Explaining physicians' acceptance of EHCR systems: An extension of TAM with trust and risk factors

This paper explains physicians' acceptance, in terms of usage intentions, of a central component of health information technology: electronic health care records (EHCR systems). For this purpose, the original version of the Technology Acceptance Model (TAM), which included perceived usefulness, perceived ease of use, attitude towards usage, and usage intentions, is extended with trust and risk-related factors such as physicians' perceptions of institutional trust, perceived risk, and information integrity. The results stress the special importance of attitudinal factors (attitude towards usage and perceived institutional trust) and cognitive instrumental processes (mainly, usefulness perceptions) in determining physicians' intention to use EHCR systems. Perceptions of institutional trust exerted strong direct effects on physicians' perceived usefulness, perceived ease of use, and attitude towards the use of EHCR systems. In addition, trust fully mediated the influences of perceived risk and information integrity perceptions on physicians' acceptance of EHCR systems.

[1]  Detmar W. Straub,et al.  Validating Instruments in MIS Research , 1989, MIS Q..

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

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

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

[5]  Gilbert A. Churchill.  A Paradigm for Developing Better Measures of Marketing Constructs , 1979 .

[6]  A. Satorra,et al.  Corrections to test statistics and standard errors in covariance structure analysis. , 1994 .

[7]  David J. Paper,et al.  User Acceptance of Voice Recognition Technology: An Empirical Extension of the Technology Acceptance Model , 2007, J. Organ. End User Comput..

[8]  P. A. Dabholkar,et al.  Integrating attitudinal theories to understand and predict use of technology‐based self‐service: The Internet as an illustration , 2001 .

[9]  R. Gurrea,et al.  The role played by perceived usability, satisfaction and consumer trust on website loyalty , 2006, Inf. Manag..

[10]  D. Rubin,et al.  Statistical Analysis with Missing Data. , 1989 .

[11]  Thompson S. H. Teo,et al.  Intrinsic and extrinsic motivation in Internet usage , 1999 .

[12]  C. Fornell,et al.  Evaluating structural equation models with unobservable variables and measurement error. , 1981 .

[13]  Mary Jo Bitner,et al.  Technology infusion in service encounters , 2000 .

[14]  A. Allen,et al.  Telemedicine technology and clinical applications. , 1995, JAMA.

[15]  Detmar W. Straub,et al.  The Relative Importance of Perceived Ease of Use in IS Adoption: A Study of E-Commerce Adoption , 2000, J. Assoc. Inf. Syst..

[16]  Mun Y. Yi,et al.  Understanding information technology acceptance by individual professionals: Toward an integrative view , 2006, Inf. Manag..

[17]  Su-Chao Chang,et al.  An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry , 2008, Int. J. Medical Informatics.

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

[19]  William R. King,et al.  A meta-analysis of the technology acceptance model , 2006, Inf. Manag..

[20]  Qingxiong Ma,et al.  The Technology Acceptance Model: A Meta-Analysis of Empirical Findings , 2004, J. Organ. End User Comput..

[21]  Li-Min Lin,et al.  Testing the technology acceptance model for evaluating healthcare professionals' intention to use an adverse event reporting system. , 2007, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[22]  Karl G. Jöreskog,et al.  Lisrel 8: User's Reference Guide , 1997 .

[23]  Diego Gambetta.  Trust : making and breaking cooperative relations , 1992 .

[24]  K. Grønhaug,et al.  Perceived Risk: Further Considerations for the Marketing Discipline , 1993 .

[25]  D. Gefen,et al.  E-commerce: the role of familiarity and trust , 2000 .

[26]  Viswanath Venkatesh,et al.  Technology Acceptance Model 3 and a Research Agenda on Interventions , 2008, Decis. Sci..

[27]  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.

[28]  V. Mitchell.  Consumer perceived risk: conceptualisations and models , 1999 .

[29]  Nena Lim,et al.  Consumers' perceived risk: sources versus consequences , 2003, Electron. Commer. Res. Appl..

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

[31]  Elizabeth Murray,et al.  The Impact of Health Information on the Internet on Health Care and the Physician-Patient Relationship: National U.S. Survey among 1.050 U.S. Physicians , 2003, Journal of medical Internet research.

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

[33]  Fred D. Davis,et al.  A critical assessment of potential measurement biases in the technology acceptance model: three experiments , 1996, Int. J. Hum. Comput. Stud..

[34]  James C. Anderson,et al.  STRUCTURAL EQUATION MODELING IN PRACTICE: A REVIEW AND RECOMMENDED TWO-STEP APPROACH , 1988 .

