Applying Electronic Medical Records in Health Care: Physicians' Perspective

A contextual ICT model to explain adoption of mobile applications in developing countries: A case study of Tunisia

In Tunisia, agriculture is the main source of livelihood for more than 75% of small and subsistence farmers with minimal use of technology. The use of information and communication technology (ICT),such as mobile applications, represents a pertinent opportunity for these smallholders to access agricultural innovation and market information and improve their farming technologies and farm management. Thus, ICT can act as a replacement to foster access to innovation for this category of farmers. Unfortunately, the underuse of mobile applications has contributed to low and slow adoption of agricultural innovation and consequently the benefits of this technology have not been attained. The purpose of this study is to identify the factors affecting the adoption of Short Message Service (SMS) through a contextual ICT model for livestock, olive crop, and beekeeping. Data were collected from 200 small-scale beekeepers, 225 olive growers, and 140 livestock breeders selected in Jendouba, Kairouan, and Zaghouan in Tunisia. The objective of this paper is to examine the factors that influence mobile applications using the partial least squares structural equation modelling technique, for livestock, olive crop, and beekeeping agricultural activities. The results showed that the final ICT-induced structural models were highly predictive of the use of SMS and its increased adoption. Factors affecting the use of SMS differed according to the farming system. The major perceived factor affecting the use of SMS was 'observability' for livestock farmers, 'compatibility' for olive growers, and 'information quality' for beekeepers. Understanding these factors by taking into account the specificity of the agricultural activity leads to a better understanding of the adoption of ICT tools by smallholder farmers in Tunisia.

Assessing E-Health adoption readiness using diffusion of innovation theory and the role mediated by each adopter's category in a Mauritian context

BACKGROUND

The preparedness of healthcare institutes for the foreseen changes expected to arise through the implementation of E-Health is a significant turning point in determining its success. This should be evaluated through the awareness and readiness of healthcare workers to adopt E-Health technology to reduce health information technology failures.

METHODS

This study investigated the relationship between the perceived attributes of innovation and E-Health adoption decisions of healthcare workers as part of a preimplementation process. Using a cross-sectional quantitative approach, the dimensions of the diffusion of innovation (DOI) theory were used to assess the E-Health readiness of 110 healthcare workers in a Mauritian specialized hospital.

RESULTS

A strong inclination towards E-Health adoption was observed, where the prime stimulators were perceived as modernization of healthcare management (84.1%, ẋ=4.19), increased work efficiency through reduction of duplication (77.6%, ẋ=4.10) and faster generation of results (71.1%, ẋ=4.07). The findings of this study also validated the use of five DOI dimensions (i.e. relative advantage, compatibility, complexity, trialability and observability) in a predictability model (F(5, 101)=17.067, p<0.001) towards E-Health adoption. A significant association between 'adopter category' and 'willingness to recommend E-Health adoption' (χ2(8)=74.89, p<0.001) endorsed the fact that physicians and nursing managers have central roles within a social ecosystem to facilitate the diffusion of technology and influence the adoption of innovation.

CONCLUSION

This is the first study of its kind in Mauritius to successfully characterize each adopter's profile and demonstrate the applicability of the DOI framework to predict the diffusion rate of E-Health platforms, while also highlighting the importance of identifying key opinion leaders who can be primed by innovators regarding the benefits of E-Health platforms, thus ensuring non-disruptive evolutionary innovation in the Mauritian healthcare sector.

Determinant factors in adopting mobile health application in healthcare by nurses

Background

Mobile applications are among effective learning tools and have a significant role in transferring information and knowledge to nurses. The current study was carried to identify the factors affecting nurses’ use of practical health related mobile applications in education and patient interaction based on the combined Technology Acceptance Model (TAM) and Diffusion of Innovation (DOI).

Method

The study is a descriptive-analytical study with a cross-sectional method. The research population includes nurses working at Tabriz University of Medical Sciences hospitals, 150 of which were selected as the research sample using simple and available sampling. The data collection instrument was a questionnaire, the validity and reliability of which were confirmed (α = 0.9). Data analysis was carried out using a correlation test and regression analysis by applying SPSS _v16 software.

