An investigation of the effects of cultural differences on physicians’ perceptions of information technology acceptance as they relate to knowledge management systems

The mediating effects of perceived usefulness and perceived ease of use on nurses' intentions to adopt advanced technology

This study explored the role of technology systems in influencing nurses' intentions to adopt medical applications that enhance their performance and how technology contributes to improvements in hospital systems. The study examines the intention to use technology through the mediating effects of perceived usefulness and perceived ease of use, with technology sophistication. A random sampling method was employed to gather 687 responses from nurses. The statistical analysis was conducted using AMOS version 25.0 and SPSS. The findings indicate a significant association between technology sophistication (TS), perceived usefulness (PU), perceived ease of use (PEU), and intention to use (IU). Additionally, PU and PEU positively mediate the relationship between TS and IU. This research will benefit policymakers aiming to enhance nurses' performance by adopting modern technology. Authorities should consider introducing advanced technology systems to meet the goals of hospital administration and support nurses effectively.

Adoption of new banking models from a consumer perspective: the case of Iran

Purpose

Traditionally, the banking and financial sectors have pioneered adoption of new technologies and business models. One important digital banking model that has proven its efficacy in recent times, is Digital-Only Banking (DOB) where consumers interact with their banks through digital channels only. Having detailed knowledge of what actually happens at the consumer level during the adoption of new digital models and technologies is paramount to the success of these technological initiatives. The present study aims to investigate DOB adoption behavior and possible barriers using a quantitative approach at the consumer level. A conceptual model is developed by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) model, incorporating Trust (TR), Perceived Risk (PR) constructs and cultural moderators of Individualism (IDV) and Uncertainty Avoidance (UA).

Design/methodology/approach

For this study, an online survey instrument was created and administered in Iran. The research sample was selected through the application of purposive sampling. Data from 788 respondents were analyzed. The proposed model was tested using Partial Least Square.?.s Structural Equation Modeling (PLS-SEM).

Findings

The results show that DOB adoption is positively influenced by Effort Expectancy (EE), Social Influence (SI), and Facilitating Conditions (FC), while PR negatively influences DOB adoption intention. Unexpectedly, the results indicate that TR has no significant impact on DOB usage intention. Additionally, this study demonstrates that with individuals having a low level of IDV, the relationship between PE and BI is stronger, and with individuals having a low level of UA, the impact of SI on BI is stronger. It also reveals that the impact of TR on BI is stronger in low individualistic cultures.

Practical implications

DOB providers should enhance support features of their services or provide facilities that make it simpler for users to accomplish online transactions. Here, in order to improve the UI/UX design of their apps, DOB product managers should carefully observe the technical guidelines of the operating systems of digital devices, such as the Human Interface Guidelines (HIG) for iOS and Material You for Android. Additionally, DOB providers should build partnerships with mega online retailers to provide hassle-free and easy to use payment solutions for consumers.

Originality/value

DOB, as a novel and business model, has been investigated in very few studies, especially regarding any which focus on its adoption. To fill this gap, this research investigates DOB adoption through a modified version of the UTAUT model. The findings of this study suggest that future research regarding DOB should consider sources of TR, types of non-adopters, and context. This study, as the first of its kind in DOB literature, also highlights the significant role played by cultural values in customer behavior regarding DOB adoption.

Predictors of Health Care Practitioners' Intention to Use AI-Enabled Clinical Decision Support Systems: Meta-Analysis Based on the Unified Theory of Acceptance and Use of Technology

BACKGROUND

Artificial intelligence-enabled clinical decision support systems (AI-CDSSs) offer potential for improving health care outcomes, but their adoption among health care practitioners remains limited.

OBJECTIVE

This meta-analysis identified predictors influencing health care practitioners' intention to use AI-CDSSs based on the Unified Theory of Acceptance and Use of Technology (UTAUT). Additional predictors were examined based on existing empirical evidence.

METHODS

The literature search using electronic databases, forward searches, conference programs, and personal correspondence yielded 7731 results, of which 17 (0.22%) studies met the inclusion criteria. Random-effects meta-analysis, relative weight analyses, and meta-analytic moderation and mediation analyses were used to examine the relationships between relevant predictor variables and the intention to use AI-CDSSs.

