Factors Influencing the Adoption of Clinical Informatics Tools among Medical Doctors in South Africa
Authors
-
Nimbe Adedipe Library, Federal University of Agriculture, Abeokuta, Ogun State
Owolabi Kehinde Abayomi -
Department of Information Studies, University of Zululand, Richards Bay, 3900Neils Evan D.
-
Nimbe Adedipe Library, Federal University of Agriculture, Abeokuta, Ogun StateAderibigbe Nurudeen Ajao
DOI:
https://doi.org/10.17821/srels/2020/v57i3/149658Keywords:
Adoption, Clinical Informatics, Medical Doctors, UTAUT and South Africa.Abstract
The adoption of clinical informatics tools has been very poor in many developing countries and a better understanding of the factors that influence clinical informatics integration is expected to promote the effective utilisation of its tools. To shed more light on this phenomenon, the study employed the use of Universal Theory of Acceptance and Use of Technology (UTAUT) to identify the factors that influence the use of clinical informatics tools. The study employed a positivism research paradigm anchored on survey research design. Simple random sampling technique was used to select one hundred and five medical doctors in a tertiary hospital in South Africa. Data were collected with the use of a structured questionnaire. Structural equation modelling was used to analyse the data collected. Findings from the study revealed that facilitating condition was not related to behavioural intention to use clinical informatics (β = 0.09, p>0.05), effort expectancy was related to behavioural intention to use clinical informatics (β = 0.41, p<0.05), performance expectancy was related to behavioural intention to use clinical informatics (β = 0.47, p<0.01) and social influence was not related to behavioural intention to use clinical informatics (β = -0.11, p>0.05). The study therefore recommends the need for the hospital management to create conducive environment that will promote effective use of clinical informatics make clinical information tools more user friendly and organise training programmes for effective use of the tools.. The study contributes to debates and discussions on UTAUT theory. The evidence from the study will help to identify the factors that influence behavioural intention towards the use of clinical informatics tools, which will provide a strong opportunity for a better understanding of factors that can motivate medical doctors to use clinical informatics effectively.
Downloads
Metrics
References
Ahiaku, P. K. (2015). Utilisation of healthcare facilitates in Mthonjaeni Local Municipality, First degrees project, University of Zululand, KwaDlangezwa.
Ahmed, M. (2007). Evaluating the effectiveness of information communication technology use in urban hospitals in Uganda, doctoral thesis, Department of Computing and Information Technology, University of Makerere, Uganda.
Ajzen, I. (1991). The theory of planned behaviour. Organizational Behaviour and Human Decision Processes, 50(2), 179-211. https://doi.org/10.1016/07495978(91)90020-T.
Ajzen, I. and Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.
Almulhen, J. A. and Alarfaj, M. (2015). Importance of medical informatics in medical students’ curricula in Saudi Arabia. A thesis submitted to the Department of Health care Informatics, University of Wiscoinsin –Milwaukee. https://www.researchgate.net/publication/334960578_Importance_of_Medical_Informatics_in_Medical_ Students%27_Curricula_in_Saudi_Arabia.
Ani, O. E. (2013). Accessibility and utilization of electronic information resources for research and effect on productivity of academic staff in selected Nigerian universities between 2005-2012. PhD thesis, University of South Africa. http://uir.unisa.ac.za/bitstream/ handle/10500/13057/thesis_.pdf?sequence.
7. Archangel, B. (2007). Integration or patchwork for communication and messages in a hospital, master thesis, Department of Telematics, Norwegian University of Science and Technology.
Arvanities, K. and Loukis, E. (2016). Investigating the effects of ICT on innovation and performance of European hospitals: an exploratory study. European Journal of Health Economic, 17(4), 403-18. https://doi.org/10.1007/s10198-015-0686-9. PMid: 25822165.
Bagozzi, R. P. and Warshaw, P. R. (1990). Warshaw, “Trying to Consume”. Journal of Consumer Research, 17, 127-40. https://doi.org/10.1086/208543.