[35]  Matthew K. O. Lee,et al.  A Trust Model for Consumer Internet Shopping , 2001, Int. J. Electron. Commer..

[36]  A. Bandura.  Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[37]  John R. Rossiter,et al.  The C-OAR-SE procedure for scale development in marketing , 2002 .

[38]  J. H. Davis,et al.  An Integrative Model Of Organizational Trust , 1995 .

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

[40]  Jaeki Song,et al.  Investigating the role of attitude in technology acceptance from an attitude strength perspective , 2009, Int. J. Inf. Manag..

[41]  L. Cronbach.  Essentials of psychological testing , 1960 .

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

[43]  Chen-Tan Lin,et al.  Expectations of Patients and Physicians Regarding Patient-Accessible Medical Records , 2005, Journal of medical Internet research.

[44]  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..

[45]  Norman L. Chervany,et al.  What Trust Means in E-Commerce Customer Relationships: An Interdisciplinary Conceptual Typology , 2001, Int. J. Electron. Commer..

[46]  S. Curry,et al.  eHealth research and healthcare delivery beyond intervention effectiveness. , 2007, American journal of preventive medicine.

[47]  Diego Gambetta.  Can We Trust Trust , 2000 .

[48]  Sirkka L. Jarvenpaa,et al.  Consumer trust in an Internet store , 2000, Inf. Technol. Manag..

[49]  Tenko Raykov,et al.  Coefficient Alpha and Composite Reliability With Interrelated Nonhomogeneous Items , 1998 .

[50]  S. Schoenbaum,et al.  Information technologies: when will they make it into physicians' black bags? , 2004, MedGenMed : Medscape general medicine.

[51]  Michaela Koller.  Risk as a Determinant of Trust , 1988 .

[52]  Christy M. K. Cheung,et al.  Trust in Internet Shopping: A Proposed Model and Measurement Instrument , 2000 .

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

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

[55]  A. Bandura.  Self-efficacy mechanism in human agency. , 1982 .

[56]  Rohan Jayasuriya,et al.  Determinants of microcomputer technology use: implications for education and training of health staff , 1998, Int. J. Medical Informatics.

[57]  J P Kassirer,et al.  Patients, physicians, and the Internet. , 2000, Health affairs.

[58]  Jonathan M. Teich,et al.  Research Paper: Implementation of Physician Order Entry: User Satisfaction and Self-Reported usage Patterns , 1996, J. Am. Medical Informatics Assoc..

[59]  Guy Paré,et al.  Research Paper: The Effects of Creating Psychological Ownership on Physicians' Acceptance of Clinical Information Systems , 2006, J. Am. Medical Informatics Assoc..

[60]  C. Burt,et al.  Which physicians and practices are using electronic medical records? , 2005, Health affairs.

[61]  Brian E. Dixon,et al.  A Roadmap for the Adoption of e-Health , 2007 .

[62]  J. Rossiter,et al.  The Predictive Validity of Multiple-Item versus Single-Item Measures of the Same Constructs , 2007 .

[63]  Graham Pervan,et al.  ICT and OTs: A model of information and communication technology acceptance and utilisation by occupational therapists , 2007, Int. J. Medical Informatics.

[64]  Suzanne Rivard,et al.  A Multilevel Model of Resistance to Information Technology Implementation , 2005, MIS Q..

[65]  T. Ferguson,et al.  Online patient-helpers and physicians working together: a new partnership for high quality health care , 2000, BMJ : British Medical Journal.

[66]  Clifford C. Clogg,et al.  Latent Variables Analysis: Applications for Developmental Research. , 1995 .

[67]  D. Collard,et al.  Trust : making and breaking cooperative relations , 1989 .

[68]  David Gefen,et al.  Managing User Trust in B2C e-Services , 2003 .

[69]  Lawrence A. Crosby,et al.  Relationship Quality in Services Selling: An Interpersonal Influence Perspective: , 1990 .

[70]  Charles J. Kacmar,et al.  Developing and Validating Trust Measures for e-Commerce: An Integrative Typology , 2002, Inf. Syst. Res..

[71]  Detmar W. Straub,et al.  Trust and TAM in Online Shopping: An Integrated Model , 2003, MIS Q..

[72]  Jeroen K. Vermunt,et al.  Factor Analysis with Categorical Indicators: A Comparison Between Traditional and Latent Class Approaches , 2005 .

[73]  Malcolm Cl.  Five e-business strategies you can take to the bank. , 2001 .

