Understanding User Resistance to Information Technology: Toward A Comprehensive Model in Health Information Technology

The successful implementation of health information systems is expected to increase legibility, reduce medical errors, boost the quality of healthcare and shrink costs. Yet, evidence points to the fact that healthcare professionals resist the full use of these systems. Physicians and nurses have been reported to resist the system. Even though resistance to technology has always been identified as key issue in the successful implementation of information technology, the subject remains largely under-theorized and deficient of empirical testing. Only two proposed model have been tested so far. Hence, though user resistance is clearly identified and defined in literature, not very much is known about its antecedents; and about how and why it comes about. This study seeks therefore, to fill this gap. If organizational change managers must go past the hurdle of under-utilized systems, low productivity and the high implementation costs associated with them, a clear understanding of the very nature of resistance is important. The following questions are investigated: (1) why do healthcare personnel resist health information technology? (2) What are the antecedents of perceived threats to health information technology? And, (3) does user resistance vary across healthcare professions? The study utilizes the theory of psychological reactance, the cognitive dissonance theory, the extended technology acceptance model and other relevant theories to build on the Lapointe and Rivard (2005) resistance framework. The resulting theoretical model is further tested empirically using primary data. Partial Least Squares technique will be used to analyze data and findings would be discussed. This work is expected to contribute to both our understanding of the resistance theory—through the extension of current theory—as well as provide useful tools for change practitioners to mitigate the phenomenon and improve electronic health records implementation outcomes

The Nature and Role of Perceived Threats in User Resistance to Healthcare Information Technology: A Psychological Reactance Theory Perspective

The efforts of the United States government in the past 15 years have included harnessing the power of health information technology (HIT) to improve legibility, lessen medical errors, keep costs low, and elevate the quality of healthcare. However, user resistance is still a barrier to overcome in order to achieve desired outcomes. Understanding the nature of resistance is key to successfully increasing the adoption of HIT systems. Previous research has showed that perceived threats are a significant antecedent of user resistance; however, its nature and role have remained vastly unexplored. This study uses the psychological reactance theory to explain both the nature and role of perceived threats in HIT-user resistance. The study shows that perceived helplessness over process and perceived dissatisfaction over outcomes are two unique instances of perceived threats. Additionally, the results reveal that resistance to healthcare information systems can manifest as reactance, distrust, scrutiny, or inertia. The theoretical and practical implications of the findings are discussed

E-Book Acceptance among Undergraduate Students: A Look at the Moderating Role of Technology Innovativeness

This paper utilizes the technology acceptance model (TAM) to uncover the moderating roles of technology innovativeness. A study of 158 undergraduate students revealed that the original TAM constructs and relationships were reliable, supported, and applicable in the measurement of e-book acceptance. Interestingly, personal technology innovativeness was found to moderate in a significant way, the relationship between behavioral intention to use e-book and actual usage of e-book. These findings suggest that while individuals who are more open to technology (adopters) as well as less technologically innovative individuals (late adopters and non-adopters) are likely to have the intention to use webbased instructional technologies like e-book, only highly innovative individuals, may actually translate intention into actual usage. These results have serious implications on adopters, implementers and users of instructional technologies who would need to factor into their decision-making the role of the individual technology innovativeness of its users

The Effects of Technology Innovativeness and System Exposure on Student Acceptance of E-textbooks

The efforts of educators in the last three decades have, among other things, focused on the use of information technology (IT) in education. It has become commonplace to view information systems both as an effective carrier of course content as well as a cost-effective tool to improve student learning outcomes. One of such technologies is the e-book. Decision-makers in the education field need make sense of this technological transformation. However, despite the growing popularity of e-books in higher education, its adoption by students is yet to be crystalized. This study exploits the technology acceptance model (TAM) framework to examine student acceptance of e-textbooks as “internally” impacted by technology innovativeness and “externally” influenced by system exposure. The results showed that students’ technology innovativeness is associated with student acceptance of e-textbooks and that system exposure was a strong moderator of the TAM relationships. The findings suggest that students’ openness to new technology, in general, is likely to positively affect the adoption of a specific new instructional technology. Additionally, system exposure was found to be a significant moderator of the TAM relationships. It is concluded that students’ technology innovativeness and system exposure must therefore be factored into instructional technology usage decision-making models