Baraldi, A. N. and Enders, C. K. (2010). An introduction to modern missing data analyses. Journal of School Psychology, 48, 5-37. https://doi.org/10.1016/j.jsp.2009.10.001. PMid: 20006986.
Bean, K., Davis, A. and Valdez, H. (2013). Bridging the digitals: A bilingual interactive by health kiosk for disparity. The Journal of Community Informatics, 9(2) 1-7.
Bello, I. S. Arogundade F. A. Sanusi, A. A., Ezeoma, I. T., Abioye-Kuteyi, E. A. and Akinsola, A. (2004). Knowledge and utilization of information technology among health care professionals and students in Ile-Ife, Nigeria: A case study of a university teaching hospital. Journal of Medical Internet Research, 6(4), 1-12. https://doi.org/10.2196/ jmir.6.4.e45. PMid: 15631969, PMCid: PMC1550621.
Bukachi, F. and Pakenhamo-Walsh, N. (2007). Information technology for health in developing countries. Chest, 132(50), 1624-30. https://doi.org/10.1378/chest.07-1760.PMid: 17998362.
Chau, P. and Hu, P. (2013). Investigating healthcare professionals’ decisions to accept telemedicine technology: An empirical test of competing theories. Information Manager, 39, 297-311. https://doi.org/10.1016/S03787206(01)00098-2.
Chinghai, P. N. and Holt, A. (2010). The disparity information and communication technology for developing countries has in the delivery of healthcare information. Open Medical Informatics, 4(1), 195-201. https://doi.org/10.2174/1874431101004010195. PMid: 21594006, PMCid: PMC3096885.
Cohen, J. F. Bancihon, J. and Jones. M. (2013). South African physicians of e-prescribing technology: An empirical test of a modified UTAUT model. South Africa Computer Journal, 50(1), 43-50. https://doi.org/10.18489/ sacj.v50i1.175.
Coleman, A. Herselman., H. E. and Corade, D. P. (2013). ICT applications as e-health solutions in rural healthcare in the Eastern Cape -Province of South Africa. Health Information Management Journal, 39(1), 17-26. https:// doi.org/10.1177/183335831003900104. PMid: 20335646.
Compeau, D. R. and Higgins, C. A. (1995). Application of social cognitive theory to training for computer skills. Information Systems Research, 6(2), 118-43. https://doi.rg/10.1287/isre.6.2.118.
David, A. (2009). Information Behaviours of physicians: Implications for digital reference. Health Information and Libraries Journal, 24(1), 78-94.
De Boer, M. J. Versteengen, G. J. and van Wijhe, M. (2007). Patients’ use of the Internet for pain-related medical information. Patient Education and Counselling, 68(1), 86-97. https://doi.org/10.1016/j.pec.2007.05.012. PMid: 17590563.
Dunnebeil, S. Sunyaev A, Blohm I, Leimeister J. M, and Krcmar, H. (2012). Determinants of physicians’ technology acceptance for e-health in ambulatory care. International Journal Medical Informatics, 81(11), 74660. https://doi.org/10.1016/j.ijmedinf.2012.02.002. PMid: 22397989.
Edwards, K. Felix, P. and Lambert, M. (2010). Caffeine for the prevention of injuries and errors in shift workers. The Cochrane Database of Systematic Reviews, 5(5), 1-12.
English, D. Ankem, K and English, K. (2017). Acceptance of clinical decision support surveillance technology in the clinical pharmacy. Inform Health Social Care, 42(2), 135-52. https://doi.org/10.3109/17538157.2015.1113415.PMid: 26890621.
European Commission (2008). Survey takes pulse of e-health in Europe and prescribes wider ICT use among doctors, press realise data base. Accessed on 6 July, 2016. Retrieved from https://release_IP-08-641en.htm?locale=en.
