Abstract

This study aimed to investigate the factors influencing physicians use of the PharmaCloud system in Taiwan through Technology Continuance Theory (TCT) and to construct a TCT-based structured questionnaire to demonstrate the attitude and behavior of physicians in the Taiwanese medical system. It focused on investigating “confirmation”, “perceived usefulness”, “perceived ease of use”, “attitude”, “satisfaction”, and “continuance intention” towards the preload-based comparison and manual search in PharmaCloud by attending physicians during their outpatient clinics. Path analysis was used to analyze the cause and effect relationship between variables. This study collected 528 valid questionnaires and the results of path analysis found that factors affecting physicians’ continued use of preload-based comparison in PharmaCloud included “perceived usefulness”, “satisfaction”, and “attitude” (all p < 0.001); however, factors that influenced physicians’ continued use of manual search in PharmaCloud were only “satisfaction” and “attitude” (all p < 0.001). Additionally, the effects of “perceived usefulness” and “perceived ease of use” on “satisfaction” could only be seen in preload-based comparison in PharmaCloud. In conclusion, when physicians’ actual use of PharmaCloud met their expectations, physicians had higher levels of confirmation and better perceived usefulness, which naturally increased their satisfaction and attitude towards PharmaCloud and positively prompted them to continue using it.

Highlights

  • IntroductionThe National Health Insurance (NHI) Administration in Taiwan constructed the PharmaCloud System in July 2013 to integrate the medical records of patients when treatments are sought at different medical institutions [1]

  • Our results revealed that the influence of perceived usefulness on continuance intention and satisfaction is only significant with preload-based comparison and is not significant with manual search, even though many studies have indicated that perceived usefulness is the primary factor that can best predict usage intention or continuance intention [5,15,16]

  • This study found that when the actual usage of the PharmaCloud System was closer to the expectations of physicians, the physicians perceived greater usefulness in the system, displayed better satisfaction and attitude toward the system, and expressed a greater likelihood that they would continue using the system for a longer period of time

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Summary

Introduction

The National Health Insurance (NHI) Administration in Taiwan constructed the PharmaCloud System in July 2013 to integrate the medical records of patients when treatments are sought at different medical institutions [1]. The NHI database compiled the medication information of each patient from clinics, hospitals, and pharmacies and uploaded this information to the cloud system, creating a dedicated medication file for each patient. The medication used by a patient during the last three months can be queried, including medication from the hospital where the query was made, as well as from other hospitals [1,2].

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