Results

The findings show that perceived usefulness and perceived ease of use have a direct and significant effect on the rate of using mobile applications by nurses (P value ≤ 0.01), [(β = 0.52), (β = 0.40)]. Other findings indicate that relative advantage, compatibility, trialability and observability, have a direct and significant effect on nurses’ use of mobile applications, while complicatedness does not have a significant effect.

Conclusion

The current study identifies the effective factors in nurses’ use of health-related mobile applications based on an integrated model of TAM and DOI. Designers of mobile applications should consider these factors in designing and developing programs so that mobile applications can successfully fulfill their purpose in healthcare.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01784-y.

The acceptance level of Hospital Information Management System (HIMS) among the nursing officials working in a teaching hospital

BACKGROUND

The acceptability of hospital staff in the use of hospital information management system (HIMS) is an emerging research area it can explain the fate of any HIMS development and implementation project in hospitals. The aim of this study was to observe the level of acceptance of HMIS among nursing officials working at a teaching hospital.

MATERIALS AND METHODS

This cross-sectional study was conducted for 1 year in a teaching hospital of northern India by using a pretested questionnaire. Our study participants were nursing officers who were not under the probation period and we used a purposive sampling (10% nurses from each ward). Our sample size was 256.

RESULTS

We have observed that majority of 174 (67.96%) participants had good acceptability to the HIMS system. Our study revealed that most of the participants were aware of HIMS. Among all participants, nearly half of them had good acceptability to the HIMS system. This is may be due to their job profiles, distribution of their working places, and their past experiences with HMIS. The bottlenecks such as connectivity problem, error prevention, and lack of training can be addressed by the hospital management by proper measures.

CONCLUSION

The acceptance level of HIMS among the nursing officials working in a teaching hospital was good.

Electronic Medical Records implementation in hospital: An empirical investigation of individual and organizational determinants

The implementation of hospital-wide Electronic Medical Records (EMRs) is still an unsolved quest for many hospital managers. EMRs have long been considered a key factor for improving healthcare quality and safety, reducing adverse events for patients, decreasing costs, optimizing processes, improving clinical research and obtaining best clinical performances. However, hospitals continue to experience resistance from professionals to accepting EMRs. This study combines institutional and individual factors to explain which determinants can trigger or inhibit the EMRs implementation in hospitals, and which variables managers can exploit to guide professionals' behaviours. Data have been collected through a survey administered to physicians and nurses in an Italian University Hospital in Rome. A total of 114 high-quality responses had been received. Results show that both, physicians and nurses, expect many benefits from the use of EMRs. In particular, it is believed that the EMRs will have a positive impact on quality, efficiency and effectiveness of care; handover communication between healthcare workers; teaching, tutoring and research activities; greater control of your own business. Moreover, data show an interplay between individual and institutional determinants: normative factors directly affect perceived usefulness (C = 0.30 **), perceived ease of use (C = 0.26 **) and intention to use EMRs (C = 0.33 **), regulative factors affect the intention to use EMRs (C = -0.21 **), and perceived usefulness directly affect the intention to use EMRs (C = 0.33 **). The analysis carried out shows that the key determinants of the intention to use EMRs are the normative ones (peer influence) and the individual ones (perceived usefulness), and that perceived usefulness works also as a mediator between normative factors and intention to use EMRs. Therefore, Management can leverage on power users to motivate, generate and manage change.

Initial perceptions of, and intention to use, an online guideline adaptation framework: a descriptive survey

AIM

The aim of this research was to evaluate CAN-Implement.Pro as a structured and systematic process for planning local evidence implementation, to develop a contextual and demographic profile of potential users and assess their initial perceptions and intention to use CAN-Implement.Pro.

METHODS

Ethics approval was obtained from the University of Adelaide Human Research Ethics Committee (Approval number: H-2016-157). A descriptive cross-sectional study was undertaken to capture the demographic characteristics of participants, as well as their initial perceptions of, and intention to use, the software for guideline adaptation projects.

