Why Blockchain Benefits Don't Guarantee Adoption: An Integrated TAM-TOE Analysis of Technology Acceptance and Organizational Readiness.
Despite blockchain technology's demonstrated potential to enhance security, transparency, and efficiency in healthcare systems, adoption rates remain significantly lower than predicted, creating a persistent gap between perceived benefits and adoption feasibility. This study addresses the critical question of what explains this adoption paradox by developing and testing a comprehensive theoretical framework that integrates the Technology Acceptance Model (TAM) with the Technology-Organization-Environment (TOE) framework. A systematic literature review is conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to synthesize existing research on blockchain adoption in health care. This study develops four key propositions examining how technology characteristics, organizational factors, external environmental pressures, perceived risks, and system quality collectively influence healthcare organizations' blockchain adoption intentions. The analysis reveals that blockchain adoption in health care is influenced by a complex interplay of facilitating and inhibiting factors. Technology characteristics such as perceived usefulness (PU) and ease of use, combined with organizational innovation readiness and technology compatibility, positively influence adoption intention. External factors enhance perceived technology benefits and consequently affect adoption decisions. However, perceived risks moderate the relationship between PU and adoption intention. Blockchain technology represents a transformative solution for persistent healthcare challenges, but successful adoption requires a holistic approach that simultaneously addresses technology, organizational, and environmental factors. The adoption gap can be bridged through strategic planning that aligns institutional readiness with user incentives, comprehensive risk management, and supportive regulatory frameworks. Future research should focus on establishing ethical governance models to support broad blockchain adoption in health care.
- Research Article
328
- 10.1108/imds-08-2018-0365
- Jun 27, 2019
- Industrial Management & Data Systems
PurposeBlockchain possesses the potential to disrupt and reshape a plethora of industries in the next decade. However, blockchain adoption rates in technology developed countries, such as Ireland, are relatively low. Motivated by blockchain’s potential to transform sociotechnical systems, the lack of systematic inquiry pertaining to blockchain studies from an information system perspective, the authors propose the following research question: “How do organizational factors influence blockchain adoption in organizations based in a developed country?” Specifically, the purpose of this paper is to elucidate the impact of organizational factors on the adoption of blockchain and the adoption of blockchain in companies based in Ireland.Design/methodology/approachA comprehensive literature review was conducted, and the methods of qualitative content analysis were used to identify the most important technology–organization–environment (TOE) blockchain adoption factors. Organizational factors are often viewed as the most significant determinants of IT innovation adoption in organizations. Consequently, using a multiple-case study of 20 companies based in Ireland, the authors investigate how the top three organizational factors identified from the blockchain literature affected these companies decision to adopt or not adopt blockchain.FindingsThe literature review on blockchain adoption identified specific technological, organizational and environmental factors. Furthermore, the case study findings identified three patterns: top management support and organizational readiness are enablers for blockchain adoption, and large companies are more likely to adopt blockchain than small to medium-sized enterprises (SMEs). The authors explain these patterns by examining the nature of blockchain and the characteristics of Ireland as a developed country. Practical and scientific contributions are also presented.Research limitations/implicationsThis study makes several important scientific contributions. First, the findings revealed that top management support and organizational readiness are significant enablers of blockchain adoption. Ireland is recognized as a technology developed country; however, the findings in relation to top management support contradict existing IT adoption literature pertaining to developed countries. Second, previous IT innovation adoption literature suggests that organizations size has a positive influence on a company’s IT innovation adoption process. This study demonstrates that large organizations are more likely to not only adopt blockchain but are also more likely to conduct increased levels of blockchain research and development activities. Finally, and most significantly, the authors identified several patterns, which relate specifically to Ireland as a developed country that influenced the findings. These findings could hold particular relevance to governments and organizations of other developed countries in terms of accelerating blockchain adoption.Practical implicationsThe findings about the low level of blockchain awareness and the lack of information pertaining to viable business use cases indicate that the Irish government could play a more significant role in promoting the benefits of blockchain technologies. Further, the findings could also encourage IT providers to formulate enhanced strategies aimed at disseminating information pertaining to blockchain technologies. Second, the positive influence of top management support and organizational readiness, particularly about core competencies, on blockchain adoption suggests that equipping managers with the requisite knowledge and skills will be crucial in adopting these IT innovations. Finally, organizations who adopted blockchain used cloud-based blockchain platforms and tools to overcome the constraints of their initial low levels of organizational readiness.Originality/valueThis is one of the first studies to identify specific TOE blockchain adoption factors. Further, the authors examine how the three most identified organizational adoption factors impact organizations decisions to adopt blockchain. Finally, the authors discuss how the resulting three patterns identified by examining the nature of blockchain and the characteristics of Ireland as a technology developed country.