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

[75]  Jorgen P. Bansler,et al.  Corporate Intranet Implementation: Managing Emergent Technologies and Organizational Practices , 2000, J. Assoc. Inf. Syst..

[76]  Rex B. Kline,et al.  Principles and Practice of Structural Equation Modeling , 1998 .

[77]  Yoav Ganzach,et al.  Intelligence and Job Satisfaction , 1998 .

[78]  Naresh K. Malhotra,et al.  Common Method Variance in IS Research: A Comparison of Alternative Approaches and a Reanalysis of Past Research , 2006, Manag. Sci..

[79]  Jan-Benedict E. M. Steenkamp,et al.  The use of LISREL in validating marketing constructs. , 1991 .

[80]  J. Kahan,et al.  What Is eHealth (4): A Scoping Exercise to Map the Field , 2005, Journal of medical Internet research.

[81]  Shankar Ganesan.  Determinants of Long-Term Orientation in Buyer-Seller Relationships , 1994 .

[82]  Klaas Sijtsma,et al.  New Developments in Categorical Data Analysis for the Social and Behavioral Sciences , 2005 .

[83]  Ingoo Han,et al.  The Impact of Customer Trust and Perception of Security Control on the Acceptance of Electronic Commerce , 2003, Int. J. Electron. Commer..

[84]  E. Vance Wilson,et al.  Modeling patients' acceptance of provider-delivered e-health. , 2004, Journal of the American Medical Informatics Association : JAMIA.

[85]  Jari Salo,et al.  A conceptual model of trust in the online environment , 2007, Online Inf. Rev..

[86]  J. Hair.  Multivariate data analysis , 1972 .

[87]  Martin Wetzels,et al.  A meta-analysis of the technology acceptance model: Investigating subjective norm and moderation effects , 2007, Inf. Manag..

[88]  Barbara M. Byrne,et al.  Structural equation modeling with EQS : basic concepts, applications, and programming , 2000 .

[89]  M. Lindell,et al.  Accounting for common method variance in cross-sectional research designs. , 2001, The Journal of applied psychology.

[90]  Paul A. Pavlou,et al.  Predicting E-Services Adoption: A Perceived Risk Facets Perspective , 2002, Int. J. Hum. Comput. Stud..

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

[92]  Fay Cobb Payton,et al.  Lessons learned from three interorganizational health care information systems , 2000, Inf. Manag..

[93]  Youngjin Yoo,et al.  It's all about attitude: revisiting the technology acceptance model , 2004, Decis. Support Syst..

[94]  Joseph P. Cannon,et al.  An Examination of the Nature of Trust in Buyer–Seller Relationships: , 1997 .

[95]  Fred D. Davis,et al.  Extrinsic and Intrinsic Motivation to Use Computers in the Workplace1 , 1992 .

[96]  Steven Furnell,et al.  Security implications of electronic commerce: a survey of consumers and businesses , 1999, Internet Res..

[97]  Paul Jen-Hwa Hu,et al.  Investigating healthcare professionals' decisions to accept telemedicine technology: an empirical test of competing theories , 2002, Inf. Manag..

[98]  I. Ajzen,et al.  Application of the theory of planned behavior to adolescents condom use: a panel study. , 1996 .

[99]  L. Berry.  Relationship marketing of services—growing interest, emerging perspectives , 1995 .

[100]  K. Mardia.  Measures of multivariate skewness and kurtosis with applications , 1970 .

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

[102]  Scott B. MacKenzie,et al.  Common method biases in behavioral research: a critical review of the literature and recommended remedies. , 2003, The Journal of applied psychology.

[103]  Naresh K. Malhotra,et al.  Marketing Research: An Applied Orientation , 1993 .

[104]  Robert H. Miller,et al.  Physician use of IT: results from the Deloitte Research Survey. , 2004, Journal of healthcare information management : JHIM.

[105]  D. F. Blankertz,et al.  Risk taking and information handling in consumer behavior , 1969 .

[106]  Amy K. Yarbrough,et al.  Technology Acceptance among Physicians , 2007, Medical care research and review : MCRR.

[107]  Michael J. Ryan,et al.  An Investigation of Perceived Risk at the Brand Level , 1976 .

[108]  Wood Eb.  Collaboration: walking the talk. , 1996 .

[109]  Paul A. Pavlou,et al.  Consumer Acceptance of Electronic Commerce: Integrating Trust and Risk with the Technology Acceptance Model , 2003, Int. J. Electron. Commer..