Esmaeilzadeh Pouyan, Sambasivan Murali, Kumar Naresh, Nezakati Hossein
College of Business Administration, Florida International University, USA.
Taylor's Business school, Taylor's University Lakeside Campus, Subang Jaya, Malaysia.
Int J Med Inform. 2015 Aug;84(8):548-60. doi: 10.1016/j.ijmedinf.2015.03.007. Epub 2015 Apr 8.
The basic objective of this research is to study the antecedents and outcomes of professional autonomy which is a central construct that affects physicians' intention to adopt clinical decision support systems (CDSS). The antecedents are physicians' attitude toward knowledge sharing and interactivity perception (about CDSS) and the outcomes are performance expectancy and intention to adopt CDSS. Besides, we include (1) the antecedents of attitude toward knowledge sharing-subjective norms, social factors and OCB (helping behavior) and (2) roles of physicians' involvement in decision making, computer self-efficacy and effort expectancy in our framework.
Data from a stratified sample of 335 Malaysian physicians working in 12 public and private hospitals in Malaysia were collected to test the hypotheses using Structural Equation Modeling (SEM).
The important findings of our research are: (1) factors such as perceived threat to professional autonomy, performance expectancy, and physicians' involvement in making decision about CDSS have significant impact on physicians' intention to adopt CDSS; (2) physicians' attitude toward knowledge sharing, interactivity perception and computer self-efficacy of physicians play a crucial role in influencing their perceived threat to professional autonomy; and (3) social network, shared goals and OCB (helping behavior) impact physicians' attitude toward knowledge sharing.
The findings provide a comprehensive understanding of the factors that influence physicians' intention to adopt CDSS in a developing country. The results can help hospital managers manage CDSS implementation in an effective manner.
本研究的基本目的是探究职业自主性的前因和结果，职业自主性是一个核心概念，它影响医生采用临床决策支持系统（CDSS）的意愿。前因包括医生对知识共享的态度和（关于CDSS的）交互性认知，结果包括绩效期望和采用CDSS的意愿。此外，我们在研究框架中纳入了：（1）对知识共享态度的前因——主观规范、社会因素和组织公民行为（帮助行为）；（2）医生参与决策、计算机自我效能感和努力期望的作用。
从马来西亚12家公立和私立医院工作的335名医生的分层样本中收集数据，使用结构方程模型（SEM）来检验假设。
我们研究的重要发现如下：（1）诸如对职业自主性的感知威胁、绩效期望以及医生参与CDSS决策等因素，对医生采用CDSS的意愿有显著影响；（2）医生对知识共享的态度、交互性认知以及计算机自我效能感，在影响他们对职业自主性的感知威胁方面起着关键作用；（3）社交网络、共同目标和组织公民行为（帮助行为）影响医生对知识共享 的态度。
这些发现全面地揭示了在一个发展中国家影响医生采用CDSS意愿的因素。研究结果有助于医院管理者有效地管理CDSS的实施。
