Evaluation of Healthcare IT Applications: The User Acceptance Perspective

As healthcare costs continue to spiral upward, healthcare institutions are under enormous pressure to create cost efficient systems without risking quality of care. Healthcare IT applications provide considerable promises for achieving this multifaceted goal through managing inofrmation, reducing costs, and facilitating total quality management and continuous quality improvement programs. However, the desired outcome can not be achieved if these applications are not being used. In order to better predict, explain, and increase the usage of IT, it is of vital importance to understand the antecedents of end users’ IT adoption decisions. This chapter first reviews the theoretical background of intention models that have been widely used to study factors governing IT acceptance, with particular focus on the technology acceptance model (TAM)—a prevalent technology adoption theory in the area of information system research. Although TAM has been extensively tested and shown to be a robust, powerful, and parsimonious model, its limitations have also been recognized. The second part of this chapter analyzes these limitations and discusses possible precautions of potential pitfalls. The third part of this chapter specifically addresses the applicability of the technology acceptance model in the professional context of physicians, with a review of available studies that have applied TAM to the technology adoption issues in healthcare.

[1]  E. Mayo.  The Human Problems of an Industrial Civilization , 1934, Nature.

[2]  H. Kelman.  Compliance, identification, and internalization three processes of attitude change , 1958 .

[3]  E. Rogers.  Diffusion of Innovations , 1962 .

[4]  J. Coleman,et al.  Medical Innovation: A Diffusion Study. , 1967 .

[5]  G. D. Weeks,et al.  Subjective time estimates of work tasks by office workers , 1977 .

[6]  I. Ajzen,et al.  Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research , 1977 .

[7]  I. Ajzen,et al.  Understanding Attitudes and Predicting Social Behavior , 1980 .

[8]  G. Bole,et al.  Evaluation of a continuing education program in rheumatoid arthritis. , 1980, Arthritis and rheumatism.

[9]  Pamela J. Fischer,et al.  Human problems in computerized medicine , 1981 .

[10]  Raymond S. Nickerson,et al.  Why Interactive Computer Systems are Sometimes Not Used by People Who Might Benefit from Them , 1999, Int. J. Man Mach. Stud..

[11]  M. Tushman,et al.  Boundary Spanning Individuals: Their Role in Information Transfer and Their Antecedents , 1981 .

[12]  Henry C. Lucas,et al.  The impact of office automation on the organization: some implications for research and practice , 1982, CACM.

[13]  L. G. Tornatzky,et al.  Innovation characteristics and innovation adoption-implementation: A meta-analysis of findings , 1982, IEEE Transactions on Engineering Management.

[14]  D. S. Kitz,et al.  Development of attitudes about sharing decision-making: a comparison of medical and surgical residents. , 1983, Journal of health and social behavior.

[15]  A. Bandura.  Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[16]  Fred D. Davis.  A technology acceptance model for empirically testing new end-user information systems : theory and results , 1985 .

[17]  Icek Ajzen,et al.  From Intentions to Actions: A Theory of Planned Behavior , 1985 .

[18]  R. Hirschheim,et al.  Critical issues in information systems research , 1987 .

[19]  T. H. Kwon,et al.  Unifying the fragmented models of information systems implementation , 1987 .

[20]  R. Burt.  Social Contagion and Innovation: Cohesion versus Structural Equivalence , 1987, American Journal of Sociology.

[21]  E. Blair,et al.  Cognitive Processes Used by Survey Respondents to Answer Behavioral Frequency Questions , 1987 .

[22]  Stephen J. Jay,et al.  Physician Communication Networks and the Adoption and Utilization of Computer Applications in Medicine , 1987 .

[23]  L. Rips,et al.  Answering autobiographical questions: the impact of memory and inference on surveys. , 1987, Science.

[24]  James G. Anderson,et al.  Use and Impact of Computers in Clinical Medicine , 2011, Computers and Medicine.

[25]  Blair H. Sheppard,et al.  The Theory of Reasoned Action: A Meta-Analysis of Past Research with Recommendations for Modifications and Future Research , 1988 .

[26]  C. Aydin.  Occupational adaptation to computerized medical information systems. , 1989, Journal of health and social behavior.

[27]  Fred D. Davis,et al.  User Acceptance of Computer Technology: A Comparison of Two Theoretical Models , 1989 .

[28]  Fred D. Davis.  Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology , 1989, MIS Q..

[29]  C. L. Gatch,et al.  Predicting exercise intentions: the theory of planned behavior. , 1990, Research quarterly for exercise and sport.

[30]  R. Zmud,et al.  Information technology implementation research: a technological diffusion approach , 1990 .

[31]  I. Ajzen.  The theory of planned behavior , 1991 .

[32]  I. Ajzen,et al.  Predicting dishonest actions using the theory of planned behavior , 1991 .

[33]  Kieran Mathieson,et al.  Predicting User Intentions: Comparing the Technology Acceptance Model with the Theory of Planned Behavior , 1991, Inf. Syst. Res..