- Research Article
59
- 10.3390/buildings12091349
- Sep 1, 2022
- Buildings
Blockchain is considered a breakthrough technology in the construction industry, with the potential to improve the trust environment and workflow of construction stakeholders. Although recent research offers hints regarding possible contributing elements to blockchain adoption in the construction industry, no specific study has addressed this topic. This knowledge gap hinders the adoption and promotion of blockchain in construction organizations. This study aimed to identify the determinants of blockchain adoption in the construction industry and verify the influence of the combination of various factors on adoption intention. Based on the technology–organization–environment framework, a conceptual model of blockchain adoption in the construction industry was constructed. Data were collected through the distribution of questionnaires, and 244 professionals in the construction field participated in this study. To evaluate the model hypotheses, we used a two-stage partial least squares structural equation modeling (PLS-SEM) and fuzzy-set qualitative comparative analysis (fsQCA) combination. The PLS-SEM revealed that factors such as compatibility, top management support, relative advantage, regulatory support, cost, competitive pressure, organizational readiness, and firm size significantly influence blockchain adoption. The fsQCA indicated that six causal conditions achieve high adoption intention. This is one of the first empirical studies on blockchain adoption in the construction industry, which can aid organizations, policymakers, and project participants in making informed decisions regarding the adoption of blockchain.
- Research Article
- 10.5267/j.uscm.2024.5.021
- Jan 1, 2024
- Uncertain Supply Chain Management
The study aims to investigate the moderating role of Organizational Readiness (OR) in the relationship between Supply Chain Agility (SCA) and Blockchain Adoption Intention (BAI) among these SMEs, drawing on the Resource-Based View (RBV) theory. The study adopts a positivist approach and a cross-sectional design to explore how organizational readiness moderates blockchain adoption in Saudi SMEs. It uses a quantitative methodology, surveying decision-makers from SMEs engaged in supply chain activities to gather data. Data analysis is performed using Structural Equation Modeling (SEM). The study's findings indicate that Operational Supply Chain Transparency (OSCT) impacts Supply Chain Alignment (SCL), Supply Chain Adaptability (SCD), SCA, and BAI. Moreover, there is a positive influence of SCL on SCD and SCA. SCA also significantly influences BAI. Furthermore, the moderation analysis shows that OR significantly affects the SCA-BAI relationship, indicating that higher OR amplifies the positive impact of supply chain agility on blockchain adoption intention, underscoring the critical roles of supply chain factors and OR in blockchain adoption among SMEs. Based on the RBV theory, the study delves into how constructs like SCL, OSCT, SCD, and SCA are influenced by blockchain technology. It assesses the extent to which these factors would impact the propensity of SMEs to implement blockchain yet explores the moderating influence of OR on this dynamic.