RESULTS

A total of 21 individuals representing guideline groups completed the survey. Only 43% had taken part in at least one previous implementation project. Thirty-three percent reported embarking on their first implementation project; 24% had yet to participate in an evidence implementation project. Nursing was the most highly referenced profession at 75%, followed by medical specialties (40%); two respondents indicated allied health professions were included in their implementation group. Respondents represented countries or regions of high and upper middle income as classified by the WHO Regional Office for the Eastern Mediterranean. The majority (67%) found CAN-Implement.Pro to be well-organized, easy to navigate and reliable. Most (80%) also indicated they were more likely to return to the software than not; 20% were neutral. In terms of overall satisfaction, more than half (60%) were very satisfied or satisfied, a third (33%) was neutral and 7% were dissatisfied. Over 66% of the respondents considered their group to be familiar with the knowledge-to-action model. A slightly higher percentage (74%) reported software based upon the knowledge-to-action model had a strong conceptual framework. In terms of evidence informed functionality, 75% of the respondents concluded that the software could assist guideline groups to provide structure for their implementation planning; a similar proportion (75%) indicated that the software would also enhance or improve coordination, communication and logistics management in guideline-related implementation projects. Participants were familiar with a range of resources, models, theories and frameworks for implementation, implementation planning and guideline adaptation. The most common frameworks were related to behavioural theories or variations of the Promoting Action on Research Implementation in Health Services framework.

CONCLUSION

Eighty percent of the respondents indicated that their group would be likely to use the software to guide implementation planning in future projects, whereas 20% were neutral. In terms of expectations for contemporary software, multimedia resources rated highly, as did interactive components within the knowledge-to-action model.

A Systematic Review of the Technology Acceptance Model in Health Informatics

BACKGROUND

One common model utilized to understand clinical staff and patients' technology adoption is the technology acceptance model (TAM).

OBJECTIVE

This article reviews published research on TAM use in health information systems development and implementation with regard to application areas and model extensions after its initial introduction.

METHOD

An electronic literature search supplemented by citation searching was conducted on February 2017 of the Web of Science, PubMed, and Scopus databases, yielding a total of 492 references. Upon eliminating duplicates and applying inclusion and exclusion criteria, 134 articles were retained. These articles were appraised and divided into three categories according to research topic: studies using the original TAM, studies using an extended TAM, and acceptance model comparisons including the TAM.

RESULTS

The review identified three main information and communication technology (ICT) application areas for the TAM in health services: telemedicine, electronic health records, and mobile applications. The original TAM was found to have been extended to fit dynamic health service environments by integration of components from theoretical frameworks such as the theory of planned behavior and unified theory of acceptance and use of technology, as well as by adding variables in specific contextual settings. These variables frequently reflected the concepts subjective norm and self-efficacy, but also compatibility, experience, training, anxiety, habit, and facilitators were considered.

CONCLUSION

Telemedicine applications were between 1999 and 2017, the ICT application area most frequently studied using the TAM, implying that acceptance of this technology was a major challenge when exploiting ICT to develop health service organizations during this period. A majority of the reviewed articles reported extensions of the original TAM, suggesting that no optimal TAM version for use in health services has been established. Although the review results indicate a continuous progress, there are still areas that can be expanded and improved to increase the predictive performance of the TAM.

Determinant Factors in Applying Picture Archiving and Communication Systems (PACS) in Healthcare

OBJECTIVES

Meaningful use of picture archiving and communication systems (PACS) can change the workflow for accessing digital images, lead to faster turnaround time, reduce tests and examinations, and increase patient throughput. This study was carried out to identify determinant factors that affect the adoption of PACS by physicians.

METHODS

This was a cross-sectional study in which 190 physicians working in a teaching hospital affiliated with Tehran University of Medical Sciences were randomly selected. Physicians' perceptions concerning the adoption of PACS were assessed by the conceptual path model of the Unified Theory of Acceptance and Use of Technology (UTAUT). Collected data were analyzed with regression analysis. Structural equation modeling was applied to test the final model that was developed.

RESULTS

The results show that the UTAUT model can explain about 61 percent of the variance on in the adoption of PACS (R² = 0.61). The findings also showed that performance expectancy, effort expectancy, social influences, and behavior intention have a direct and significant effect on the adoption of PACS. However, facility condition showed to have no significant effect on physicians' behavior intentions.

CONCLUSIONS

Implementation of new technology such as PACS in the healthcare sector is unavoidable. Our study clearly identified significant and nonsignificant factors that may affect the adoption of PACS. Also, this study acknowledged that physicians' perception is a key factor to manage the implementation of PACS optimally, and this fact should be considered by healthcare managers and policy makers.