Investigating switching intentions of patients to healthcare robots: a push–pull-mooring theory perspective

Healthcare Robot Technology Development

PurposeTechnology has revolutionized the delivery of health-care services, with e-consultations becoming popular mode of service delivery, especially during the pandemic. Extant research has examined the adoption of e-health consultation services, with little attention paid to examine the switching behavior. This study aims to identify factors affecting patients’ intentions to switch from conventional mode i.e. visiting hospitals/clinics to e-health consultations.Design/methodology/approachTo understand this we use the push–pull–mooring (PPM) framework and integrate variables from status quo bias framework to the model. A cross-section research design was used, which rendered 413 valid responses which were obtained from the patients visiting a traditional hospital setup. The data was analyzed using partial least square – structural equation modeling using SmartPLS 3.0.FindingsFindings suggest that push effects (inconvenience and perceived risk), pull effects (opportunity for alternatives and ubiquitous care), mooring effects (trust) and inertia significantly influence patients’ switching intentions from visiting hospitals/clinics to e-health consultations. Further, habit and switching cost positively influence inertia.Practical implicationsThis study shall enable online health-care service providers and practitioners to understand patients’ intentions to switch to online health platforms and accordingly develop related marketing strategies, services and policies to encourage them to switch to the new offerings.Originality/valueThe current study enriches the previous research on e-health services by applying and extending PPM framework as the base model and showing its efficiency in predicting individuals switching intentions in the context of emerging economies. This study bridges the gap by focusing on switching behavior in context of health services.

BackgroundIntelligent physical robots based on artificial intelligence have been argued to bring about dramatic changes in health care services. Previous research has examined the use of intelligent physical robots in the health care context from different perspectives; however, an overview of the antecedents and consequences of intelligent physical robot use in health care is lacking in the literature.ObjectiveIn this paper, we aimed to provide an overview of the antecedents and consequences of intelligent physical robot use in health care and to propose potential agendas for future research through a systematic literature review.MethodsWe conducted a systematic literature review on intelligent physical robots in the health care field following the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Literature searches were conducted in 5 databases (PubMed, Scopus, PsycINFO, Embase, and CINAHL) in May 2021, focusing on studies using intelligent physical robots for health care purposes. Subsequently, the quality of the included studies was assessed using the Mixed Methods Appraisal Tool. We performed an exploratory content analysis and synthesized the findings extracted from the included articles.ResultsA total of 94 research articles were included in the review. Intelligent physical robots, including mechanoid, humanoid, android, and animalistic robots, have been used in hospitals, nursing homes, mental health care centers, laboratories, and patients’ homes by both end customers and health care professionals. The antecedents for intelligent physical robot use are categorized into individual-, organization-, and robot-related factors. Intelligent physical robot use in the health care context leads to both non–health-related consequences (emotional outcomes, attitude and evaluation outcomes, and behavioral outcomes) and consequences for (physical, mental, and social) health promotion for individual users. Accordingly, an integrative framework was proposed to obtain an overview of the antecedents and consequences of intelligent physical robot use in the health care context.ConclusionsThis study contributes to the literature by summarizing current knowledge in the field of intelligent physical robot use in health care, by identifying the antecedents and the consequences of intelligent physical robot use, and by proposing potential future research agendas in the specific area based on the research findings in the literature and the identified knowledge gaps.

The use of robots in surgery and healthcare has brought about a paradigm change that is revolutionizing how patients are treated and medical operations are carried out. Simple tele manipulators gave way to complex, autonomous platforms as robotic technologies in surgery advanced. They provide unmatched dexterity, precision, and the capacity to carry out minimally invasive treatments with improved visualization. Now, difficult surgeries may be carried out by surgeons with fewer incisions, less blood loss, and quicker patient recoveries. Robotic surgery is used in a variety of surgical specialties, including general surgery, urology, gynecology, and orthopedics. Robots are being used in the healthcare industry for patient care, rehabilitation, and medical logistics in addition to surgery. Robots used in telemedicine make it possible to monitor and consult on patients from a distance, enhancing access to healthcare services, particularly in underdeveloped regions. Robotic exoskeletons and other assistive technology improve the quality of life for those with mobility limitations by helping with physical therapy and rehabilitation. Autonomous delivery robots also streamline the supply chain, guaranteeing prompt distribution of medical goods and lightening the load on medical staff. Robotics use in healthcare is not without difficulties, though. Regulation barriers, high start-up costs, and worries about employment displacement must all be addressed. Additionally, it is important to carefully address the ethical implications of robots in healthcare, including responsibility and data privacy. In conclusion, the use of robots in healthcare and surgery is a revolutionary development. Although there are still issues, the advantages in terms of better patient outcomes, increased effectiveness, and more access to healthcare services are indisputable. Robotics integration is positioned to become more and more important in determining the future of patient care and healthcare delivery as technology develops.