Flynn-Dapaah, K. and Rashid, A. T. (2010). Gender digital equity in ICT intervention in health: evidence from IDRC supported projects in developing countries. The Journal of community Informatics, 6(1), 1-9.
Fornell, C. and Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18, 39-50. https://doi.org/10.2307/3150980, https://doi.org /10.1177/002224378101800104, https://doi.org/10.1177/00 2224378101800313, https://doi.org/10.2307/3151312.
Fornell, C., and Larcker, D. F. (1981). Structural Equation Models with Unobservable Variables and Measurement Error: Algebra and Statistics. Journal of Marketing Research, 18, 382-88. https://doi.org/10.2307/3150980, https://doi.org/10.1177/002224378101800104, https://doi.org/10.1177/002224378101800313, https://doi.org/10.2307/3151312.
Gatero, G. (2011). Utilisation of ICTs for accessing health information by medical professional in Kenya;a case study of Kenyatta National Hospital. Journal of Health Informatics in Developing Countries, 5(1), 1-7.
Gray, A. and Verda, Y. (2014). Health Policy and legislation. In padarathe, A. English. South Africa Health Review 2013/14, 3(1), 1-7.
Hair, J. F., Hult, G. T., Ringle, C. M. and Sarstedt, M. (2014). A primer on partial least squares structural equation modelling (PLS-SEM), Los Angeles, Sage Publications.
Haux, E. (2006). Health information systems: Past, present, future. International Journal of Medicare. 75(1), 268-81. https://doi.org/10.1016/j.ijmedinf.2005.08.002. PMid: 16169771.
Holden, R. J. and Karsh, B. T. (2010). The technology acceptance model: Its past and its future in health care. Journal of Biomedical Informatics, 43(1), 159-72. https:// doi.org/10.1016/j.jbi.2009.07.002. PMid: 19615467, PMCid: PMC2814963.
Houshyar, A. B. Bahadorani, M. Tootoonchi, M. Gardiner, W. and Adib, P. (2012). ICTs in medical education: An experience from a developing country. Journal of Pakistan Medical Association, 3(2), 71-75. https://doi.org/10.4103/2277-9531.94411. PMid: 23555106, PMCid: PMC3577362.
International Telecommunication Union (2012). Key ICT indicators 2012-2014. World Telecommunication Press. Accessed on 9th July, 2016. http://www.itu.int/en/ITU-D/Statistics/Pages/publications/w tid.aspx.
Jha, A. Desroches, C. M. Capbell, E. G. Donelan. K. Rao, S. Timothy, F. Sheilds, A. Rodenbary, S. and Bluementhel. M. D. (2009). Use of electronic health records in US hospitals New English. Journal of Medicine, 360. 162838. https://doi.org/10.1056/NEJMsa0900592. PMid: 19321858.
Jones, S. and Fox, S. (2009). Generations online in 2009. Data memo. Washington, DC: Pew Internet and American Life Project. Retrieved October, 2016. http://www.pewinternet.org/w/media//Files/Reports/2009/ PIP_Generations_2009.pdf.
Kaba, B. Diallo, A. Plaisent, M Bernard, P. and N’ Da, K. (2017). Explaining the factors influencing cellur phones use in Guinea. The Electronic Jounral of Information Syatems in Developing Countres, 28(1), 1-7. https://doi.org/10.1002/j.1681-4835.2006.tb00187.x.
Karsenti, T. and Charlin B. (2008). Information and Communication Technologies (ICT) in medical education and practice: The major challenges. International Journal of Technologies in Higher Education, 5, 68-81. https://doi.org/10.7202/037475ar.
Kijsanayotin, B. Pannarunothai, S. and Speedie, S. M. (2009). Factors influencing health information technology adoption in Thailand’s community health centers: Applying the UTAUT model. International Journal of Medical Informatics, 78(6), 404-16. https://doi.org/10.1016/j.ijmedinf.2008.12.005. PMid: 19196548.