- Research Article
46
- 10.3390/buildings12101709
- Oct 17, 2022
- Buildings
Blockchain has great potential for facilitating the development of the construction industry but has not been widely used to this end. The objective of this study was to identify the factors affecting the adoption of blockchain in the construction industry from the technical, organizational, and environmental dimensions with the help of theories related to technology adoption. Empirical results showed that relative advantage, compatibility, competitive pressure, technological maturity, organizational readiness, and policy have an impact on intention to adopt blockchain in the construction industry through perceived usefulness or perceived ease of use. Competitive pressure has the greatest impact on the internal variables of the technology acceptance model (TAM) (0.696). Perceived cost of adoption does not have a significant effect on blockchain adoption behavior. However, in contrast to previous research, organizational readiness has a negative effect (−0.03) on perceived usefulness. The research results provide inspiration for further research on the impact mechanisms of blockchain adoption in the construction industry, as well as guidance for governments to formulate blockchain adoption policies and guidance for the widespread application of blockchain in construction.
- Research Article
6
- 10.1108/jbim-04-2024-0253
- Apr 7, 2025
- Journal of Business & Industrial Marketing
PurposeThis study aims to analyze antecedents of blockchain technology adoption (BCTA) based on a technological–organisational–environment (TOE) framework and the performance outcomes of such adoption. The authors further examine the moderating effect of the institutional environment (developed versus developing economies) on the above relationship.Design/methodology/approachUsing structural equation modeling, the authors analyze the research model using a sample of 255 responses from supply chain practitioners across nations. The findings indicate: (a) technological (technological compatibility), organizational [organizational readiness (OR)] and environmental [mimetic pressure and coercive pressure (CP)] factors enhance BCTA; (b) BCTA reduces operational costs and (c) intriguing differences in the above relationships exist between firms located in developed and developing economies.FindingsThe result indicates that OR affects BCTA in developing economies, not in developed economies, while the CPs drive BCTA only in developed economies, not in developing economies.Practical implicationsThis study highlights the contextual nuances of blockchain adoption across economies but is limited by its cross-sectional design and uneven representation of developed economies. The insights help firms assess opportunities and drivers associated with blockchain adoption.Originality/valueThe study uniquely integrates the TOE framework with institutional theory to reveal the moderating impact of macro-institutional differences on blockchain adoption and its outcomes.
- Research Article
58
- 10.1108/apjml-02-2018-0074
- Jan 14, 2019
- Asia Pacific Journal of Marketing and Logistics
Purpose The purpose of this paper is to examine a framework integrating the technology acceptance model (TAM), individuals’ task–technology fit (TTF) and perceptions toward adopting automobile telematics devices. Design/methodology/approach This study integrated the TAM with TTF to understand individual perceptions of a technology’s value. In addition, the intrinsic motivational factors toward technology usage, including positive perceptions (perceived enjoyment, personal innovation and perceived uniqueness) and negative perceptions (perceived risk and performance gap), were considered in the model. Furthermore, the moderating effect of driving experience was examined. Findings The perceived usefulness (PU) of telematics as well as perceived ease of use (PEOU) affected drivers’ adoption intentions. PEOU had a greater effect on adoption intentions than PU, and technology characteristics had a greater effect on TTF than task characteristics. Moreover, individuals’ perceptions of perceived enjoyment and uniqueness affected PU and PEOU. The negative perceptions of perceived risk and performance gap affected PU and PEOU, respectively. Furthermore, driving experience significantly weakened the relationship between PU and intentions. Originality/value Telematics is a niche market due to the development of the Internet of Things, but users’ adoption intentions remain unknown. This study constructed a more comprehensive model and tested the impacts of certain variables on telematics adoption, with driving experience as a crucial moderator.
