Rationale, aims and objectives Sufficient evidence suggests that health information technology (HIT) will soon become part of physician procedure. This paper poses that the outcome of using HIT is affected by the intentions of use. Note that ethical indoctrination is a crucial mechanism for monitoring physicians. Judicious and sufficient use of HIT is expected to be the prerequisite for deploying these technologies to help in delivering better care. This research paper, therefore, aims to define professional concerns and intent to use HIT, and identify their associations. Methods A survey study was conducted to collect data for developing a seven‐dimensional eHealth success measure. This paper focuses on deriving a structural equation model that can explain the associations among professional concerns and intent to use HIT. Statistical analyses were, therefore, only performed on the Intent to Use and Physician Attributes constructs. Results The statistical results show that altruism, autonomy, physician‐patient relationship and (subconscious) autonomy significantly associate with each other at least at P < 0.05. Only altruism shows to be a significant determinant of intent to use HIT (with P = 0.00005). Other professional concerns only associate with it indirectly through altruism. Conclusions Medicine has been a science‐using and compassionate practice. Medical practice including HIT use may only be reliably assessed from a sociotechnical perspective. Professional concerns show to be associated with intent to use HIT is an expected result. This research direction may contribute to deriving policies to deploy HIT for delivering better care through implementing sufficient and judicious HIT use.
A physician chooses not only the supply of medical treatment, contingent on the result of a diagnostic test, but also the quality of his service. Two sources of uncertainty are introduced. One source arises as, based on the patient's "apparent" symptoms, only a priori estimates of the likelihood of alternative medical conditions can be inferred. They can be improved upon by a diagnostic test, but inherent in such tests is the possibility of a "false positive". This second source of uncertainty is shown to be critical in the possible over-or undersupply of medical treatment. Remedial pricing structures are suggested.
Economics is en route to its further expansion in medicine, but many in the medical community remain unconvinced that its impact will be positive. Thus, a philosophical enquiry into the compatibility of economics and medicine is necessary to resolve the disagreements. The fundamental mission of medicine obliges physicians to practise science and compassion to serve the patient's best interests. Conventional (neoclassical) economics assumes that individuals are self-interested and that competitive markets will emerge optimal states. Economics is seemingly incompatible with the emphasis of putting patients' interests first. This idea is refuted by Professor Kenneth Arrow's health economics seminal paper. Arrow emphasizes that medical practice involves agency, knowledge, trust and professionalism, and physician-patient relation critically affects care quality. The term Arrow Physician is used to mean a humanistic carer who has a concern for the patient and acts on the best available evidence with health equity in mind. To make this practice sustainable, implementing appropriate motivations, constitutions and institutions to enable altruistic agency is critical. There is substantial evidence that polycentric governance can encourage building trust and reciprocity, so as to avoid depletion of communal resources. This paper proposes building trusting institutions through granting altruistic physicians adequate autonomy to direct resources based on patients' technical needs. It also summarizes the philosophy bases of medicine and economics. It, therefore, contributes to developing a shared language to facilitate intellectual dialogues, and will encourage trans-disciplinary research into medical practice. This should lead to medicine being reoriented to care for whole persons again.
Rationale, aims and objectives: Knowledge is the basis and mediator of medical care. Health information technology (HIT) can help in improving care only if physicians faithfully apply their knowledge during its use. A measure of judicious HIT use has recently been proposed. Behavioural research and the oft-cited technology acceptance model suggest that beliefs/perceptions may also represent decision factors. This paper proposes a perception scale and an alternative measure of judicious HIT use. Methods: Statistical analyses were performed on a subset of survey data collected for developing an eHealth success model. This paper focuses on deriving a structural equation model that can explain the associations among intent to use HIT, professional concerns and perceptions about the impacts of HIT on care benefits. Results:The statistical results show that altruism, autonomy, the physician-patient relationship, (subconscious) autonomy, efficiency and efficacy significantly associate with each other to different extents. Only altruism and efficacy appear to be significant determinants of intent to use at p<0.01 and p<0.05, respectively. The scaled 2 difference test shows that this model is not significantly different from Tsang's model. Conclusion: Physician performance cannot be reliably evaluated and monitored when based purely on direct observations. The statistical results indicate that professional concerns associate with physicians' perceptions about the impacts of HIT and influence intent to use HIT. This paper shows a tendency of physicians to internalise factors that cannot be directly observed in the evaluation of HIT use. The study is advanced as of use in deriving policies that aim at coalescing evidencebased medical practice with humanism and thus as a significant contribution to the advancement of person-centered healthcare.
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