RESULTS

The meta-analysis results supported the application of the UTAUT to the context of the intention to use AI-CDSSs. The results showed that performance expectancy (r=0.66), effort expectancy (r=0.55), social influence (r=0.66), and facilitating conditions (r=0.66) were positively associated with the intention to use AI-CDSSs, in line with the predictions of the UTAUT. The meta-analysis further identified positive attitude (r=0.63), trust (r=0.73), anxiety (r=-0.41), perceived risk (r=-0.21), and innovativeness (r=0.54) as additional relevant predictors. Trust emerged as the most influential predictor overall. The results of the moderation analyses show that the relationship between social influence and use intention becomes weaker with increasing age. In addition, the relationship between effort expectancy and use intention was stronger for diagnostic AI-CDSSs than for devices that combined diagnostic and treatment recommendations. Finally, the relationship between facilitating conditions and use intention was mediated through performance and effort expectancy.

CONCLUSIONS

This meta-analysis contributes to the understanding of the predictors of intention to use AI-CDSSs based on an extended UTAUT model. More research is needed to substantiate the identified relationships and explain the observed variations in effect sizes by identifying relevant moderating factors. The research findings bear important implications for the design and implementation of training programs for health care practitioners to ease the adoption of AI-CDSSs into their practice.

Cultivate customer loyalty in national culture: a meta-analysis of electronic banking customer loyalty

Purpose

This paper presents a meta-analysis of the electronic banking (e-banking) customer loyalty literature in the last 10 years. The study investigated the moderating role of national culture in the relationship between e-banking customer loyalty and its antecedents.

Design/methodology/approach

Using a meta-analysis of customer loyalty in 19 countries, the authors incorporated national culture scores based on Hofstede's cultural dimensions to explore how the relative importance of e-banking customer loyalty antecedents varies across cultures.

Findings

The study revealed that national culture moderates the relationship between e-banking customer loyalty and its seven antecedents for four cultural dimensions, yet there was no significant moderation for satisfaction.

Research limitations/implications

This study reviewed the relationships in the literature on customer loyalty in e-banking contexts, extending and enriching the current knowledge. However, some specific limitations, such as the non-use of qualitative studies and the clipping of adverse concepts, exist in the secondary data and should be considered.

Practical implications

The results show that the seven antecedents affect e-banking customer loyalty to different degrees. Managers should incorporate cultural factors in e-banking customer management.

Originality/value

Only a few studies have assessed cultural differences in relation to e-banking customer loyalty. The authors address this need by offering deeper insights into how cultural dimensions moderate the relationships between e-banking customer loyalty and its antecedents through a meta-analytical review. The study findings offer managers a new perspective of leveraging the benefits of cultural differences, enhancing their decision-making in international business.

Impact of the Moderating Effect of National Culture on Adoption Intention in Wearable Health Care Devices: Meta-analysis

BACKGROUND

Wearable health care devices have not yet been commercialized on a large scale. Additionally, people in different countries have different utilization rates. Therefore, more in-depth studies on the moderating effect of national culture on adoption intention in wearable health care devices are necessary.

OBJECTIVE

This study aims to explore the summary results of the relationships between perceived usefulness and perceived ease of use with adoption intention in wearable health care devices and the impact of the moderating effect of national culture on these two relationships.

METHODS

We searched for studies published before September 2021 in the Web of Science, EBSCO, Engineering Village, China National Knowledge Infrastructure, IEEE Xplore, and Wiley Online Library databases. CMA (version 2.0, Biostat Inc) software was used to perform the meta-analysis. We conducted publication bias and heterogeneity tests on the data. The random-effects model was used to estimate the main effect size, and a sensitivity analysis was conducted. A meta-regression analysis was used to test the moderating effect of national culture.

RESULTS

This meta-analysis included 20 publications with a total of 6128 participants. Perceived usefulness (r=0.612, P<.001) and perceived ease of use (r=0.462, P<.001) positively affect adoption intention. The relationship between perceived usefulness and adoption intention is positively moderated by individualism/collectivism (β=.003, P<.001), masculinity/femininity (β=.008, P<.001) and indulgence/restraint (β=.005, P<.001), and negatively moderated by uncertainty avoidance (β=-.005, P<.001). The relationship between perceived ease of use and adoption intention is positively moderated by individualism/collectivism (β=.003, P<.001), masculinity/femininity (β=.006, P<.001) and indulgence/restraint (β=.009, P<.001), and negatively moderated by uncertainty avoidance (β=-.004, P<.001).

CONCLUSIONS

This meta-analysis provided comprehensive evidence on the positive relationship between perceived usefulness and perceived ease of use with adoption intention and the moderating effect of national culture on these two relationships. Regarding the moderating effect, perceived usefulness and perceived ease of use have a greater impact on adoption intention for people in individualistic, masculine, low uncertainty avoidance, and indulgence cultures, respectively.

Explaing users' technology acceptance through national cultural values in the hospital context

Background

Current research demonstrates that health information technology can improve the efficiency and quality of health services. However, many implementation projects have failed due to behavioural problems associated with technology usages, such as underuse, resistance, sabotage, and even rejection by potential users. Therefore, user acceptance was one of the main factors contributing to the success of health information technology implementation. However, research suggests that behavioural models do not universally hold across cultures.

