Adoption of health information systems in emerging economies: Evidence from Ghana

Successful adoption and implementation of health information systems (HIS) has been the subject of extensive research as can be evidenced by the large body of recent research literature on this topic. Most scholars agree that these solutions are complex to understand and should be analysed under the lens of theoretically informed analytical tools. One approach identified in the literature used to facilitate correct and accurate capturing of the complexities and levels of interactions in healthcare operations and technologies is to use structuration theory (ST). To demonstrate the benefits and strengths of using ST, this chapter evaluates the merits of an ST analysis for the implementation and adoption of health information systems (HIS).

The trends in EMR and CPOE adoption in Japan under the national strategy

Implementation status of health information systems in hospitals in the eastern province of Saudi Arabia

Adoption of a health information system is always a challenge for hospitals. It is because most of the medical staff do not have enough skills to use the new technology and due to the sensitivity of medical data. These factors pose a challenge for the successful adoption of health information system in hospitals. The aim of this research is to find out the factors which influence the adoption of information systems in hospitals. The study investigated the impact of the Financial status of the Hospital; Perceived Usefulness and Perceived Ease of Use on the adoption of health information systems through a questionnaire survey. Data was collected from 602 healthcare workers from 20 hospitals through close-ended questionnaire in Pakistan, where the adoption of health information systems is very slow. PLS-SEM was used for the analysis. The findings show that the Financial status of the Hospital; Perceived Usefulness and Perceived Ease of Use have positive and significant role in the adoption of Health Information Systems. The finding also shows that hospital size moderates the relationship of Perceived ease of use and the adoption of health information systems and interestingly it does not moderate the relationship among perceived usefulness and financial strength toward the adoption of health information systems. The study concludes that perceived ease of use, perceived usefulness and financial strength are the main factors, necessary for the adoption of health information systems. The findings of the study have useful implications for policy makers, medical professionals to successfully adopt health information systems in hospitals. It also provides new avenues for researchers to explore other factors and test this framework in other countries.

Sustainable technology means technology is capable of being maintained over a long span of time; independent of shifts in both hardware and software. Effective implementation and use of Health information Systems (HIS) for years to come is crucial as sustainable HIS. Numbers of studies have discussed various factors contributes towards barriers for successful implementation of HIS. However, very few studies discussed factors on HIS sustainability. Through critical analysis of existing literature on success, failure and challenges of HIS adoption, this paper identifies four crucial factors that shape the sustainable HIS. The importance of strong leadership support, proper contingency planning and practice, continuous vendor support and protection of security and privacy issues are identified by classifying all the factors within these four constructs, and with it, we argue these factors crucial for sustainable HIS. This paper proposes a novel conceptual framework which incorporated all these constructs as HIS sustainability factors. This paper also described the theoretical basics behind the development of the model and methodology to be employed to validate the proposed model.

Adopting electronic medical records in primary care: Lessons learned from health information systems implementation experience in seven countries

The healthcare industry has embraced Information and Communication Technology in the performance of its duties to provide quality healthcare services. Though this system provides numerous benefits, research has shown that adoption and use of such systems are limited in the developing world. This study examines factors that will motivate healthcare personnel to adopt and use Health Information Systems using the Unified Theory of Acceptance and Use of Technology (UTAUT2) model. One hundred and ten (110) respondents were selected for the study. The data collected was analysed using Partial Least Square (PLS) with a standard error of 0.10. The findings indicate that Performance Expectancy, Habit and Hedonic Motivation are the main factors users considered to influence their behavioural intention to adopt and use health information system. The results show that when users perceive Health Information systems to improve their performance, they are more likely to adopt and use the system. Stakeholders should consider system quality issues, such as response time and interface design, when developing a new system as these serve as motivational factors towards adoption and use of health information system. This study is among the first few attempts to understand adoption and use of health information systems in Sub-Saharan Africa.

As interest in medical informatization has been increasing steadily worldwide, the adoption of health information systems (HISs) in medical institutions is essential. In this study, we intended to identify users’ adoption, utilization and helpfulness derived from HISs to determine the status of medical informatization by using 2016 Korean Physician Survey data. A total of 8564 members responded to the 2016 survey, we extracted the data of 6949 HISs related part for this study. As a result, about 68% of the self-employed physicians adopted the Order Communication System and Electronic Medical Records, while only one-third adopted the Picture Archiving and Communication System. Overall, the proportions of utilization and helpfulness of HISs were higher for females; for employed physicians or professors; for physicians working in hospitals; and for those specializing in surgical medicine. As applying information technology to the medical environment becomes more important, HIS will become a necessary requirement and the demand for information systems considering user and patient oriented information environments will be increasing. Therefore, it is necessary to discuss the HISs use environment considering not only technical aspects but also users’ or patients’ viewpoints. In that respect, this study will give a meaningful evidence of HIS related policies.