- Research Article
24
- 10.1016/j.jdec.2022.11.001
- Sep 1, 2022
- Journal of Digital Economy
PurposeWhile blockchain is considered to have many unprecedented characteristics, and its application is recognized as another new opportunity for the development of e-commerce, there is limited evidence on the factors affecting the adoption of blockchain in the commercial e-commerce sector. This study aims to identify determinants influencing consumers' intention to adopt blockchain technology in e-commerce. Design/methodology/approachDrawing on the classic technology acceptance model (TAM), a conceptual framework is developed and empirically assessed to present the relationships between the core characteristics of blockchain and consumers' adoption intention. Survey data were collected from 228 users of the blockchain e-commerce system in China. The structural equation modeling (SEM) approach is used to test the hypotheses. FindingsThe results indicate that cost saving and traceability have a positive effect on perceived usefulness while insignificant associations are found between data privacy security and perceived usefulness, and perceived ease of use and consumers' adoption intention. Research limitations/implicationsThe research only examined Chinese users, which may affect the generalizability of the findings. Future research is encouraged to conduct comparative studies beyond this region, e.g., emerging markets versus developed economies. It would also be useful to explore mediating and moderating effects of other new technologies that complement the application and adoption of blockchain. Practical implicationsThe research results also bring managerial implications with the ways of attracting customers via blockchain technology, including improving system ability to reduce cost and enhance traceability. Originality/value -This paper is one of the early empirical endeavors that examines determinant factors affecting individual users towards the adoption of blockchain technology in e-commerce that is absent in the extant research. This study further contributes to the development of the knowledge bank of blockchain via the conceptual framework of its adoption under the e-commerce context, in particular considering its technical features.
- Conference Article
- 10.64920/icbi25056
- Nov 25, 2025
"Internet of things (IoT) can greatly enhance service quality, boost operational efficiency, and improve patient outcomes in healthcare. This study examines the factors influencing healthcare professionals in Sri Lanka regarding the adoption of IoT-based patient management systems, utilising the Technology Acceptance Model (TAM) and incorporating organisational and technological aspects to develop a contextual framework. We surveyed 170 respondents, comprising doctors, nurses, and consultants, using a structured questionnaire. The study used correlation and regression analyses to explore the relationships among perceived usefulness (PU), perceived ease of use (PEOU), perceived challenges (PC), perceived benefits (PB), technological factors (TF), and organisational factors (OF). In this framework, attitude toward technology acted as a mediator, while behavioural intention was the dependent variable. Findings show that perceived usefulness and ease of use significantly impact attitude and behavioural intention, confirming the mediating role of attitude. Organisational and technological factors were not very effective in predicting outcomes, highlighting the infrastructural and managerial challenges in Sri Lanka’s healthcare system. Successful IoT implementation hinges on technological readiness, organisational support, and staff training. This study enhances the Technology Acceptance Model by incorporating contextual factors relevant to developing nations, providing valuable insights for healthcare administrators and policymakers to inform improved IoT adoption strategies. The findings clarify how perceived ease, usefulness, and organisational readiness influence behavioural intention towards IoT healthcare innovations. Keywords: Attitude toward technology, behavioural intention, internet of things, Sri Lankan healthcare sector, Technology Acceptance Model "
- Research Article
14
- 10.5267/j.uscm.2022.3.009
- Jan 1, 2022
- Uncertain Supply Chain Management
The importance of E-procurement is significant for the development of nations. Findings of previous studies in terms of predictors and consequences of using E-procurement are inconsistent and most prior literature were conducted in developed countries. The purpose of this study is to examine the predictors and consequences of using e-procurement. Based on resource-based view (RBV) and Technology-Organization-Environment framework (TOE), the study proposed that technological (relative advantage, compatibility, and complexity) and organizational factor (top management support, organizational readiness, and Information System (IS) committee) will have significant effect on e-procurement which in turn expected to affect the firm performance. Competitive pressure is proposed as a moderating variable between technological and organizational factors, and e-procurement. The population of the study includes large companies in Jordan. Purposive sampling was deployed to collect the data using a questionnaire. The findings were derived from 221 responses. Data analysis was conducted using Smart PLS. The findings showed that technological (relative advantage, compatibility, and complexity) and organizational (top management support and organizational readiness) have significant effect on e-procurement which in turn affected firm performance. Competitive pressure did not moderate the effect of technological and organizational factors on e-procurement. The findings help the policy makers in Jordan to increase the usage of e-procumbent and firm performance by focusing on the benefits and reducing the complexity of using a new technology.
