A novel evaluation model of user acceptance of software technology in healthcare sector

Effective evaluation of healthcare information systems is necessary in order to ensure systems adequately meet the requirements and information processing needs of the users and healthcare organisations. A number of studies have proposed evaluation frameworks to aid in evaluation work. However, some of them can be improved upon. This paper proposes a novel evaluation model to evaluate user acceptance of software technology within the healthcare sector. It describes the theoretical basis behind the development of the research model and methodology being employed to validate the model

A review of selected multi-criteria decision analysis techniques and applications

This paper presents a review of various multi-criteria decision analysis techniques. The focus of this research is to identify suitable techniques to be used to assign weights between different factors that influence user acceptance of software technology in the healthcare industry. Three widely known methodologies used for identifying, classifying and evaluating various alternatives are briefly described, namely the Analytic Hierarchy Process, Fuzzy Cognitive Maps and Fuzzy AHP, in order to identify the applicability and suitability of each in addressing our research problem

Exploring new factors and the question of 'which' in user acceptance studies of healthcare software

The importance of user acceptance of technology is critical for the success of technology implementation in the health-care sector. Spending on the procurement of new technology is growing in the hope of improving patient care as well as providing better services to the public, thus it is important that the technology is used to achieve its intended purpose. Success or failure of technology implementation depends upon the acceptance of the user and this is evident through the growing number of studies on evaluation particularly on user acceptance of the technology. While various models and frameworks have been developed to address factors associated with technology acceptance, they provide little understanding on the reasons for discrepancies in acceptance of the same system among different users. In response to this issue, this thesis proposes a theoretical model which suggests the role of ‘fit’ between user, technology and organization as an antecedent of user acceptance factors. This model was suggested based on a review of the literature and was empirically investigated on medical students’ intention to use medically related software. The proposed model in this thesis integrates three very well known existing models namely the Unified Theory of Acceptance and Use of Technology (UTAUT), the DeLone McLean IS Success Model and the Task-Technology Fit Model. The model is examined as a single model, which investigates (1) the effect of perceived fit between user, technology and organization on factors defined by UTAUT and the IS Success Model; (2) the effect of perceived fit between user, technology and organization on management support and information security expectancy construct; and (3) the effect of management support and information security expectancy on intention to use. In particular, this thesis seeks to investigate the role of ‘fit’ between user, technology and organization variable as an antecedent of performance expectancy, effort expectancy, social influence, facilitating conditions, software quality, service quality, information quality, management support and information security expectancy. This thesis also investigates the role of management support and information security expectancy constructs on intention to use which, to the best of researcher’s knowledge, have not been investigated together with an integrated model, as proposed in this thesis. Further, it presents and discusses empirical findings from the Internet survey and Drop-off approaches of 113 respondents which examined students’ intention to use medically related software using the Partial Least Square (PLS) approach to Structural Equation Modeling (SEM). WarpPLS version 3.0 software was used to analyze the empirical data in this thesis. The findings of this thesis support the hypothesized relationship proposed in the theoretical model. Specifically, the results revealed that perceived user-technology-organization fit has a significant effect on all the factors defined in the model except for social influence. The results also provide strong evidence of the relationships between the management support and information security expectancy constructs with the intention to use construct. This thesis contributes to theoretical and practical knowledge by providing, for the first time, evidence about the relationship between perceived user-technology-organization fit with constructs defined by both UTAUT and the IS Success Model. Further, the relationships between perceived user-technology-organization fit with management support and information security constructs are shown. Additionally this thesis provides empirical support on the relationship between the management support and information security expectancy constructs with the intention to use construct. The introduction and inclusion of organization fit with user and technology fit contributes to the body of knowledge in evaluation studies and provides a more complete model within user acceptance studies to help to understand the reasons for different acceptance among users of the same system or technology. Further, this thesis investigates the applicability of the multi-criteria decision analysis (MCDA) techniques to answer the question of ‘which’ in evaluation studies particularly within user acceptance studies. Existing evaluation studies provide the means to answer the question of what, why, who, when and how, but not explicitly the question of ‘which’. The question of ‘which’ needs to be explicitly addressed and specifically recognized in user acceptance studies. Although various studies implicitly provide the answer to the question of ‘which’, the importance of ‘which’ as the most critical factor or the most influential factor should be addressed explicitly in user acceptance studies. This thesis examined three well used methods which are classical AHP, Fuzzy AHP Changs’ method and Fuzzy AHP a and l method, to assign weights between various factors and subfactors of user acceptance. Acceptance factors of two different types of software were computed using each of these methods. The empirical data were collected from medical students for medically-related software and from research students for research-related software. The approaches examined, in this second part of thesis, are not intended to show which is the best method or techniques to evaluate user acceptance, but rather to illustrate the various options which are available within MCDA approaches to derive weights among evaluation items and subsequently provide an answer to address the question of ‘which’ explicitly within user acceptance studies. The results of assigning weights to factors and sub-factors using three different methods provide strong justification on the applicability of the MCDA methods as a decision support tool. The results show that these methods produced the same ranking of the factors which influence user acceptance (with slight variation using Fuzzy Chang’s method on medical software acceptance). The inclusion of the ‘which’ question can enhance evaluation studies in the health informatics research and findings related to user acceptance of health-care technology