The present article considers national cultural values (power distance, uncertainty avoidance, individualism/collectivism, masculinity/femininity, and time orientation) as individual difference variables that affect user behaviour and incorporates them into the Technology Acceptance Model (TAM) as moderators of technology acceptance relationships. Therefore, this research analyses which national cultural values affect technology acceptance behaviour in hospitals.

Methods

The authors develop and test seven hypotheses regarding this relationship using the partial least squares (PLS) technique, a structural equation modelling method. The authors collected data from 160 questionnaires completed by clinicians and non-clinicians working in one hospital.

Results

The findings show that uncertainty avoidance, masculinity/femininity, and time orientation are the national cultural values that affect technology acceptance in hospitals. In particular, individuals with masculine cultural values, higher uncertainty avoidance, and a long-term orientation influence behavioural intention to use technology.

Conclusion

The bureaucratic model still decisively characterises the Italian health sector and consequently affects the choices of firms and workers, including the choice of technology adoption. Cultural values of masculinity, risk aversion, and long-term orientation affect intention to use through social norms rather than through perceived utility.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07488-3.

Technology Acceptance in Healthcare: A Systematic Review

Understanding the factors affecting the use of healthcare technologies is a crucial topic that has been extensively studied, specifically during the last decade. These factors were studied using different technology acceptance models and theories. However, a systematic review that offers extensive understanding into what affects healthcare technologies and services and covers distinctive trends in large-scale research remains lacking. Therefore, this review aims to systematically review the articles published on technology acceptance in healthcare. From a yield of 1768 studies collected, 142 empirical studies have met the eligibility criteria and were extensively analyzed. The key findings confirmed that TAM and UTAUT are the most prevailing models in explaining what affects the acceptance of various healthcare technologies through different user groups, settings, and countries. Apart from the core constructs of TAM and UTAUT, the results showed that anxiety, computer self-efficacy, innovativeness, and trust are the most influential factors affecting various healthcare technologies. The results also revealed that Taiwan and the USA are leading the research of technology acceptance in healthcare, with a remarkable increase in studies focusing on telemedicine and electronic medical records solutions. This review is believed to enhance our understanding through a number of theoretical contributions and practical implications by unveiling the full potential of technology acceptance in healthcare and opening the door for further research opportunities.

Influence of national culture on knowledge management process: literature review and research agenda

Purpose

The purpose of this study is to explore, understand and investigate the relationship between national culture and knowledge management (KM) process.

Design/methodology/approach

This study is based on systematically and objectively capturing the contents of extant research papers published by researchers in this area by using the literature review methodology.

Findings

The study demonstrates significant relationship between national culture and KM process. Further, it also provides directions for future research.

Practical implications

The study will help top management to understand and appreciate the impact of national culture on KM process in organization, where people from different nations are working together. The management may apply appropriate organizational interventions to manage people of different national cultures in effective manner and effective utilization of knowledge of the organization through KM process. This paper will be considered as a quick reference and resource for anyone interested in this area.

Originality/value

This study is a comprehensive literature review of influence of national culture on KM process. Further, it also sets the research agenda for future researchers.

Knowledge management in health care: an integrative and result-driven clinical staff management model

Purpose

This paper aims to propose an integrative and result-driven health-care knowledge management (HKM) model and discuss the findings of a research that examines how the KM initiatives of a major private Brazilian hospital system are linked to its health-care performance outcomes.

Design/methodology/approach

Data were collected from a top-level Brazilian private hospital system (Mater Dei Healthcare System – MDHS), which is composed of three large hospitals internationally accredited by ISO 9001/2000, NIAHO and JCI. Multiple qualitative approaches were used to collect data such as 16 in-depth interviews with health professionals and managers, document analysis, participatory observation and benchmarking interviews with two reference hospital networks in Brazil.

Findings

The proposed health-oriented KM model is an expansion of the organizational knowing cycle model (Choo, 1996), adding absorptive capacity (ACAP) as a new construct. The paper discusses how ACAP integrates with sense-making, knowledge creation and decision-making processes within the health-care context. Information technology and clinical governance were identified as support factors to the HKM processes.

Practical implications

The paper presents a pragmatic and result-driven knowledge management (KM) model using health-care-welfare key performance indicators, as well as the emergence of KM as an integrative and strategic approach to hospital management.

Originality/value

The present study presents a knowledge-based perspective to clinical staff management, demonstrating the tangible results of KM initiatives that contribute to health and management performance outcomes.