[34]  Izak Benbasat,et al.  Development of an Instrument to Measure the Perceptions of Adopting an Information Technology Innovation , 1991, Inf. Syst. Res..

[35]  Jane M. Howell,et al.  Personal Computing: Toward a Conceptual Model of Utilization , 1991, MIS Q..

[36]  G Godin,et al.  Predictors of smoking behaviour: an application of Ajzen's theory of planned behaviour. , 1992, British journal of addiction.

[37]  Peter A. Todd,et al.  Perceived Usefulness, Ease of Use, and Usage of Information Technology: A Replication , 1992, MIS Q..

[38]  James S. Baxter,et al.  Intention to commit driving violations: An application of the theory of planned behavior. , 1992 .

[39]  T. Massaro.  Introducing Physician Order Entry at a Major Academic Medical Center: I. Impact on Organizational Culture and Behavior , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[40]  C. Gallois,et al.  The theory of reasoned action and cooperative behaviour: it takes two to use a condom. , 1993, The British journal of social psychology.

[41]  Fred D. Davis.  User Acceptance of Information Technology: System Characteristics, User Perceptions and Behavioral Impacts , 1993, Int. J. Man Mach. Stud..

[42]  T. Massaro.  Introducing physician order entry at a major academic medical center: I. Impact on organizational culture and behavior. , 1993 .

[43]  Seymour Sudman,et al.  Autobiographical memory and the validity of retrospective reports , 1994 .

[44]  Jane M. Howell,et al.  Influence of Experience on Personal Computer Utilization: Testing a Conceptual Model , 1994, J. Manag. Inf. Syst..

[45]  Girish H. Subramanian,et al.  A Replication of Perceived Usefulness and Perceived Ease of Use Measurement , 1994 .

[46]  Wynne W. Chin,et al.  The Effects of Group Attitudes Toward Alternative GDSS Designs on the Decision‐making Performance of Computer‐Supported Groups* , 1994 .

[47]  Larry V. Hedges,et al.  Telescoping and Temporal Memory , 1994 .

[48]  Henri Barki,et al.  Measuring User Participation, User Involvement, and User Attitude , 1994, MIS Q..

[49]  Paul H. Cheney,et al.  System effectiveness of knowledge-based technology: the relationship of user performance and attitudinal measures , 1994, 1994 Proceedings of the Twenty-Seventh Hawaii International Conference on System Sciences.

[50]  Peter A. Todd,et al.  Understanding Information Technology Usage: A Test of Competing Models , 1995, Inf. Syst. Res..

[51]  Sue A. Conger,et al.  INNOVATIONS : A CLASSIFICATION BY IT LOCUS OF IMPACT AND RESEARCH APPROACH , 2002 .

[52]  Juhani Iivari,et al.  Why do individuals use computer technology? A Finnish case study , 1995, Inf. Manag..

[53]  Gordon B. Davis,et al.  Testing the Determinants of Microcomputer Usage via a Structural Equation Model , 1995, J. Manag. Inf. Syst..

[54]  Bernadette Szajna,et al.  Empirical evaluation of the revised technology acceptance model , 1996 .

[55]  Fred D. Davis,et al.  A Model of the Antecedents of Perceived Ease of Use: Development and Test† , 1996 .

[56]  Daniel E. Sichel,et al.  The Computer Revolution: An Economic Perspective , 1997 .

[57]  Detmar W. Straub,et al.  Gender Differences in the Perception and Use of E-Mail: An Extension to the Technology Acceptance Model , 1997, MIS Q..

[58]  Detmar W. Straub,et al.  Testing the technology acceptance model across cultures: A three country study , 1997, Inf. Manag..

[59]  Ritu Agarwal,et al.  The Role of Innovation Characteristics and Perceived Voluntariness in the Acceptance of Information Technologies , 1997 .

[60]  Anurag Sharma.  Professional as Agent: Knowledge Asymmetry in Agency Exchange , 1997 .

[61]  Bonnie Kaplan,et al.  Review: Addressing Organizational Issues into the Evaluation of Medical Systems , 1997, J. Am. Medical Informatics Assoc..

[62]  M. S. Spencer,et al.  Beliefs about substance use among pregnant and parenting adolescents. , 1998, Journal of research on adolescence : the official journal of the Society for Research on Adolescence.

[63]  Ritu Agarwal,et al.  Are Individual Differences Germane to the Acceptance of New Information Technologies , 1999 .

[64]  Dennis F. Galletta,et al.  Extending the technology acceptance model to account for social influence: theoretical bases and empirical validation , 1999, Proceedings of the 32nd Annual Hawaii International Conference on Systems Sciences. 1999. HICSS-32. Abstracts and CD-ROM of Full Papers.

[65]  Olivia R. Liu Sheng,et al.  Examining the Technology Acceptance Model Using Physician Acceptance of Telemedicine Technology , 1999, J. Manag. Inf. Syst..