This study aims to analyze the effect of push, pull, and mooring effect on switching intention in the group of participants in the National Health Insurance (JKN) program in the South Jakarta area. The object of this study is a member of the JKN participants at the Atma Jaya Semanggi Clinic. Data was collected using non-probability sampling, especially purposive sampling, with 150 respondents. Empirical data were processed using the Structural Equation Modeling (SEM) method with SmartPLS. All five hypotheses were accepted. The analysis results showed that the push, pull, and mooring effects had a direct and significant effect on switching intention. The mooring effect moderates the push and pull effects on switching intention. The implications of the results of this study show that health facilities need to pay attention to the factors that drive dissatisfaction, increase the attractiveness of alternative services, and manage patient attachment strategically to retain JKN participants. Clinics also need to design loyalty programs and service innovations based on patient needs to strengthen long-term relationships. In addition, BPJS Kesehatan is expected to improve the FKTP selection mechanism through education and increased service quality transparency to reduce participants' intention to switch

Background/Objectives: The advent of self-service technology (SST) (e.g.,kiosks and Automatic Response System), has made it possible for service providersto make use of non-face-to-face channels to meet users’needs and decrease users’costs and time. On the other hand, however, more complex technology and/or services inhibit users’ satisfaction and,consequently,the intention to adopt SST, because such SST can instill fear in users. Nevertheless, at present, patients and other people who are interested in their own health and well-being are paying great attention to healthcare robots (as a form of SST)and,consequently, it has become crucial to investigate how these healthcare robots can positively influence users’ satisfaction with them. Hence, this study aims to empirically investigate the factors that affect users’ satisfaction with healthcare robots, especially in regard to human-robot interaction (HRI).Methods/Statistical analysis: We focused on the theory of heterophily and applied a series of factors identified in previous robot-adoption studies.Uniquely, this study focuses on users’ heterophily with healthcare robots, examining heterophily through three fundamental elements, empathy, professionalism, and personality, which we considered to be suitable fordetermining user satisfaction with HRI-based communication.To prove the validity of our hypotheses, we conducted an empirical testthat involved participants receiving a short health assessment from a robot.Findings: The findings of our empirical test supported our hypothesis that the lower the difference in empathy between a user and robot, the higher the level of user satisfaction with the humanoid-style healthcare service. Further, our results also suggest that heterogeneity between a user and healthcare robot is positively associated with user satisfaction.Improvements/Applications: First, to increase user satisfaction,robots must be provided with the ability to somehow recognizea user’s personality and adjust their own accordingly before beginning the robot-based healthcare service. Secondly, users’ behavior patterns should be analyzed by the healthcare robot. Overall, our study empirically shows the importance of ensuring thatprofessionalism is present in healthcare-domain-related HRI.

Background: Technology has reshaped healthcare delivery, particularly during and after the COVID-19 pandemic, by providing faster, safer, and more accessible alternatives to in-person care. However, there is limited evidence on the factors and behavioral drivers of e-health adoption in Pakistan. This study investigates the factors influencing switching intentions among healthcare users in Islamabad, Pakistan. Methods: A quantitative cross-sectional survey was conducted to collect data from 930 healthcare service users in Islamabad, Pakistan. Structural Equation Modelling (SEM) was used to test the hypothesized relationships. Results: The findings revealed that the push factors of inconvenience (0.251) and perceived risk (-0.221) and the mooring factors of trust (0.442) and switching cost (− 0.211) were significantly associated with switching intentions (p< 0.05), whereas the pull factors of ubiquitous care and opportunity for alternatives had no significant relationship with the switching intentions of healthcare service users. Conclusion: The study concludes that inconvenience with traditional hospital services, risk perceptions, trust in e-services, and perceived switching costs are key drivers of e-health adoption in Islamabad. These findings underscore the need for user-centered digital health strategies that address both infrastructural and behavioral concerns to accelerate equitable healthcare transformation in the new era of technological development.

