Karoly Bozan

Social Influence on Health IT Adoption Patterns of the Elderly: An Institutional Theory Based Use Behavior Approach☆

Abstract This study aims to investigate and improve understanding of the social forces that influence patient portal use behavior among the elderly. Underpinned by institutional theory and using the Unified Theory of Acceptance and Use of Technology, our proposed model examines the three social environmental factors of normative, mimetic, and coercive forces within the health Information Technology (HIT) context. The proposed model was tested using an empirical study of 117 subjects in the United States. Using the partial least squares method, the study found that coercive and mimetic pressures significantly influence patient portal use behavior. These findings signal that older people follow their providers’ advice and follow the behavior of a respected, higher-status peer from their network. Normative pressure was found to be an insignificant force, which indicated that older people do not follow the bandwagon effect.

Health informatics program design and outcomes: Learning from an early offering at a mid-level university

Curriculum development is particularly challenging in computing-related disciplines as the computing industry changes more quickly than most. As information technology degrees have become relatively pervasive, some institutions that offer information systems degrees have recognized a need to develop specialist studies in information systems. This detailed case study shows the forces related to a successful implementation of new Health Informatics degrees. The case describes both an unsuccessful and then a successful attempt at essentially the same curriculum development. Although the case includes some local political factors, these represent typical considerations that a curriculum developer is likely to encounter.

Alternatives for pragmatic responses to group work problems

Group work can provide a valuable learning experience, one that is especially relevant for those preparing to enter the information system workforce. While much has been discussed about effective means of delivering the benefits of collaborative learning in groups, there are some problems that arise due to pragmatic environmental factors such as the part time work commitments of students. This study has identified a range of problems and reports on a longitudinal Action Research study in two universities (in Australia and the USA). Over three semesters problems were identified and methods trialled using collaborative tools. Several promising solutions are presented to the identified problems, including the use of video tutorials and commentary using screen recordings as a means of providing feedback to students.

The Effect of Unmet Expectations of Information Quality on Post-Acceptance Workarounds among Healthcare Providers

Electronic health record (EHR) systems have the capacity to aid clinical decision making by providing timely and relevant information about patients. However, providers’ lack of access to complete and upto-date information in the required format hinders their ability to make timely decisions and often leads to misdiagnosis or redundant, duplicate tests. This research evaluates the extent to which pre-adoption information quality expectations are met and their effect on post-adoption satisfaction with an EHR system in terms of information quality and the workarounds that they may generate. The hypotheses were empirically tested through analysis of the responses of 64 healthcare stakeholders. The results indicate that lower information quality was perceived post-adoption than was expected at pre-adoption of the EHR system. Ultimately, workarounds were found largely to be a direct result of dissatisfaction with the EHR system. The results have implications for remedies to workarounds in terms of policy, training, and EHR system features modifications.

The Perceived Level of Collaborative Work Environment’s Effect on Creative Group Problem Solving in a Virtual and Distributed Team Environment

Continuous product development and market introduction of new products are central to sustaining company performance, and information systems (IS) development project managers face increasing pressure for quicker product delivery, despite cost constraints. To respond to these challenges, virtual and distributed (V&D) teams are formed, which present a unique environment to foster collaboration among the project team members. We investigated the sources and effects of team members’ perceived level of collaboration on creative group problem solving in V&D IS project settings. Based on relational coordination theory, we performed semi-structured interviews and used a Qmethodology to confirm certain communication and relationship dimensions as precursors to collaborative environments. Using empirical tests, we found that relationships have a direct effect on creative group problem solving and that communication is mediated by perceived collaboration. We present practical implications and recommendations for V&D IS project managers for enhancing creative problem solving for V&D IS projects.

A Closer Look at the Social Influence Construct in the UTAUT Model: An Institutional Theory Based Approach to Investigate Health IT Adoption Patterns of the Elderly

This study aims to investigate and improve understanding of the social influence construct in the Unified Theory of Acceptance and Use of Technology (UTAUT) model that influence patient portal use behavior among the elderly. Underpinned by institutional theory, our proposed model examines the three social environmental factors of normative, mimetic, and coercive forces within the health Information Technology (HIT) context. The proposed model was tested using an empirical study of 117 subjects in the United States. Using the partial least squares method, the study found empirical support that normative and mimetic pressures significantly influence patient portal use behavior when mediated by behavioral intention. Coercive pressure is found to have a direct effect on patient portal use behavior when not mediated by behavioral intention. These findings signal that social influences just partially influence behavioral intention and in part they directly influence the use behavior. A revised UTAUT model social influence section is introduced.

Patient-centered Information System to Enhance Patient Experience for the Elderly and Provide Strategic Advantage for the Provider

Despite the widespread provider acceptance of health information systems (HIS), there is little empirical evidence and no clear understanding that patient-centered HIS enhance the patient experience. This is especially true for elderly patients, whose involvement in their own care, through the use of a HIS, may have a major impact on their experience. In this study, we review opportunities for developing HIS features that support the integration of services for elderly patients while providing strategic advantages for the provider. We use the customer resource life cycle (CRLC) concept to identify the needs of patients at all stages of dealing with provider throughout the care delivery. To do so, we developed a scale that contained multiple statements for each of the 13 stages of CRLC. Then, using Q-methodology, we asked elderly patients to sort the statements in regard to HIS features that they would find beneficial if they were available to them. Using partial least squares (PLS) analysis, we tested our structural model and hypotheses and found that the perceived benefit of a patient-centered HIS has a direct effect on perceived patient experience when mediated by patient education.