[66]  Detmar W. Straub,et al.  Information Technology Adoption Across Time: A Cross-Sectional Comparison of Pre-Adoption and Post-Adoption Beliefs , 1999, MIS Q..

[67]  Zhiping Walter,et al.  Theory of user acceptance of information technologies: an examination of health care professionals , 1999, Proceedings of the 32nd Annual Hawaii International Conference on Systems Sciences. 1999. HICSS-32. Abstracts and CD-ROM of Full Papers.

[68]  Fred D. Davis,et al.  A Theoretical Extension of the Technology Acceptance Model: Four Longitudinal Field Studies , 2000, Management Science.

[69]  Viswanath Venkatesh,et al.  Why Don't Men Ever Stop to Ask for Directions? Gender, Social Influence, and Their Role in Technology Acceptance and Usage Behavior , 2000, MIS Q..

[70]  Viswanath Venkatesh,et al.  Determinants of Perceived Ease of Use: Integrating Control, Intrinsic Motivation, and Emotion into the Technology Acceptance Model , 2000, Inf. Syst. Res..

[71]  Mary Czerwinski,et al.  Individual differences in virtual environments - Introduction and overview , 2000, J. Am. Soc. Inf. Sci..

[72]  Wynne W. Chin.  The Measurement And Meaning Of IT Usage : Reconciling Recent Discrepancies Between Self Reported And Computer Recorded Usage . In a recent study , 2000 .

[73]  D. R. Dixon,et al.  Exploring information technology adoption by family physicians: survey instrument valuation , 2000, AMIA.

[74]  Elena Karahanna,et al.  Time Flies When You're Having Fun: Cognitive Absorption and Beliefs About Information Technology Usage , 2000, MIS Q..

[75]  M. Conner,et al.  Efficacy of the Theory of Planned Behaviour: a meta-analytic review. , 2001, The British journal of social psychology.

[76]  Norbert Schwarz,et al.  Asking Questions About Behavior: Cognition, Communication, and Questionnaire Construction , 2001 .

[77]  Bonnie Kaplan,et al.  Evaluating informatics applications - some alternative approaches: theory, social interactionism, and call for methodological pluralism , 2001, Int. J. Medical Informatics.

[78]  M. Fishbein,et al.  Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. , 2001, Psychological bulletin.

[79]  Paul Jen-Hwa Hu,et al.  Information Technology Acceptance by Individual Professionals: A Model Comparison Approach , 2001, Decis. Sci..

[80]  Wynne W. Chin,et al.  Extending the technology acceptance model: the influence of perceived user resources , 2001, DATB.

[81]  Sonja Wiley-Patton,et al.  Test of the technology acceptance model for the internet in pediatrics , 2002, AMIA.

[82]  Paul Jen-Hwa Hu,et al.  Examining a Model of Information Technology Acceptance by Individual Professionals: An Exploratory Study , 2002, J. Manag. Inf. Syst..

[83]  S. Biddle,et al.  A Meta-Analytic Review of the Theories of Reasoned Action and Planned Behavior in Physical Activity: Predictive Validity and the Contribution of Additional Variables , 2002 .

[84]  Kim E Clarke,et al.  An exploration of health beliefs and attitudes of smokers with vascular disease who participate in or decline a smoking cessation program. , 2002, Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing.

[85]  Marie-Pierre Gagnon,et al.  An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians , 2003, Int. J. Medical Informatics.

[86]  E. Rogers,et al.  Diffusion of innovations , 1964, Encyclopedia of Sport Management.

[87]  Younghwa Lee,et al.  The Technology Acceptance Model: Past, Present, and Future , 2003, Commun. Assoc. Inf. Syst..

[88]  Gordon B. Davis,et al.  User Acceptance of Information Technology: Toward a Unified View , 2003, MIS Q..

[89]  Sonja Wiley-Patton,et al.  Does the extended technology acceptance model apply to physicians , 2003, 36th Annual Hawaii International Conference on System Sciences, 2003. Proceedings of the.

[90]  S. K. Maue,et al.  Predicting physician guideline compliance: an assessment of motivators and perceived barriers. , 2004, The American journal of managed care.

[91]  Richard P. Bagozzi,et al.  A Reasoned Action Approach to Physicians' Utilization of Drug Information Sources , 1996, Pharmaceutical Research.

[92]  Wei-Fong Kao,et al.  The development of intelligent, triage-based, mass-gathering emergency medical service PDA support systems. , 2004, The journal of nursing research : JNR.

[93]  France Légaré,et al.  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 , 2005, BMC Medical Informatics Decis. Mak..

[94]  Heshan Sun,et al.  The role of moderating factors in user technology acceptance , 2006, Int. J. Hum. Comput. Stud..

[95]  A. Bandura.  SOCIAL COGNITIVE THEORY , 2008 .