- Research Article
14
- 10.1108/ajb-12-2022-0206
- Aug 3, 2023
- American Journal of Business
PurposeBlockchain technology (BCT) has multiple benefits across industries in varied contexts, but limited organizations have adopted such disruptive innovative technologies in the healthcare industry in India. The research on advancing the understanding of blockchain adoption (BCA) determinants in India's healthcare industry is limited. Thus, the study aims to identify the BCA determinants in the healthcare sector in India. Further, the impact of BCA was examined on organizational performance (OP).Design/methodology/approachThe study utilizes Technology, Organization, and Environment (TOE) framework to investigate the determinants of BCA in the healthcare sector in India. The data were gathered using a seven-point Likert seven-point ranging from “strongly agree” to “strongly disagree” from 272 respondents working in the healthcare industry in India. The relationship within the framework was investigated using structural equation modeling.FindingsThe results demonstrate the positive impact of top management support, organizational size, organizational readiness, competitive pressure and government support on BCA in the healthcare sector. On the other hand, compatibility, security and privacy issues do not affect BCA. The results emphasize and validate blockchain’s importance in improving OP in the healthcare sector. Further, the results indicate that non-technological factors are paramount to improving BCA within the healthcare sector. Organizations should invest in employee training and development to ensure their staff have the necessary knowledge and skills to effectively manage BCT.Research limitations/implicationsThe model was developed for BCA in the healthcare sector in the Indian context; however, the model applies to other countries with the same business environment. Hence, the model can be further examined in diverse countries to generalize the findings.Practical implicationsThe study offers valuable insights into the factors that influence BCA and OP in the healthcare sector. The results of this research can be used to inform policy decisions and guide practitioners toward promoting and facilitating the use of BCT in healthcare organizations.Originality/valueTo the best of the author’s knowledge, the present study is the first of its kind to examine the TOE framework in BCA within the healthcare sector and its implications on OP.
- Dissertation
1
- 10.15760/etd.7527
- Jan 1, 2021
Blockchain is an emerging technology that holds great promises in healthcare despite slow adoption and previous unsuccessful implementation projects. Blockchain adoption in healthcare has been slow, partly because healthcare is a heavily regulated and complex industry. Blockchain applications span various areas of healthcare such as patient data management, health information exchange, health supply chain management, financial and insurance claims, clinical trial, biomedical devices tracking, and pharmaceutical counterfeit. The main challenges with blockchain technology in healthcare are: scarcity of real applications, the high level of failing projects, and the need for various parties to function together. There is, however, a lack of research on how to assess the adoption and help healthcare organizations use blockchain for the management of the electronic healthcare records (EHR) systems in a comprehensive way incorporating multiple perspectives. The objective of this research is to develop a scoring model to evaluate healthcare organization's readiness to adopt blockchain for the management of the EHR systems. In this research, a literature review and expert feedback were used to identify the most important factors influencing blockchain adoption. The focus is on the application of the blockchain technology adoption for the management of the EHR systems. The Hierarchical Decision Modeling (HDM) methodology was used to elicit multiple expert's judgment to identify the relative importance of those factors influencing blockchain adoption. In addition, experts' feedback was used to identify the possible statuses an organization might have regarding each factor and the dynamic aspects of these factors was analyzed. Finally, two case studies of the blockchain adoption, Oregon Health and Science University (OHSU) hospital and a Medical City in Saudi Arabia, were conducted to demonstrate the practicality and value the research model brings to the research objective. The outcomes of the research present an identification of blockchain adoption impacting factors and their resultant rankings. The research identifies 17 factors as the most important factors influencing blockchain adoption and a healthcare organization's readiness for adoption. The factors are grouped into five perspective: financial, social, technical, organizational, and regulations & legal. The case studies are used to demonstrate how the model could be used to identify areas of deficiencies and propose corrective actions in the healthcare organization's capabilities. The goal is to prevent any possible issues, before the project starts, in order to increase chances of a successful blockchain adoption.