BACKGROUND As digital technologies and especially artificial intelligence (AI) become increasingly important in health care, it is essential to determine whether and why potential users intend to use related health information systems (HIS). Several theories exist, but they focus mainly on aspects of health care or information systems, in addition to general psychological theories, and hence provide a small number of variables to explain future behavior. Thus, research that provides a larger number of variables by combining several theories from health care, information systems, and psychology is necessary. OBJECTIVE This study aims to investigate the intention to use new HIS for decisions concerning short- and long-term medical treatments using an integrated approach with several variables to explain future behavior. METHODS We developed an integrated theoretical model based on theories from health care, information systems, and psychology that allowed us to analyze the duality approach of adaptive and nonadaptive appraisals and their influence on the intention to use HIS. We applied the integrated theoretical model to the short-term treatment using AI-based HIS for surgery and the long-term treatment of diabetes tracking using survey data with structured equation modeling. To differentiate between certain levels of AI involvement, we used several scenarios that include treatments by physicians only, physicians with AI support, and AI only to understand how individuals perceive the influence of AI. RESULTS Our results showed that for short- and long-term treatments, the variables perceived threats, fear (disease), perceived efficacy, attitude (HIS), and perceived norms are important to consider when determining the intention to use AI-based HIS. Furthermore, the results revealed that perceived efficacy and attitude (HIS) are the most important variables to determine intention to use for all treatments and scenarios. In contrast, abilities (HIS) were important for short-term treatments only. For our 9 scenarios, adaptive and nonadaptive appraisals were both important to determine intention to use, depending on whether the treatment is known. Furthermore, we determined <i>R</i>² values that varied between 57.9% and 81.7% for our scenarios, which showed that the explanation power of our model is medium to good. CONCLUSIONS We contribute to HIS literature by highlighting the importance of integrating disease- and technology-related factors and by providing an integrated theoretical model. As such, we show how adaptive and nonadaptive appraisals should be arranged to report on medical decisions in the future, especially in the short and long terms. Physicians and HIS developers can use our insights to identify promising rationale for HIS adoption concerning short- and long-term treatments and adapt and develop HIS accordingly. Specifically, HIS developers should ensure that future HIS act in terms of HIS functions, as our study shows that efficient HIS lead to a positive attitude toward the HIS and ultimately to a higher intention to use.

As digital technologies and especially artificial intelligence (AI) become increasingly important in health care, it is essential to determine whether and why potential users intend to use related health information systems (HIS). Several theories exist, but they focus mainly on aspects of health care or information systems, in addition to general psychological theories, and hence provide a small number of variables to explain future behavior. Thus, research that provides a larger number of variables by combining several theories from health care, information systems, and psychology is necessary. This study aims to investigate the intention to use new HIS for decisions concerning short- and long-term medical treatments using an integrated approach with several variables to explain future behavior. We developed an integrated theoretical model based on theories from health care, information systems, and psychology that allowed us to analyze the duality approach of adaptive and nonadaptive appraisals and their influence on the intention to use HIS. We applied the integrated theoretical model to the short-term treatment using AI-based HIS for surgery and the long-term treatment of diabetes tracking using survey data with structured equation modeling. To differentiate between certain levels of AI involvement, we used several scenarios that include treatments by physicians only, physicians with AI support, and AI only to understand how individuals perceive the influence of AI. Our results showed that for short- and long-term treatments, the variables perceived threats, fear (disease), perceived efficacy, attitude (HIS), and perceived norms are important to consider when determining the intention to use AI-based HIS. Furthermore, the results revealed that perceived efficacy and attitude (HIS) are the most important variables to determine intention to use for all treatments and scenarios. In contrast, abilities (HIS) were important for short-term treatments only. For our 9 scenarios, adaptive and nonadaptive appraisals were both important to determine intention to use, depending on whether the treatment is known. Furthermore, we determined R² values that varied between 57.9% and 81.7% for our scenarios, which showed that the explanation power of our model is medium to good. We contribute to HIS literature by highlighting the importance of integrating disease- and technology-related factors and by providing an integrated theoretical model. As such, we show how adaptive and nonadaptive appraisals should be arranged to report on medical decisions in the future, especially in the short and long terms. Physicians and HIS developers can use our insights to identify promising rationale for HIS adoption concerning short- and long-term treatments and adapt and develop HIS accordingly. Specifically, HIS developers should ensure that future HIS act in terms of HIS functions, as our study shows that efficient HIS lead to a positive attitude toward the HIS and ultimately to a higher intention to use.

