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Physicians' resistance toward healthcare information technology: a theoretical model and empirical test

This paper presents a theoretical model of physician resistance of healthcare information technology (HIT) usage by integrating the technology acceptance and resistance to change literatures, using a dual-factor model of technology usage. This model elaborates the interdependent and asymmetric effects of inhibiting usage perceptions, such as resistance, on HIT usage intentions relative to enabling perceptions, such as perceived usefulness and perceived ease of use. It also proposes perceived threat as a predictor of resistance, perceived compatibility as predicting perceived usefulness, and related knowledge as predicting perceived ease of use. The resulting model is empirically supported using a field survey of a computerized physician order entry system among 129 practicing physicians at a large acute-care hospital. Our study illustrates the importance of incorporating user resistance in technology usage studies in general and HIT usage studies in particular, grounds resistance research within extant theories of technology usage, and provides a preliminary model of resistance that can serve as the starting point for future research in this relatively unexplored yet potentially fertile area of research.

An investigation into low mail survey response rates of information technology users in health care organizations.

Surveys conducted by mail can result in a very low response rate raising the possibility of non-response bias that would question the validity of the findings. In this study, we compare the demographic profiles between the respondents and non-respondents, and conduct wave analysis as an alternative way to estimate the non-response bias among the information technology (IT) users in the health care industry. Our findings indicate that there is no significant difference among the respondents when considering the duration (early versus late) of response rate. Likewise, there was no significant difference when the available demographic characteristics (facility type and users position) of those who responded were compared to the same characteristics of the sample. We were able to reach similar conclusion by using either of the proposed methods; analysis of demographic profiles of respondents versus non-respondents, and wave analysis. Thus our findings support the validity of the results from low response mail survey studies for IT users.

An exploration of the impact of TQM and JIT on ISO 9000 registered companies

Abstract This paper addresses the implications of JIT and TQM implementation on the ISO 9000 registration process. Responses from over 500 ISO 9000 registered firms in the US were analyzed to determine whether differences in ISO 9000 registration experiences exist for firms with JIT, TQM, both JIT and TQM, or neither system. Survey results revealed that TQM and JIT firms have a better understanding of the importance of top management commitment, quality training, and communication to ISO 9000 implementation.

Married males and shopping: are they sleeping partners

Social and demographic changes are putting pressures on traditional gender roles in the house‐hold. Reports on the role of married males based on a large‐scale survey of upscale households. The data suggest that males in married households are responsible for shopping activities in varying degrees. The level of shopping responsibility is a function of the spouse′s occupation as well as the type of goods to be purchased. Responsibility for grocery shopping is limited among married males (about 15 per cent claim primary responsibility) but the ones who are responsible express the most enlightened attitudes about shopping and report the greatest degree of enjoyment with shopping at the supermarket. Although 56 per cent of the married males claim primary responsibility for their clothing, enjoyment of the shopping mall is greater among those who share responsibility jointly with their wives. The perceptions of alternative shopping methods such as store, catalogue and computer shopping suggest that store shopp...

Experiences of US- andforeign-owned firms: A new perspective on ISO 9000 implementation

Responses from over 500 companies relating to their experiences with ISO 9000 implementation are presented. Companies were categorized according to ownership: US-owned (Type U) and foreign-owned (Type F) manufacturing firms. The results reveal the importance and the dual role of documentation as a critical factor necessary to obtain ISO 9000 registration: (1) as the critical element requiring the highest level of effort in the registration process;and (2)as one of the key potential barriers to successful implementation. Increasing market share is the highest rated reason for achieving ISO 9000 registration. ISO 9000 registered companies expect a high degree of improvement in product design , process design , product quality , communication , and supplier relations. The findings also reveal that there is no significant difference between the two firm ownership types for all variables tested, indicating that the ISO 9000 standards appear universal in applicability.

The Differential Performance Effects of Healthcare Information Technology Adoption1

Abstract This article examines the relationship between the adoption of healthcare information technology (HIT) and a hospitals operational performance. Combining primary survey data from Florida hospitals and secondary data from two government agencies responsible for hospital certification and licensing, the authors find differential performance effects for different clusters of HIT: administrative, clinical, and strategic. Only clinical HIT investments were found to have a statistically significant positive effect on operational performance.