Chapter 12 - Robotics in Healthcare: An Internet of Medical Robotic Things (IoMRT) Perspective

We aimed to evaluate the opinions of individuals aged 18 and above in our country regarding the use of artificial intelligence (AI) and robots in the field of healthcare. The growing population and patient load, coupled with increasing data, can expedite the diagnosis and treatment process for patients through faster, easier, and more accurate interpretation of information. The study encompasses voluntary participants aged 18 and above, who have either undergone surgery in ahospital or have accompanied afamily member during asurgical procedure and possess internet access as well as the capability to participate in online surveys. Atotal of 725 individuals participated in our study 61% (n=442) of respondents expressed trust in the operation of AI and robots in the hospital setting. 64.1% (n=465) of participants expressed trust in AI's contribution to disease diagnosis and laboratory tests. The confidence in AI's use in radiological examinations and its contribution reached 71.6% (n=519). This study demonstrates that the use of AI and robots in healthcare services is accepted by our society and would be appropriate in our society (Tab. 5, Fig. 1, Ref. 24).

PurposeThe healthcare sector is experiencing a major paradigm shift toward a people-centered approach. The key issue with transitioning to a people-centered approach is a lack of understanding of the ever-increasing role of technology in blended human-technology healthcare interactions and the impacts on healthcare actors' well-being. The purpose of the paper is to identify the key mechanisms and influencing factors through which blended service realities affect engaged actors' well-being in a healthcare context.Design/methodology/approachThis conceptual paper takes a human-centric perspective and a value co-creation lens and uses theory synthesis and adaptation to investigate blended human-technology service realities in healthcare services.FindingsThe authors conceptualize three blended human-technology service realities – human-dominant, balanced and technology-dominant – and identify two key mechanisms – shared control and emotional-social and cognitive complexity – and three influencing factors – meaningful human-technology experiences, agency and DART (dialogue, access, risk, transparency) – that affect the well-being outcome of engaged actors in these blended human-technology service realities.Practical implicationsManagerially, the framework provides a useful tool for the design and management of blended human-technology realities. The paper explains how healthcare services should pay attention to management and interventions of different services realities and their impact on engaged actors. Blended human-technology reality examples – telehealth, virtual reality (VR) and service robots in healthcare – are used to support and contextualize the study’s conceptual work. A future research agenda is provided.Originality/valueThis study contributes to service literature by developing a new conceptual framework that underpins the mechanisms and factors that influence the relationships between blended human-technology service realities and engaged actors' well-being.

Background: Medical robotics has become an integral part of day-to-day healthcare services, revolutionizing the way medical procedures are performed and improving patient outcome. Aim: This study explored the role of medical robotics in healthcare, focusing on its impact on various aspects of patient care. Methodology: The methodology used in this study involved a comprehensive review of existing literature on medical robotics and its applications in healthcare settings. Results: The findings reveals that medical robotics has significantly enhanced the precision, efficiency, and safety of medical procedures, leading to reduced invasiveness, and faster recovery times for patients. Additionally, medical robotics has enabled healthcare providers to perform complex surgeries with greater accuracy and minimal invasiveness, ultimately improving the quality of care for patients. The findings obtained from this study also showed that robotic surgery results in fewer complications and shorter hospital stays compared to traditional surgical methods. This results in a growing adoption of robotic-assisted surgery in various medical specialties, such as urology, gynaecology, and orthopaedics. In addition to surgical procedures, medical robotics is also being used in diagnostic and therapeutic applications. For example, robotic systems are being developed for minimally invasive procedures, such as biopsies and drug delivery. Furthermore, robotic devices are being used in rehabilitation and physical therapy to assist patients in regaining mobility and function. Conclusion: One of the main concerns is the cost of implementing and maintaining robotic systems, which can be prohibitive for some healthcare facilities. Also, there are concerns about the potential for errors and malfunctions in robotic systems, which could compromise patient safety. Overall, the integration of medical robotics in day-to-day healthcare services has proven to be a game-changer, offering new possibilities for the future of healthcare delivery.

