Adoption of telemedicine technology by health care organizations: An exploratory study

Recent advances in information and biomedicine technology have significantly increased the technical feasibility, clinical viability, and economic affordability of telemedicine-enabled service collaboration and delivery. Health care organizations around the world have become increasingly interested in acquiring and implementing telemedicine technology to improve or extend existing patient care and services. The ultimate success of telemedicine in an adopting organization requires adequate attention to both technological and managerial issues. This study examined organizational technology adoption, an essential management issue facing many health care organizations interested in or currently evaluating telemedicine. On the basis of a framework proposed by Tornatzky and Fleischer [1], we developed a research model for targeted technology adoption and empirically evaluated it in a survey study that involved most of the public health care organizations in Hong Kong. Results from our exploratory study suggest that the model exhibits reasonable significance and explanatory utility to differentiate between adopting and nonadopting organizations. Specifically, the collective attitude of medical staff and perceived service risks were found to be significant determinants of targeted technology adoption. Several research and management implications that emerged from our study findings are also discussed.published_or_final_versio

Variation in the psychosocial determinants of the intention to prescribe hormone therapy prior to the release of the Women's Health Initiative trial: a survey of general practitioners and gynaecologists in France and Quebec

BACKGROUND: Theory-based approaches are advocated to improve our understanding of prescription behaviour. This study is an application of the theory of planned behaviour (TPB) with additional variables. It was designed to assess which variables were associated with the intention to prescribe hormone therapy (HT). In addition, variations in the measures across medical specialities (GPs and gynaecologists) and across countries (France and Quebec) were investigated. METHODS: A survey among 2,000 doctors from France and 1,044 doctors from Quebec was conducted. Data were collected by means of a self-administered questionnaire. A clinical vignette was used to elicit doctors' opinions. The following TPB variables were assessed: attitude, subjective norm, perceived behavioural control, attitudinal beliefs, normative beliefs and power of control beliefs. Additional variables (role belief, moral norm and practice pattern-related factors) were also assessed. A stepwise logistic regression was used to assess which variables were associated with the intention to prescribe HT. GPs and gynaecologists were compared to each other within countries and the two countries were compared within the specialties. RESULTS: Overall, 1,085 doctors from France returned their questionnaire and 516 doctors from Quebec (response rate = 54% and 49%, respectively). In the overall regression model, power of control beliefs, moral norm and role belief were significantly associated with intention (all at p < 0.0001). The models by specialty and country were: for GPs in Quebec, power of control beliefs (p < 0.0001), moral norm (p < 0.01) and cytology and hormonal dosage (both at p < 0.05); for GPs in France, power of control beliefs and role belief (both at p < 0.0001) and perception of behavioural control (p < 0.05) and cessation of menses (p < 0.01); for gynaecologists in Quebec, moral norm and power of control beliefs (both at p = 0.01); and for gynaecologists in France, power of control beliefs (p < 0.0001), and moral norm, role belief and lipid profile (all at p < 0.05). CONCLUSION: In both countries, compared with GPs, intention to prescribe HT was higher for gynaecologists. Psychosocial determinants of doctors' intention to prescribe HT varied according to the specialty and the country thus, suggesting an influence of contextual factors on these determinants

Information technology acceptance by individual professionals: A model comparison approach

The proliferation of innovative and exciting information technology applications that target individual "professionals" has made the examination or re-examination of existing technology acceptance theories and models in a "professional" setting increasingly important. The current research represents a conceptual replication of several previous model comparison studies. The particular models under investigation are the Technology Acceptance Model (TAM), the Theory of Planned Behavior (TPB), and a decomposed TPB model, potentially adequate in the targeted healthcare professional setting. These models are empirically examined and compared, using the responses to a survey on telemedicine technology acceptance collected from more than 400 physicians practicing in public tertiary hospitals in Hong Kong. Results of the study highlight several plausible limitations of TAM and TPB in explaining or predicting technology acceptance by individual professionals. In addition, findings from the study also suggest that instruments that have been developed and repeatedly tested in previous studies involving end users and business managers in ordinary business settings may not be equally valid in a professional setting. Several implications for technology acceptance/adoption research and technology management practices are discussed.link_to_subscribed_fulltex

Physician acceptance of telemedicine technology: An empirical investigation

Fast-growing interest in telemedicine and increased investment in its enabling technology have made physician technology acceptance a growing concern for development and management of telemedicine. At the dawn of large-scale technology implementation by health care organizations around the globe, it is essential to understand physicians' attitudes toward use of telemedicine technology and their intention to use the technology. In this study, we used Theory of Planned Behavior to investigate technology acceptance among physicians who practiced in public tertiary hospitals in Hong Kong. Our data supported the investigated theory and the results suggest that attitude and perceived behavioral control are crucial to physician technology acceptance. Overall, physicians showed positive attitudes toward use of telemedicine technology and exhibited moderate intention to use the technology, primarily for clinical purposes. Implications for development and management of telemedicine also are discussed.link_to_subscribed_fulltex

Technology implementation for telemedicine programs

The technology implementation of telemedicine program management to exchange medical information for the provision of health care services is discussed. The Hong Kong telemedicine programs has achieved the vertical integration of patient care and management services with regard to consultation or patient assessment and management. The role of a motivated and determined clinical administrator was found to be critical to telemedicine technology implementation. The effective management of technology implementation can remove fundamental obstacles to program success.link_to_subscribed_fulltex

Investigating healthcare professionals' decisions to accept telemedicine technology: An empirical test of competing theories

The proliferation of information technology (IT) in supporting highly specialized tasks and services has made it increasingly important to understand the factors essential to technology acceptance by individuals. In a typical professional setting, the essential characteristics of user, technology, and context may differ considerably from those in ordinary business settings. This study examined physicians' acceptance of telemedicine technology. Following a theory comparison approach, it evaluated the extent to which prevailing intention-based models, including the technology acceptance model (TAM), the theory of planned behavior (TPB) and an integrated model, could explain individual physicians' technology acceptance decisions. Based on responses from more than 400 physicians, both models were evaluated in terms of overall fit, explanatory power, and their causal links. Overall, findings suggest that TAM may be more appropriate than TPB for examining technology acceptance by individual professionals and that the integrated model, although more fully depicting physicians' technology acceptance, may not provide significant additional explanatory power. Also, instruments developed and repeatedly tested in prior studies involving conventional end-users and business managers may not be valid in professional settings. Several interesting implications are also discussed. © 2002 Elsevier Science B.V. All rights reserved.link_to_subscribed_fulltex

Evaluation of user interface designs for information retrieval systems: A computer-based experiment

In this study, we conducted a computer-based experiment to evaluate and compare the effectiveness of six different interface designs, graphical or list-based, in supporting communication of an object's `relevance' from an information retrieval (IR) system to its users. We adopted the Model Human Processor to provide a necessary framework to incorporate relevant cognitive psychology theories and user-centered design principles in the development of different interfaces. The study had a well-researched theoretical foundation, complied with relevant design principles, and included a large-scale empirical evaluation. Our results suggest that interface design may have a significant effect on system-user concept communication, regardless of users' familiarity with the search task, and that a graphical user interface may be more effective in supporting such communication than a list-based design. Furthermore, we also examined the cognitive load and user satisfaction resulting from each investigated interface design. Findings of the study have important implications for the design of IR systems (including online library systems and Internet-based search systems) as well as for the information representation and visualization of knowledge management systems, which ordinarily depend on text-based display methods to support system-user concept communication.link_to_subscribed_fulltex