Department of Informatics, Technical University of Munich, Bolzmannstrasse 3, 85748 Garching bei München, Germany.
Int J Med Inform. 2012 Nov;81(11):746-60. doi: 10.1016/j.ijmedinf.2012.02.002. Epub 2012 Mar 6.
Germany is introducing a nation-wide telemedicine infrastructure that enables electronic health services. The project is facing massive resistance from German physicians, which has led to a delay of more than five years. Little is known about the actual burdens and drivers for adoption of e-health innovations by physicians.
Based on a quantitative study of German physicians who participated in the national testbed for telemedicine, this article extends existing technology acceptance models (TAM) for electronic health (e-health) in ambulatory care settings and elaborates on determinants of importance to physicians in their decision to use e-health applications.
This study explores the opinions, attitudes, and knowledge of physicians in ambulatory care to find drivers for technology acceptance in terms of information technology (IT) utilization, process and security orientation, standardization, communication, documentation and general working patterns. We identified variables within the TAM constructs used in e-health research that have the strongest evidence to determine the intention to use e-health applications.
The partial least squares (PLS) regression model from data of 117 physicians showed that the perceived importance of standardization and the perceived importance of the current IT utilization (p<0.01) were the most significant drivers for accepting electronic health services (EHS) in their practice. Significant influence (p<0.05) was shown for the perceived importance of information security and process orientation as well as the documentation intensity and the e-health-related knowledge.
This study extends work gleaned from technology acceptance studies in healthcare by investigating factors which influence perceived usefulness and perceived ease of use of e-health services. Based on these empirical findings, we derive implications for the design and introduction of e-health services including suggestions for introducing the topic to physicians in ambulatory care and incentive structures for using e-health.
德国正在引入一个全国性的远程医疗基础设施,以实现电子医疗服务。该项目面临着德国医生的强烈抵制,导致延迟了五年多。对于医生采用电子医疗创新的实际负担和驱动因素知之甚少。
基于对参与远程医疗国家试验台的德国医生的定量研究,本文扩展了现有的电子医疗(e-health)在门诊环境中的技术接受模型(TAM),并详细阐述了对医生使用电子医疗应用程序的决策有重要影响的决定因素。
本研究探讨了门诊医生的意见、态度和知识,以发现接受信息技术(IT)利用、流程和安全导向、标准化、沟通、文档和一般工作模式等方面的技术接受驱动因素。我们确定了电子医疗研究中 TAM 结构内的变量,这些变量具有最强的证据来确定使用电子医疗应用程序的意图。
来自 117 名医生的数据的偏最小二乘(PLS)回归模型表明,标准化的感知重要性和当前 IT 利用的感知重要性(p<0.01)是接受电子医疗服务(EHS)在实践中最重要的驱动因素。信息安全和流程导向的感知重要性以及文档强度和与电子医疗相关的知识也显示出显著的影响(p<0.05)。
本研究通过调查影响电子医疗服务的感知有用性和感知易用性的因素,扩展了从医疗保健技术接受研究中获得的工作。基于这些实证发现,我们为电子医疗服务的设计和引入提出了一些建议,包括向门诊医生介绍电子医疗服务的建议和使用电子医疗服务的激励措施。