Mobile robots are being used more frequently in healthcare environments to tackle a variety of issues, such as patient monitoring, drug administration, and support for healthcare professionals. However, considering how nascent the topic of deploying mobile robots in healthcare is, there hasn’t been much investigation into the potential benefits and drawbacks of doing so. The goal of this research study is to examine the current state of mobile robots in healthcare, the opportunities they present for enhancing patient care, and the difficulties that must be solved to take advantage of these advantages, including safety concerns, dependability and accuracy issues, and cost effectiveness issues. We identify critical elements that support the successful integration of mobile robots into healthcare environments, as well as potential drawbacks and ethical concerns such as patient privacy, informed consent, autonomy, and accountability related to their use, through a systematic review of the literature of mobile robot implementations in healthcare. Our results show the potential of mobile robots to enhance patient care by delivering more effective and efficient healthcare services, but they also emphasize the need for additional research and development to overcome the difficulties in integrating these robots into healthcare workflows. In the end, this research intends to provide a basis for future research and development in this fascinating and quickly developing sector, as well as to contribute to a better understanding of the opportunities and constraints connected with the use of mobile robots in healthcare.

PT BINMED Ecomedika Industri (BINMED) is one of the companies engaged in the manufacture of medical devices in the form of special waste bins for sharps medical waste. Since starting to be marketed in 2019 until now, BINMED products have not reached the sales target. This is because conventional and/or non-standard safety boxes such as medical plastic bags, used bottles of mineral water in packaging, and jerry cans are still being used. In addition, BINMED products have just begun to be marketed in the Jabodetabek area using free trials and discounts. However, these two methods have not been able to attract the attention of potential buyers. Therefore, it is necessary to analyze the factors that influence prospective buyers to switch to using the BINMED safety box. The data collected were 72 samples using the purposive sampling technique to find the right respondents, namely prospective buyers working in the health sector. The variables used in this study include push effects (pricing, satisfaction, and trust), pull effects (attractive alternatives), and mooring effects (switching costs and subjective norms). Based on the results of data processing and analysis of research results, it was found that alternative interest had a significant effect on the intention to switch to the use of the safety box while the variables of pricing, satisfaction, trust, switching costs, subjective norms and the moderating effect of the mooring effects between push and pull effects and switching intentions did not affect switching intentions. The managerial implication that can be applied by the company is to promote on social media and cooperate with medical waste transport service providers who have collaborated with health facilities.

The healthcare sector is progressively modest and patients expect higher service quality; therefore, healthcare practitioners’ and academic researchers’ attention upsurges in exploring service quality, intensifying satisfaction and generating behavioral intention. Despite the significance of the healthcare sector and the importance of quality-related matters, there is a paucity of research and publications dealing with healthcare service quality. This conceptual review evaluates the service quality in Pakistani healthcare sector rendering patients’ perspective. The proposed model emphasizes patients’ switching intention caused by poor or inadequate service quality through intervening constructs of satisfaction and alternative attractiveness. Additionally, current review explored the alternative attractiveness as mediator which was neglected in healthcare context. The model also attempts to propose the association between alternative attractiveness and outcome variable by switching costs regarding patients’ perspectives. The conceptual framework enables hospital managers to comprehend how patients assess healthcare quality provided in the presence of alternatives. The perception of patients would assist them in allocating healthcare resources and hospital management attain performance feedback through service quality parameters. Present review developed an inclusive framework as a novel injector in healthcare sector for patients’ perceived service quality.

With the focus of the scholars and literature on the importance of customer value, the emphasis has been paid to this concept in a great number of retailing specialties, but it was neglected in the case of community pharmacies. This research focuses on the service value, trust and employee performance as factors explaining loyalty to pharmacies and adds the verification of the impact of the integration of primary healthcare services as a way to enhance or sustain the level of loyalty to the initial pharmacy or switching intentions toward other pharmacies which integrate this kind of service. Thus, an original conceptual model is proposed and tested. A survey was distributed electronically via a social media application (WhatsApp) to participants based on the convenience sampling technique. 492 respondents submitted the survey. Results show that perceived value, employee performance and trust influence initial loyalty. In addition, the integration of Primary Healthcare services sustains this loyalty, but initial loyalty does not prevent switching intentions in case other pharmacies integrate primary healthcare services.