I-Chiu Chang

Factors affecting the adoption of electronic signature: Executives' perspective of hospital information department

Abstract The healthcare industry is experiencing a major transformation towards e-healthcare, which delivers and enhances related information through the Internet among healthcare stakeholders and makes the electronic signature (e-signature) more and more important. This paper uses a mature framework, Technology–Organization–Environment (TEO), in information system discipline to identify factors that affect hospitals in adopting e-signature. A survey was conducted on regional hospitals and medical centers in Taiwan to verify the validity of the research framework. The results show that TEO framework is useful in distinguishing hospitals as adopters and non-adopters of e-signature. Based on the research findings, implications and limitations are discussed.

A neural network evaluation model for ERP performance from SCM perspective to enhance enterprise competitive advantage

Due to increasing global competition, many enterprises are aware of the benefits of Enterprise Resource Planning (ERP). While the external environments and alliance partnerships facing an enterprise are becoming more complex, executives should consider appropriate partners to enhance efficiency and performance of supply chain management (SCM) as well as to gain potential competitive advantages. This study constructs a conceptual model to evaluate the performance and competitive advantages associated with ERP from a SCM perspective. The resulting model can be used to assist an enterprise in evaluating the potential partnerships. The survey data was gathered from a transnational textile firm in Taiwan. The training and learning models were based on the strategic thrust theory and used the Back-Propagation Network (BPN) as an evaluation tool.

Auditing in the e‐commerce era

Financial statements are not as important to investors as they once were, as technology has changed the way companies create value today. While these changes pose serious threats to the economic viability of auditing, they also create new opportunities for auditors to pursue. Both the American Institute of Certified of Public Accountants and the Canadian Institute of Chartered Accountants (CICA) Task Force on Assurance Services have identified continuous auditing as a service that should be offered. Continuous auditing is significantly different from an annual financial statement audit. A latest research report produced by the CICA defines a continuous audit as: “a methodology that enables independent auditors to provide written assurance on a subject matter using a series of auditors’ reports issued simultaneously with, or a short period of time after, the occurrence of events underlying the subject matter.” However, continuous auditing would present significant technical hurdles. These technical hurdles could be overcome if certain conditions exist. Computer‐assisted audit tools (CAATs) are one of the conditions that must exist in order to conduct the continuous auditing. CAATs are defined as computer‐assisted tools that permit auditors to increase their productivity, as well as that of the audit function. Therefore, with the real‐time accounting and electronic data interchange popularizing, CAATs are becoming even more necessary. The demand for timely and forward‐looking information hints that the continuous audit will eventually replace the traditional audit report on year‐end results.

Critical factors for adopting PACS in Taiwan: views of radiology department directors

To cope with the dramatic changes and fierce competition, healthcare industry is experiencing major transformation in its information technology base. Picture Archiving and Communication Systems (PACS), an integral part of comprehensive electronic medical records, has been recognized as a strategic information technology tool to improve a hospitals competitiveness. Though many studies have investigated the critical factors concerning adoption of information systems, little attention has been focused on the healthcare industry and specifically on PACS. This study incorporates the views of Radiology Department directors and finds that the critical factors for adopting PACS in medical centers and regional hospitals of Taiwan are high-level manager support, governmental policy, and the expected benefits of using PACS.

Factors affecting cross-hospital exchange of Electronic Medical Records

Abstract Adopting Electronic Medical Record (EMR) exchange may save patients’ lives and also improve their health. Most Electronic Data Interchange studies have considered commercial enterprises and necessary funding to support business activities, EMR exchange focuses on saving patients’ lives. Our study combined transaction cost and sociological perspectives to identify factors that affect a hospitals’ willingness to implement EMR exchange. A survey was conducted with regional hospitals and medical centers in Taiwan to justify the validity of a resulting model. Our findings indicated that the model was valuable and determined which factors influenced the decision to implement EMR exchange at these hospitals (perceived benefits, uncertainty, influence, and reciprocal investments). Based on these findings, healthcare policy makers can promote EMR exchange and hospitals can identify desirable partners that will form a strategic alliance to meet the dynamic challenges in the healthcare industry.