The Differential Performance Effects of Healthcare Information Technology Adoption

ABSTRACT This article examines the relationship between the adoption of healthcare information technology (HIT) and a hospitals operational performance. Combining primary survey data from Florida hospitals and secondary data from two government agencies responsible for hospital certification and licensing, the authors find differential performance effects for different clusters of HIT: administrative, clinical, and strategic. Only clinical HIT investments were found to have a statistically significant positive effect on operational performance.

Investigating Response Bias in an Information Technology Survey of Physicians

Monitoring the diffusion of electronic health records (EHR) into ambulatory clinical practice has important policy implications. However, estimates of EHR use are typically derived from survey data and may be subject to significant response bias. The current study is a retrospective analysis testing for response bias in a large information technology survey of physicians (n=14,921). To detect bias, respondents were compared to nonrespondents on known characteristics. Moreover, early respondents were compared to late respondents with respect to key variables in the survey that are likely to influence participation. The 4203 respondents (28.2% participation rate) did not differ demographically from nonrespondents. Response rates, by specialty, differed slightly. When comparing early and late survey respondents, no differences were detected in EHR use, length of time since EHR installation, practice size, physician age, years since medical school graduation, and years of practice in their current community. Overall, response bias was not detected using established methodologies in this mailed survey of physician EHR use. Similar surveys of physicians, even with a lower than expected response rate, may still be valid.

Physicians' Resistance toward Healthcare Information Technologies: A Dual-Factor Model

This paper proposes and validates a theory of physician resistance toward IT usage by drawing on prior research in the resistance to change literature and a recent dual-factor model of IT usage. This theory elaborates the interdependent and asymmetric effects of resistance vis-a-vis current usage predictors such as behavioral intention. Additionally, we propose perceived threats as a salient determinant of user resistance in the IT usage context. The resulting model is empirically supported via a survey of practicing physicians at a large acute-care hospital in the southeastern United States. Implications of this research for IT research and practice are discussed

Impacts of mobile tablet computing on provider productivity, communications, and the process of care

OBJECTIVE Health information technology investments continue to increase while the value derived from their implementation and use is mixed. Mobile device adoption into practice is a recent trend that has increased dramatically and formal studies are needed to investigate consequent benefits and challenges. The objective of this study is to evaluate practitioner perceptions of improvements in productivity, provider-patient communications, care provision, technology usability and other outcomes following the adoption and use of a tablet computer connected to electronic health information resources. METHODS A pilot program was initiated in June 2013 to evaluate the effect of mobile tablet computers at one health provider organization in the southeast United States. Providers were asked to volunteer for the evaluation and were each given a mobile tablet computer. A total of 42 inpatient and outpatient providers were interviewed in 2015 using a survey style questionnaire that utilized yes/no, Likert-style, and open ended questions. Each had previously used an electronic health record (EHR) system a minimum of one year outside of residency, and were regular users of personal mobile devices. Each used a mobile tablet computer in the context of their practice connected to the health system EHR. RESULTS The survey results indicate that more than half of providers perceive the use of the tablet device as having a positive effect on patient communications, patient education, patients perception of the provider, time spent interacting with patients, provider productivity, process of care, satisfaction with EHR when used together with the device, and care provision. Providers also reported feeling comfortable using the device (82.9%), would recommend the device to colleagues (69.2%), did not experience increased information security and privacy concerns (95%), and noted significant reductions in EHR login times (64.1%). Less than 25% of participants reported negative impacts on any of these areas as well as on time spent on order submission, note completion time, overall workload, patient satisfaction with care experience and patient outcomes. Gender, number of years in practice, practice type (general practitioner vs. specialist), and service type (inpatient/outpatient) were found to have a significant effect on perceptions of patient satisfaction, care process, and provider productivity. CONCLUSIONS Providers found positive gains from utilizing mobile devices in overall productivity, improved communications with their patients, the process of care, and technology efficiencies when used in combination with EHR and other health information resources. Demographic and health care work environment play a role in how mobile technologies are integrated into practice by providers.