Industry predictions focus on future e-hospitals that will integrate all stakeholders into a seamless network, allowing data to be shared. The Health Level Seven (HL7) is a standard for the interchange of data within the healthcare industry. It simplifies communication interfaces and allows the interoperability among heterogeneous applications. Although the benefits of adopting HL7 are well known, only a few hospitals in Taiwan have actually adopted it. What are the reasons behind the hospitals' lack of intention to adopt HL7? Most prior studies on HL7 have focused on technical issues and general overlooked the managerial side. This has caused a lack of understanding of factors influencing hospitals' decision on HL7 adoption. In fact, main reasons behind a hospital's decision on whether to adopt an innovative technology are more often related to organizational than purely technical issues. Hence, we pay our attention to these organizational considerations over HL7 adoption. Based on the Innovation Diffusion Theory, we proposed a research model to explore the critical factors influencing Taiwan hospitals' adoption intention of HL7. 472 questionnaires were distributed to all accredited hospitals in Taiwan and 122 were returned. The valid response rate was 25.21% (119). Factor analysis, logistic regression and Pearson Chi-square test were conducted to verify the research model. The results showed that environmental pressure, top management attitude towards HL7, staff's technology capability, system integrity, and hospital's scale were critical factors influencing hospitals' intention on whether to adopt HL7. The research findings provided the government, the healthcare industry, the hospital administrators and the academia with practical and theoretical references. These factors should be considered in planning promotion plan to encourage hospital adoption of HL7. This study also opens up a new research direction as well as a new viewpoint, and consequentially improves the completeness of related researches in the medical informatics discipline.
This paper presents a two-dimensional model for measuring individual teachers' progression in ICT integration and for guiding them toward higher integration levels. There are four levels in the pedagogy dimension: direct teaching, cognitively active learning, constructive learning, and social learning. These levels are defined based on four factors: teacher pedagogical beliefs, instructional strategies used, teacher-student interactions, and the types of tasks students are expected to carry out. The technology dimension contains eight levels, ranging from Level 0 (nonuse) to Level 7 (implementing sophisticated instructional applications). The eight levels are defined based on three factors: whether a teacher is a passive consumer or an active producer of the ICT-based resources, sophistication of the ICT tools that a teacher uses, and richness of functionality of an ICT-based product developed by a teacher. To validate the proposed model in terms of its applicability and practicability, three case studies were conducted. The results showed that this model was able to adapt to individual preferences of the three participating teachers as well as guide their progressions in ICT integration.
Prior research on technology usage had largely overlooked the issue of user resistance or barriers to technology acceptance. Prior research on the Electronic Medical Records had largely focused on technical issues but rarely on managerial issues. Such oversight prevented a better understanding of users' resistance to new technologies and the antecedents of technology rejection. Incorporating the enablers and the inhibitors of technology usage intention, this study explores physicians' reactions towards the electronic medical record. The main focus is on the barriers, perceived threat and perceived inequity. 115 physicians from 6 hospitals participated in the questionnaire survey. Structural Equation Modeling was employed to verify the measurement scale and research hypotheses. According to the results, perceived threat shows a direct and negative effect on perceived usefulness and behavioral intentions, as well as an indirect effect on behavioral intentions via perceived usefulness. Perceived inequity reveals a direct and positive effect on perceived threat, and it also shows a direct and negative effect on perceived usefulness. Besides, perceived inequity reveals an indirect effect on behavioral intentions via perceived usefulness with perceived threat as the inhibitor. The research finding presents a better insight into physicians' rejection and the antecedents of such outcome. For the healthcare industry understanding the factors contributing to physicians' technology acceptance is important as to ensure a smooth implementation of any new technology. The results of this study can also provide change managers reference to a smooth IT introduction into an organization. In addition, our proposed measurement scale can be applied as a diagnostic tool for them to better understand the status quo within their organizations and users' reactions to technology acceptance. By doing so, barriers to physicians' acceptance can be identified earlier and more effectively before leading to technology rejection.
Prior researches have indicated that an appropriate adoption of information technology (IT) can help hospitals significantly improve services and operations. Radio Frequency Identification (RFID) is believed to be the next generation innovation technology for automatic data collection and asset/people tracking. Based on the Technology-Organization-Environment (TOE) framework, this study investigated high-level managers' considerations for RFID adoption in hospitals. This research reviewed literature related IT adoption in business and followed the results of a preliminary survey with 37 practical experts in hospitals to theorize a model for the RFID adoption in hospitals. Through a field survey of 102 hospitals and hypotheses testing, this research identified key factors influencing RFID adoption. Follow-up in-depth interviews with three high-level managers of IS department from three case hospitals respectively also presented an insight into the decision of RFID's adoption. Based on the research findings, cost, ubiquity, compatibility, security and privacy risk, top management support, hospital scale, financial readiness and government policy were concluded to be the key factors influencing RFID adoption in hospitals. For practitioners, this study provided a comprehensive overview of government policies able to promote the technology, while helping the RFID solution providers understand how to reduce the IT barriers in order to enhance hospitals' willingness to adopt RFID.
We showed TMSS as an effective tool that helps reduce primary caregiver isolation and uncertainty and provides round-the-clock care management and safety checks using advanced technology and a professional care team. TMSS can effectively enhance dementia care.
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