Kommalage, M. and Gunawardena, S. (2008). Feasibility of introducing information technology based activities into medical curricula in developing countries. Medical Education, 42(1), 113-20. https://doi.org/10.1111/j.13652923.2007.02906.x. PMid: 18181850.
Kosteniuck, J. C. Morgan, D. G. and D’ Arcy, C. K. (2013). Use and perceptions of information among family physician’s sources considered accessible, relevant and reliable. Journal of Medical Library Association. 101(1), 32-37. https://doi.org/10.3163/1536-5050.101.1.006. PMid: 23405045, PMCid: PMC3543145.
KPMG (2012). Funding NHI: A spoonful of sugar? An economic analysis of the NHI. KPMG South Africa.
Li, J. Talaaei-Khoei, Seale, H. Ray, P. and Maclnyre, C. R. (2013). Healthcare provider adoption of e-health systematic literature review. Internet Journal Medical Research, 2(1),1-12. https://doi.org/10.2196/ijmr.2468. PMid: 23608679, PMCid: PMC3628149.
Lluch, M. (2011). Healthcare professionals’ organisational barriers to health information technologies-A literature review. International Journal of Medical Informatics, 80(12), 849-62. https://doi.org/10.1016/j.ijmedinf.2011.09.005. PMid: 22000677.
Makary, M. A. and Daniel, M. (2016). Medical error-the third leading cause of death in the USA. BMJ, 353, 139. https://doi.org/10.1136/bmj.i2139. PMid: 27143499.
Mardia, K. (1970). Measures of multivariate skewness and kutorsis with applications. Biometrika, 57(3), 519-30. https://doi.org/10.1093/biomet/57.3.519.
Mchunu, N. N. (2013). Adequacy of healthcare information systems to support data quality inthe public healthcare sector, in the Western Cape, South Africa.
Moahi, K. H. (2009). ICT and health information in Bostswana: Towards the millemium development Goals. Information Development, 25(3), 198-206. https://doi.org/10.1177/0266666909340790.
Moududdin, A. and Moore, J. (2008) .The underserved and health information technology issues and opportunities United National Department of Health and Human Services.
Musa, P. F. (2006). Making a case for modifying the technology acceptance model to account for limited accessibility in developing countries. Journal of Information Technology for Development (JITD), 12(3), 213-24. https://doi.org/10.1002/itdj.20043.
Nwagwu, W. and Adio, A. (2013). Contexts of utilsation of ICT by medical practitioners in private hospitals in Osun State, Nigeria. World Jouranl of Scince Technology and Sustainable Development, 10(3), 229-46. https://doi.org/10.1108/WJSTSD-01-2013-0004.
Odini, S. and Omuoke, A. (2014). Use of ICT by medical professionals in accessing information for healthcare delivery at Moi Teaching and Referral Hospital MTRN) in Eldoret Kenya. Journal of International Academic Research for Multidisciplinary, 2(5), 153-80.
Ogundani, O. O (2016).Adoption and use of electronic healthcare information systems to support clinical care in public hospitals of Western Cape Master of Technology, Faculty of Information and design. Cape Peninzula University of Technology.
Olasina, G. (2014). Predictors of legislators ICT acceptance and use in the performance of legislative functions at the Nigerian National Assembly PhD thesis submitted to the Department of the Information Studies in the University of Kwazulu-Natal Pirtermariburg.
Olasina, G. and Popoola, T. (2014). Predictors of the use of e-medicine by medical doctors. Journal of Health Medical Informatics, 5(166), 16-24. https://doi.org/10.4172/21577420.1000166.
Owolabi, K. A. (2016). Access and use of clinical informatics among medical doctors in selected teaching hospitals in Nigeria and South Africa PhD thesis submitted to the Department of Information Studies , University of Zululand, Kwa-Dlengezwa.
Owolabi, K. A., Evans, N. and Mhlongo, P. T. (2016). Applying UTAUT in Clinical Informatics Research. Library Philosophy and Practice paper 1478. Published by University of Nesbraska- Lincoln. Available online at http://digitalcommons.unl.edu/libphilprac/1478.
