Business Interaction Phases of Business Action Theory. Human context was discovered to play important roles in the HIS implementation. A survey was conducted in the second phase of this study among HIS users at different categories of HIS’s hospitals. Two hundred and twenty-nine questionnaires were returned to yield a response rate of 45.8%. Based on ANOVA findings, factors affecting THIS implementation were significantly different from those in IHIS and BHIS’s hospitals. There was no significance different between IHIS and BHIS’s hospitals. There are three major contributions of this study: 1) Distinctive implementation phases for THIS hospital and IHIS-BHIS hospital were discovered for HIS implementation. 2) New models of HIS implementation which highlight the Human context were proposed, and 3) Different factors were found to affect HIS implementation at different types of HIS’s hospitals

THE CHALLENGES OF HOSPITAL INFORMATION SYSTEM IMPLEMENTATION: A CASE STUDY OF A PUBLIC HOSPITAL IN INDONESIA

The Indonesian government has mandated using the Hospital Information System (HIS) since 2013. Until now, not all hospitals in Indonesia have implemented HIS, however. Some barriers have prevented them from applying HIS. This study explores the opportunities and barriers regarding implementing the Hospital Information System (HIS) in Indonesia through a public hospital case study. This study applied a qualitative approach. The approach used interviews to gather data using a pre-tested interview guideline. The guideline used several constructs to structure the questions, i.e., predisposing, enabling, reinforcing, barrier, and projected behavior. Participants were different types of HIS users in the studied hospital, i.e., physician, nurse, pharmacist, administrators, laboratory personnel, and Information Technology (IT) personnel. Data were transcribed verbatim and analyzed thematically. The interviews involved twenty-one participants. Nine themes describe HIS implementation challenges in this case study, i.e., familiarity, flexibility, empowerment, discipline, facilities, data sharing, quality assurance, pragmatism, and capacity building. Pragmatism could be a barrier, while the other values would be opportunities. These challenges are promising in guiding HIS implementation success. The values found in this study convince that HIS implementation in Indonesia is promising. Those challenges are required to be taken into account to  implement  HIS successfully