No abstract

This study examines physicians' responses to complex information technologies (IT) in the health care supply chain. We extend individual-level IT adoption models by incorporating a new construct: system accessibility. The main premise of the study is, when faced with a decision between alternate IT systems, individual users tend to select and make use of the technology or system that is most readily accessible. We discuss both physical and logical dimensions of accessibility as they relate to adoption of electronic medical records (EMR). Physical accessibility refers to the availability of computers that can be used to access EMR, while logical accessibility refers to the ease or difficulty of logging into the system. Using data from a survey of 199 physicians practicing in a large U.S. hospital, we show that, when deciding between the paper chart and EMR, accessibility is an important consideration in a physician's decision to use the system. Both dimensions of accessibility act as barriers to EMR use intentions through their indirect effect on physicians' perceptions of EMR usefulness and ease of use. Logical access also has a direct effect on EMR use intentions. We conclude that accessibility is an important factor that limits acceptance of complex IT such as EMR.

Decisional guidance is defined as how a decision support system (DSS) influences its users as they structure and execute the decision-making process. It is assumed that decisional guidance has profound effects on decision making, but these effects are understudied and empirically unproven. This paper describes an empirical, laboratoryexperiment-based evaluation of the effectiveness of deliberate decisional guidance and its four types. We developed and used a comprehensive model consisting of four evaluation criteria: decision quality, user satisfaction, user learning, and decision-making efficiency. On these criteria, we compared decisional guidance versus no guidance, informative versus suggestive decisional guidance, and predefined versus dynamic decisional guidance. We found that deliberate decisional guidance was more effective on all four criteria; suggestive guidance was more effective in improving decision quality and user satisfaction, and informative guidance was more effective in user learning about the problem domain, whereas dynamic guidance was more effective than predefined guidance in improving decision quality and user learning; and both suggestive guidance and dynamic guidance reduced the decision time.

No abstract

In the last few years, high-speed wireless access to the Internet has grown rapidly. Surprisingly, this growth has not come through cellular phone networks as many had expected, but through IEEE 802.11 standards-based wireless local area networks (WLANs). This rise of WLANs can be partly linked to the creation of a series of open standards, a precipitous fall in the costs of related hardware, and the explosive growth of home networking. WLANs have become commonplace in the education, transportation, and manufacturing sectors and are rapidly embraced in the retail, hospitality, and government sectors.