Antecedents of Overall E-service Quality and Brand Attachment in the Banking Industry

Purpose – The study aims to examine the impact of website design, e-fulfillment, e-service and e-security on overall e-service quality and its impact on brand attachment. Design/methodology/approach – Data of 425 respondents was collected from the internet banking industry users through an online survey. Further, PLS-SEM was employed to analyze the data. Findings – Results indicate that the impact of e-security, e- customer service, and e-fulfillment on overall e-customer service quality was supported. In contrast, the impact of website design was not supported. Further, overall, e-service quality also has a significant impact on brand attachment. Originality/value – This study suggested and tested a brand attachment framework for the banking industry to support strategy formulation for managers

Exploring new factors and the question of 'which' in user acceptance studies of healthcare software

The importance of user acceptance of technology is critical for the success of technology implementation in the health-care sector. Spending on the procurement of new technology is growing in the hope of improving patient care as well as providing better services to the public, thus it is important that the technology is used to achieve its intended purpose. Success or failure of technology implementation depends upon the acceptance of the user and this is evident through the growing number of studies on evaluation particularly on user acceptance of the technology. While various models and frameworks have been developed to address factors associated with technology acceptance, they provide little understanding on the reasons for discrepancies in acceptance of the same system among different users. In response to this issue, this thesis proposes a theoretical model which suggests the role of ‘fit’ between user, technology and organization as an antecedent of user acceptance factors. This model was suggested based on a review of the literature and was empirically investigated on medical students’ intention to use medically related software. The proposed model in this thesis integrates three very well known existing models namely the Unified Theory of Acceptance and Use of Technology (UTAUT), the DeLone McLean IS Success Model and the Task-Technology Fit Model. The model is examined as a single model, which investigates (1) the effect of perceived fit between user, technology and organization on factors defined by UTAUT and the IS Success Model; (2) the effect of perceived fit between user, technology and organization on management support and information security expectancy construct; and (3) the effect of management support and information security expectancy on intention to use. In particular, this thesis seeks to investigate the role of ‘fit’ between user, technology and organization variable as an antecedent of performance expectancy, effort expectancy, social influence, facilitating conditions, software quality, service quality, information quality, management support and information security expectancy. This thesis also investigates the role of management support and information security expectancy constructs on intention to use which, to the best of researcher’s knowledge, have not been investigated together with an integrated model, as proposed in this thesis. Further, it presents and discusses empirical findings from the Internet survey and Drop-off approaches of 113 respondents which examined students’ intention to use medically related software using the Partial Least Square (PLS) approach to Structural Equation Modeling (SEM). WarpPLS version 3.0 software was used to analyze the empirical data in this thesis. The findings of this thesis support the hypothesized relationship proposed in the theoretical model. Specifically, the results revealed that perceived user-technology-organization fit has a significant effect on all the factors defined in the model except for social influence. The results also provide strong evidence of the relationships between the management support and information security expectancy constructs with the intention to use construct. This thesis contributes to theoretical and practical knowledge by providing, for the first time, evidence about the relationship between perceived user-technology-organization fit with constructs defined by both UTAUT and the IS Success Model. Further, the relationships between perceived user-technology-organization fit with management support and information security constructs are shown. Additionally this thesis provides empirical support on the relationship between the management support and information security expectancy constructs with the intention to use construct. The introduction and inclusion of organization fit with user and technology fit contributes to the body of knowledge in evaluation studies and provides a more complete model within user acceptance studies to help to understand the reasons for different acceptance among users of the same system or technology. Further, this thesis investigates the applicability of the multi-criteria decision analysis (MCDA) techniques to answer the question of ‘which’ in evaluation studies particularly within user acceptance studies. Existing evaluation studies provide the means to answer the question of what, why, who, when and how, but not explicitly the question of ‘which’. The question of ‘which’ needs to be explicitly addressed and specifically recognized in user acceptance studies. Although various studies implicitly provide the answer to the question of ‘which’, the importance of ‘which’ as the most critical factor or the most influential factor should be addressed explicitly in user acceptance studies. This thesis examined three well used methods which are classical AHP, Fuzzy AHP Changs’ method and Fuzzy AHP a and l method, to assign weights between various factors and subfactors of user acceptance. Acceptance factors of two different types of software were computed using each of these methods. The empirical data were collected from medical students for medically-related software and from research students for research-related software. The approaches examined, in this second part of thesis, are not intended to show which is the best method or techniques to evaluate user acceptance, but rather to illustrate the various options which are available within MCDA approaches to derive weights among evaluation items and subsequently provide an answer to address the question of ‘which’ explicitly within user acceptance studies. The results of assigning weights to factors and sub-factors using three different methods provide strong justification on the applicability of the MCDA methods as a decision support tool. The results show that these methods produced the same ranking of the factors which influence user acceptance (with slight variation using Fuzzy Chang’s method on medical software acceptance). The inclusion of the ‘which’ question can enhance evaluation studies in the health informatics research and findings related to user acceptance of health-care technology

