Improving the Performance of Hospital Information System Usage: Adaptive Structuration Theory and Job Demand-Control Perspectives

Abstract

Background: More healthcare facilities have been forced to introduce hospital information systems (HISs) aimed at integrating daily clinical and administrative concerns. As a result, China begun to implement HISs with basic functionalities among large and medium-sized hospitals. Although still in the initial stages of HIS usage, the performance of adopting HISs has yet to be evaluated. These applications are suitable for investigating user-system performance issues but seldom been utilized in a healthcare context. Even though models such as the technology acceptance model incorporates the determinants of technology use, the predictors assembled by these models largely focuses on interindividual user characteristics, yet none of them comprehensively exhaust other complex user adaptation characteristics relating to structure and task. We fill this gap by empirically investigating the motivators for improving Chinese physicians’ performance through HIS usage, based on the lens of adaptive structuration theory and job demand-control model.Methods: Using survey methodology, 305 valid responses were collected and analyzed via partial least squares.Results: The eight proposed hypotheses were supported in their entirety. Further, a moderating analysis was undertaken and it was determined that the associations of technology adaptation-task adaptation, technology adaptation-job demand, task adaptation-job demand, and job demand-attitude showed significant differences occurring between residents and attending physicians.Conclusions: Based on the findings, administrators are suggested to increase the training of physicians regarding their use of an HIS, and to grant physicians sufficient discretion necessary to improve the level of job demand and job control. This must be done in order to improve the performance of current HIS usage.