Adequacy of UTAUT in clinician adoption of health information systems in developing countries: The case of Cameroon

Introduction: The integration of Health Information Systems (HIS) has transformed healthcare by incorporating systems for acquiring, processing, analyzing, and sending critical information, therefore enhancing management efficiency. This study aimed to identify users' adoption, acceptance, and perceived utility of HIS using bibliometric analysis of the Scopus database from 2014 to 2024, concentrating on the literature regarding HIS. Methods: The present research utilized a bibliometric methodology. This study includes 418 articles from the Scopus database that met the inclusion criteria. Inclusion criteria were limited to English-language articles and review papers published between 2014 and 2024. Duplicate records and non-open-access publications were excluded. The dataset was transformed into RIS and CSV formats and analyzed using VOSviewer, applying clustering, overlay, and density visualization techniques to reveal thematic structure, collaboration patterns, and the temporal evolution of research on HIS. Results: The United States leads in HIS publications, contributing 137 articles between 2014 and 2024. The Journal of Medical Internet Research is the most prolific journal with 16 articles, and Bates, D.W., is the leading author with 7 publications. Key factors influencing HIS adoption and acceptance include technological infrastructure, user training, and organizational support. Theories such as the Technology Acceptance Model (TAM) and Unified Theory of Acceptance and Use of Technology (UTAUT) are commonly applied to explain acceptance by users and managers. Keyword analysis revealed major themes including patient care, telemedicine, mHealth, COVID-19 impacts, acceptance, and satisfaction. Perceived benefits driving HIS utilization involve time-saving, effort reduction, cost efficiency, and overall effectiveness. Conclusion: The effective implementation of HIS depends on elevated levels of user acceptance and perceived usefulness, which directly affect the purpose of utilizing these technologies. The utilization of HIS enhances satisfaction among healthcare providers and patients, while also reducing healthcare costs and improving clinical procedures and care quality.

Towards an Evaluation Framework for Ubiquitous, Self-Evolving Patient Identification Solutions in Health Information Systems

To study the number of health information systems (HISs), applicable to administrative, clinical, and executive decision support functionalities, adopted by acute care hospitals and to examine how hospital market, organizational, and financial factors influence HIS adoption. A cross-sectional analysis was performed with 1441 hospitals selected from metropolitan statistical areas in the United States. Multiple data sources were merged. Six hypotheses were empirically tested by multiple regression analysis. HIS adoption was influenced by the hospital market, organizational, and financial factors. Larger, system-affiliated, and for-profit hospitals with more preferred provider organization contracts are more likely to adopt managerial information systems than their counterparts. Operating revenue is positively associated with HIS adoption. The study concludes that hospital organizational and financial factors influence on hospitals' strategic adoption of clinical, administrative, and managerial information systems.

In the past three decades, several studies have extracted antecedents to the user adoption of health information systems (HIS). This study proposes a reflective pause on the HIS adoption literature to broaden our understanding of factors contributing to the user adoption of electronic medical record (EMR). This paper provides a comprehensive taxonomy of the factors influencing the user adoption of EMR and classifies these factors into meaningful categories. We searched the selected keywords on several academic databases and found an initial set of 9,684 studies. We excluded papers on the basis of their title, abstract, and full text (89 remaining papers). The effectiveness of adoption theories has been explored based on the empirical results identified in the EMR research. Furthermore, according to the conceptualization of the factors in the literature, a list of 78 factors affecting EMR adoption was identified. These factors were classified to eight categories: individual factors, psychological factors, behavioural factors, environmental factors, organizational factors, financial factors, legal factors, and technical factors. The results have implications for researchers and practitioners, including policymakers, marketers, information technology (IT) professionals, health information management (HIM) practitioners, health practice managers, and EMR system developers.