Health Information Systems (HIS) sustainable framework

A sustainable technology is a technology that is capable of being maintained over a long period of time; independent of shifts in both hardware and software. Numbers of studies have discussed various factors contributes towards barriers to successful implementation of HIS. Through critical analysis of existing literature on success, failure and challenges of HIS adoption, this paper identifies four crucial factors that shape the sustainable HIS. This paper describes the theoretical basis behind the development of the model and methodology employed to validate the proposed model. This paper proposes a novel theoretical framework which integrates the expectation-confirmation model with the constructs identifies through literature reviews act as HIS sustainability factors. The proposed framework was tested by collecting data from three major public hospitals in Malaysia. A field studies of users who had experience using health information systems mainly medical staffs and administrative staffs were conducted. A valid 166 respondents participated to test the research model using structural equation modeling with the partial least squares method. The results show that all five proposed constructs had a significant impact on HIS continuance usage. Satisfaction had a significant impact on user continue usage of HIS. This study showed that the extended expectation conformation model effectively predicts users’ continuance usage which leads to factors discovered for sustainable HIS. The present study provides some insights for hospital management and HIS developers

A novel conceptual framework of Health Information Systems (HIS) sustainability

Sustainable technology means technology is capable of being maintained over a long span of time; independent of shifts in both hardware and software. Effective implementation and use of Health Information Systems (HIS) for years to come are crucial as sustainable HIS. Numbers of studies have discussed various factors contributes towards barriers for successful implementation of HIS. However, very few studies discussed factors on HIS sustainability. Through critical analysis of existing literature on success, failure, and challenges of HIS adoption, this paper identifies four crucial factors that shape the sustainable HIS. The importance of strong leadership support, proper contingency planning, and practice, continuous vendor support, and protection of security and privacy issues are identified by classifying all the factors within these four constructs, and with it, we argue these factors crucial for sustainable HIS. This paper proposes a novel conceptual framework which incorporated all these constructs as HIS sustainability factors. This paper also described the theoretical basics behind the development of the model and methodology to be employed to validate the proposed model

The technology factors as barriers for sustainable Health Information Systems (HIS) – a review

Information system is widely adopted in many fields including healthcare. Healthcare organizations now consider increased efficiency, improved patient care, quality of services, and safety. Hence Health Information System (HIS) is basically introduced to transform the traditional way of data collection and organization in hospitals, to a modern way of systematic collection, maintaining and dissemination of data. Its implementation is to support medical practitioners and administrative staff in securing patients’ health information in a digital-based record, to efficiently and effectively improve performance in the health system or any of its component parts. However, despite its numerous benefits, some of barriers still hinder its successful implementation and adoption, which needs to be addressed. This study discussed these barriers related to technology using the IS Success Model. This review paper becomes necessary in order to highlight the barriers that led to technical difficulties facing HIS implementation in hospitals, so as to suggest possible solutions that will improve services rendered in health industry based on finding

Impact of E-service quality on brand attachment and willingness to spend more

E-service quality is important in current business practices. This concept is yet to be explored in context of influencing other important variables. This paper aims to conceptualize e-service quality relationship with brand attachment and willingness to spend more. Understanding the relationship between these constructs is important for service providers in order to enhance superior online customer service experience. Suggested linkages amongst variables further need empirical support. Theoretical implications and future research directions are also proposed

Improving information quality requirements for online health information systems: a review on the previous frameworks

Access to online health information has increased tremendously as it gives patients competency to find answers related to their health. The value of online health information is strongly depends on the quality of the information provided to the users. However, there are evidences that some online health information portals provide poor quality of information, due to the exclusion of information quality requirements in the early stages of the system development process. The objective of this research is to review existing frameworks that capture information quality requirements and to select a framework that is appropriate for the research. A total of six frameworks were searched and analyzed from various sources. The findings show that most frameworks focus more on technical aspect when capturing information quality requirements rather than the human aspect, which is the actual use of the information by the users. This research provide some insights to the health practitioners and system developers about the importance of capturing information quality at the early stage of system development based on actual information use