Hah Hyeyoung, Goldin Deana, Ha Sejin
Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States.
Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, United States.
J Med Internet Res. 2019 Aug 29;21(8):e15087. doi: 10.2196/15087.
Telehealth technology can create a disruptive communication environment for frontline care providers who mediate virtual communication with specialists in electronic consultations. As providers are dealing with various technology features when communicating with specialists, their flexible attitude and behaviors to use various telehealth-related technology features can change the outcome of virtual care service.
The objective of this study is to examine frontline care providers' technology adaptation behaviors in the electronic consultation context. From the perspective of frontline care providers, we reapply and retest a theoretical model, reflecting a mechanism through which technology users' personal characteristics and technology adaptation behavior enhance virtual service performance, which is an important performance enabler in this online meeting context. In provider-to-provider communication, particularly, we explore the association among providers' information technology (IT)-related personal characteristics, adaptive telehealth technology use, and virtual service performance.
An online survey was administered to collect individual providers' personal traits, IT adaptation, and perception on virtual service performance. Partial least squares-structural equation modeling was used to estimate our predictive model of personal traits-IT adaptation, such as exploitative use (use the telehealth technology in a standard way), and exploratory use (use the telehealth technology as innovative way)-and virtual service performance.
We collected 147 responses from graduate nursing students who were training to be nurse practitioners in their master's program, resulting in 121 valid responses from the cross-section online survey. Our theoretical model explained 60.0% of the variance in exploitative use of telehealth technology, 44% of the variance in exploratory use of telehealth technology, and 66% of the variance in virtual service performance. We found that exploitative IT use is an important driver to increase virtual service performance (β=0.762, P<.001), and personal characteristics such as habit are positively associated with both exploitative (β=0.293, P=.008) and exploratory use behaviors (β=0.414, P=.006), while computer self-efficacy is positively associated with exploitative use of telehealth technology (β=0.311, P=.047).
This study discusses the unique role of frontline care providers in a virtual care service context and highlights the importance of their telehealth adaptation behavior in provider-to-provider communication. We showed that providers perceive that telehealth technologies should function as intended, otherwise it may create frustration or avoidance of the telehealth technology. Moreover, providers' habitual use of various technologies in daily lives also motivates them to adaptively use telehealth technology for improving virtual care service. Understanding providers' technology habit and adaptation can inform health care policy and further provide a better view of the design of telehealth technology for online communication.
远程医疗技术可为一线医疗服务提供者创造一个颠覆性的沟通环境，这些提供者在电子会诊中负责协调与专科医生的虚拟沟通。由于提供者在与专科医生沟通时要应对各种技术功能，他们对使用各种远程医疗相关技术功能的灵活态度和行为会改变虚拟护理服务的结果。
本研究的目的是考察一线医疗服务提供者在电子会诊背景下的技术适应行为。从一线医疗服务提供者的角度出发，我们重新应用并重新测试了一个理论模型，该模型反映了技术用户的个人特征和技术适应行为增强虚拟服务绩效的机制，而虚拟服务绩效是这种在线会议背景下的一个重要绩效推动因素。特别是在提供者之间的沟通中，我们探讨了提供者与信息技术（IT）相关的个人特征、适应性远程医疗技术使用和虚拟服务绩效之间的关联。
进行了一项在线调查，以收集个体提供者的个人特质、IT适应情况以及对虚拟服务绩效的看法。使用偏最小二乘结构方程建模来估计我们关于个人特质-IT适应（如开发性使用（以标准方式使用远程医疗技术）和探索性使用（以创新方式使用远程医疗技术））与虚拟服务绩效的预测模型。
我们从正在攻读硕士学位、接受执业护士培训的护理学研究生中收集了147份回复，在线横断面调查得到121份有效回复。我们的理论模型解释了远程医疗技术开发性使用中60.0%的方差、探索性使用中44%的方差以及虚拟服务绩效中66%的方差。我们发现，开发性IT使用是提高虚拟服务绩效的一个重要驱动因素（β=0.762，P<0.001），习惯等个人特征与开发性（β=0.293，P=0.008）和探索性使用行为（β=0.414，P=0.006）均呈正相关，而计算机自我效能感与远程医疗技术的开发性使用呈正相关（β=0.311，P=0.047）。
本研究讨论了一线医疗服务提供者在虚拟护理服务背景下的独特作用，并强调了他们在提供者之间沟通中的远程医疗适应行为的重要性。我们表明，提供者认为远程医疗技术应按预期发挥作用，否则可能会导致对远程医疗技术的挫败感或回避。此外，提供者在日常生活中对各种技术的习惯性使用也促使他们适应性地使用远程医疗技术以改善虚拟护理服务。了解提供者的技术习惯和适应情况可为医疗保健政策提供参考，并进一步为在线沟通的远程医疗技术设计提供更好的视角。