Owolabi, K. A. Adenekan, F. N. Nssein, F. N. and Durojaiye, A. O. (2018). Behavioural Intention to use of Health Information Technology among medical doctors in Nigeria. International Journal of Information Processing and Communication. 6(2), 241-54. Published by Faculty of Information and Information Communication Technology, University of Ilorin.
Owolabi, K. A. Evans, N. D. and Ocholla, D. N. (2017). Factor that influence medical doctors that influence medical doctors behavioural intention to use clinical informatics. MOUSAION: Journal of Library and Information Science, 36(1), 130-54. Published by the University of South Africa. https://doi.org/10.25159/00272639/2321.
Price, M. and Lau, F. (2014). The clinical adoption metamodel: a temporal meta-model describing the clinical adoption of health information systems. BMC Medical Informatics and Decision Making, 14(1), 43. https://doi.org/10.1186/1472-6947-14-43. PMid: 24884588, PMCid: PMC4050391.
Protti, D. J. Bowden, T. and Johansen, I. (2008). Adoption of information technology in primary care physician offices in New Zealand and Denmark, part 1: Health care system comparisons. Informatics in Primary Care, 16(3), 183-87. https://doi.org/10.14236/jhi.v16i3.692. PMid: 19094404.
Ranta, P. (2005). Information and communications technology in health care master’s thesis, Department of Economics, Aalto University School of Economics.
Rao, S. S. (2009). Role of ICTs in India rural communities. Journal of Community Informatics. 5(1), 1-6. http://www.ci-journal.net/index.php/ciej/article/view/313.
Rogers, E. M. (1995). Diffusion of innovations (4th ed). New York: The Free press.
Ruxwana, N., Herselman, M. and Conradie, Dp. (2010). ICT applications as e-health solutions in rural healthcare in the Eastern Cape Province of South Africa. Health Information Management Journal, 39(1), 17. https://doi.org/10.1177/183335831003900104. PMid: 20335646.
Safdari, R. Jebraeily, M. Rahimi, B. and Doulani, A. (2014). Smartphones medical training of medical students of UMSU and its influencing factors. Relagia Research Library, 2(1), 633-37.
Sahay, S. (2007). Focusing equally on ‘E’ and health: case studies from India and Ethiopia. E-Health, 2 (1), 15-23.
Salman, S. B. and Ahamed, S. (2013). Information seeking in primary care: A survey of doctors working in remote government health facilities in Pakistan. Library Philosophy and Practices, Paper 9. Accessed on 12 July, 2015. Retrieved from https://digitalcommons.unl.edu/libphilprac, https://digitalcommons.unl.edu/cgi/ viewcontent.cgi?article=2436&context=libphilprac.
Schumacker, R. E. and Lomax, R. G. (1996). A beginner’s guide to structural equation modelling. Erlbaum: Mahwah, NJ. https://doi.org/10.1080/10705519609540025.
Shifeew. F. and Zolfo. M. (2012). The role of ICT towards universal health coverage. The first steps of a telemedicine. Global Health Action, 5(1), 1-17. https://doi.org/10.3402/ gha.v5i0.15638. PMid: 22479235, PMCid: PMC3318899.
Shikhtaheri, A, Sadeqi-Jabali, M and Hashemi-Dehaghi, Z (2018). Physciansperpectives strategies: A study in a developing country. Iranian Journal of Public Health, 47(5), 720-28.
Simba, D. (2004). Application of ICT in strengthen health information systems in developing countries in the wake of globalisation. African Health Science, 4(3), 194-99.
Taylor, S. and Todd, P. A. (1995). Understanding Information Technology Usage: A Test of Competing Models. Information Systems Research, 6(4), 144-76. https://doi.org/10.1287/isre.6.2.144.