Factors Influencing Computer Literacy of Taiwan and South Korea Nurses

Healthcare is experiencing a major transformation in its information technology base. Hospitals are adopting information technology (IT) to reduce costs and increase competitiveness. IT applications in healthcare are trending towards electronic patient records and even health records. Therefore, practices in nursing are also affected by IT. Many researchers have studied what computer literacy a nurse should possess, but have focused less on factors that actually impact computer literacy. The purposes of this study are to examine current computer literacy levels of nurses, and to indicate what variables influence their computer literacy. Taiwan and South Korea both implemented a national health insurance system, and used state-of-the art IT to provide higher volume and better quality of services. The data were collected from two case hospitals which are located in Taiwan and South Korea, respectively. By using a structured questionnaire, a total of 203 nurses responded; 104 from Taiwan and 99 from South Korea. The results revealed that personal innovativeness in IT, computer education, and age are significant factors that affected computer literacy levels. These factors serve as reference for administrators and executives in hospitals, or nursing educators seeking the data necessary to make decisions on curriculum.

Electronic medical record quality and its impact on user satisfaction — Healthcare providers' point of view

Abstract With the increasing mobility of the population, Electronic Medical Records (EMRs) become a promising opportunity for governmental investment to many countries. An EMR project usually involves a huge grant and needs tight control of the output. However, most measuring tools for the quality of paper-based medical records placed a focus on data format and compliance with law which may not be sufficient and adequate enough in measuring the EMRs quality. The purposes of this study are to firstly develop and validate an instrument for measuring the quality of EMRs using 217 physicians and nurses at 25 hospitals and then examine the relationship between the EMRs quality and user satisfaction. Four first-order constructs of EMR quality were identified, namely data content quality, data model quality, information quality, and knowledge quality. Only the quality of data content and information impact user satisfaction significantly. Based on the research findings, implications and limitations are discussed.

An empirical study of the factors affecting Internet security for the financial industry in Taiwan

Abstract Security is a pre-requisite for internet banking. The purpose of this study is to explore the factors that are important to the implementation of Internet security of different types of financial institutes. A questionnaire survey was conducted on all types of financial institutions in Taiwan. A total of 573 questionnaires were mailed out to CIOs in domestic financial institutions with a response rate of 11.69%. The results of the study showed that different types of financial institutions have significantly different levels of concern in terms of factors such as the concern of software systems, hardware security, executives support, internal Internet system users, organizational characteristics, and organizational security policy. The implications of this study are discussed and suggestions for future research are presented.

Applying Non-synchronized E-learning to the Nursing Clinical Ladder System

The time and spatial constraints of face-to-face learning often affect nursing staff’s inclination to enroll in ladder system training classes. Hence, their competence in clinical care may be unable to meet the requirements of the hospitals they work at. The e-learning mechanism offers a way to overcome such constraints. However, the differences in learners’ achievement and satisfaction between traditional face-to-face and non-synchronized e-learning classes in the nursing clinical ladder system have not been thoroughly investigated. In this study, 155 nursing personnel serving at the case hospital, enrolled in N1/N2 ladder courses, were invited to participate as the subjects. The results showed that those who attended face-to-face learning classes reported higher satisfaction but achieved less in class than those in the e-learning class. The factors which influence the subjects’ satisfaction with e-learning were investigated and summarized.

How business intelligence maturity enabling hospital agility

The current volume of information accumulated in hospitals has exceeded the capacity of their medical information systems.Some hospitals employ business intelligence systems (BIS) to extract correct, timely, and useful information for hospital decision-makers.Medical information quality was significantly influenced by BIS maturity.Medical information quality exerted a significant effect on medical decision quality, BIS usage, and user satisfaction.The positive influence of user satisfaction on medical decision quality is also noted. Executives of information officers polled agree that rapid and accurate decision-making are essential to organizational agility and data plays an important role in decision making process. With Advanced information technologies, collecting data can be ubiquitously. However, the current volume of data accumulated in hospitals has exceeded the capacity of their medical information systems, not to mention using the data to make decisions. Hospitals started to employ business intelligence systems (BIS) to extract correct, timely, and useful information for hospital decision-makers. Most studies in the area focus on the establishment and related benefits of BIS. This research aims to evaluate the BIS maturity and its influences on decision quality to reveal the BIS impacts on hospital agility. To test the research model, opinions were collected by distributing questionnaires to clinical and administrative decision-makers who had experiences of using BIS in hospitals. The results showed that medical information quality was significantly influenced by BIS maturity. Furthermore, medical information quality exerted a significant effect on medical decision quality, BIS usage, and user satisfaction. The positive influence of user satisfaction on medical decision quality is also verified.