Thompson, R. L., Higgins, C. A. and Howell, J. M. (1991). Personal computing: toward a conceptual model of utilization. MIS Quarterly, 15(1), 124-43. https://doi.org/10.2307/249443.
Venkatesh, V. and Davis, F. (2000). Theoretical extension of the technology acceptance model: Four longitudinal field studies. Management Science, 46(2), 186-204. https://doi.org/10.1287/mnsc.46.2.186.11926.
Venkatesh, V. and Davis, F.D. (2000) A theoretical extension of the technology acceptance model: Four longitudinal field studies. Management Science, 46, 186204. https://doi.org/10.1287/mnsc.46.2.186.11926.
Venkatesh, V., Morris, G., Michael, G. Davis, G. and Davis, F. D. (2003) .User acceptance of information technology: Toward a unified view. MIS Quarterly, 27(3), 425-78. https://doi.org/10.2307/30036540.
Venkatesh, V., Morris, M., Davis, G. and Davis, F. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 27(3), 425-78. https://doi.org/10.2307/30036540.
Venkatesh, V., Morris, M. G., Hall, M., Davis, G. B., Davis, F. D. and Walton, S. M. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 27(3):425-78. https://doi.org/10.2307/30036540.
Venkatesh, V., Davis, F. D. and Morris, M. G. (2007). Dead or Alive? The development, trajectory and future of technology adoption research. Journal of the AIS, 8(4), 268-86 https://doi.org/10.17705/1jais.00120.
Venkatesh. V., Thong, J. Y. L. and Xu, X. (2012). Consumer acceptance and use of information technology: Extending the unified theory of acceptance and use of technology. MIS Quarterly, 36(1), 157-78. https://doi.org/10.2307/41410412.
Verbeke, F., Karara, G. and Nyssen, M. (2010). Evaluating the impact of ICT-tools on health care delivery in subsaharan hospitals. Studies in Health Technology and Informatics, 192(1),11-21.
WHO (2013). E-health and innovation in women’s and children health: A baseline review. Global Observatory for Health WHO Press.
Williams, M. D. Rana, P. N. and Dwivedi, Y. K. (2015). The unified theory of acceptance and use of technology (UTAUT): A literature review. Journal of Enterprise Information Management, 28(3), 2-8. https://doi.org/10.1108/JEIM-09-2014-0088.
Woreta, S. A. Kebede, Y. and Zegeye, D. T. (2013). Knowledge and utilisation of ICT among health science students at the University of Gondoar, North Western Ethiopia. Medical Informatics Decision Making, 13(13), 1-12. https://doi.org/10.1186/1472-6947-13-31. PMid: 23452346, PMCid: PMC3599196.
Wu, J. H., Wang, S. C. and Lin, L. M. (2007). Mobile computing acceptance factors in thehealthcare industry: A structural equation model. International Journal of Medical Information, 76(1), 66-77. https://doi.org/10.1016/j.ijmedinf.2006.06.006. PMid: 16901749.
Yoo, S. J. Han, S. H. and Huang, W. B. (2012). The roles of intrinsic motivators and extrinsic motivators in promoting e-learning in the workplace: A case from South Korea. Computers in Human Behavior, 28(1), 94250. https://doi.org/10.1016/j.chb.2011.12.015.
Zhang, H. Cocosile, M. and Archer, N. (2010). Factors of adoption of mobile information technology by homecare nurses: A technology acceptance model 2 approach. Computers Informatics, 28(1), 49-50. https://doi.org/10.1097/NCN.0b013e3181c0474a. PMid: 19940621.
Downloads
Published
How to Cite
Issue
Section
License
All the articles published in Journal of Information and Knowledge are held by the Publisher. Sarada Ranganathan Endowment for Library Science (SRELS), as a publisher requires its authors to transfer the copyright prior to publication. This will permit SRELS to reproduce, publish, distribute and archive the article in print and electronic form and also to defend against any improper use of the article.
Accepted 2020-06-25
Published 2020-07-07