- Research Article
19
- 10.9734/ajrcos/2021/v7i230177
- Mar 10, 2021
- Asian Journal of Research in Computer Science
Blockchain is an emerging technology that depends on distribution, decentralization, and encryption. Recently, it has gained wide interest in various fields of studies. Several considerable research on blockchain adoption has appeared in international journals across different disciplines, however, a review of literature on the adoption of blockchain remains rare. This study aimed to provide a comprehensive literature review of the current blockchain adoption studies that use individual adoption models or theories. This paper included the papers that are published in the 7 Scopus database from 2017-2021. Studies were analyzed to determine the adoption models or theories that are used, industry, country, methodology, and identify the most important influencing factors that drive the user to accept the adoption of blockchain technology. The results showed that there are still limitations in adoption studies in various fields such as health and education however, the field of supply chain management is one of the areas that received the most attention in the studies. Common studies relied on the Technology Acceptance Model (TAM) model as well as the Unified Theory of Acceptance and Use of Technology (UTAUT). Moreover, perceived ease of use (PEOU), perceived usefulness (PU) are considered the most important factors affecting the intention of users in adopting blockchain technology in different fields. The research findings have implications on blockchain adoption research. In terms of theory, the findings provide a guideline for the other researchers to put their own research in a better context and thus contribute to understanding the relevant blockchain adoption issues that require further investigation.
- Research Article
2
- 10.54660/.ijmrge.2024.5.1.1281-1292
- Jan 1, 2024
- International Journal of Multidisciplinary Research and Growth Evaluation
Blockchain technology has emerged as a transformative innovation with significant potential to reshape financial markets, particularly in emerging economies. The decentralized, immutable, and transparent nature of blockchain systems offers solutions to long-standing challenges such as fraud, inefficiencies, and lack of transparency in financial transactions. This study explores blockchain technology adoption models tailored to the unique characteristics of emerging financial markets, emphasizing the integration of technological, organizational, and environmental (TOE) factors. By leveraging blockchain, financial institutions can enhance operational efficiency, build trust among stakeholders, and foster economic resilience. The research identifies key drivers and barriers to blockchain adoption in these markets, including regulatory frameworks, technological infrastructure, organizational readiness, and cultural attitudes toward technology. A comparative analysis of existing adoption models reveals that successful implementation requires a holistic approach, addressing both technical and socio-economic aspects. Furthermore, the study presents a conceptual framework that integrates stakeholder collaboration, data governance, and regulatory compliance to ensure effective blockchain deployment. Case studies from emerging markets illustrate the transformative impact of blockchain in improving transparency and accountability, particularly in areas such as cross-border payments, supply chain financing, and digital identity management. The findings highlight the role of blockchain in reducing transaction costs, minimizing fraud, and improving access to financial services for underbanked populations. Additionally, the study underscores the importance of fostering innovation ecosystems and public-private partnerships to drive blockchain adoption. The proposed adoption models incorporate critical success factors, such as scalability, interoperability, and user-centric design, to maximize blockchain’s potential benefits. The study concludes by outlining actionable recommendations for policymakers, financial institutions, and technology providers to accelerate blockchain adoption in emerging financial markets. This research contributes to the growing body of knowledge on blockchain technology, providing practical insights and strategies for its application in enhancing transparency, reducing fraud, and improving efficiency in financial systems.
- Conference Article
5
- 10.1109/telsiks52058.2021.9606343
- Oct 20, 2021
The adoption of blockchain necessitates the attention of a wide range of elements, much beyond the primarily technological focus of most present investigations. The present inquiries do not provide appropriate models as to how SMEs ought to go about blockchain adoption. Thus, this research study sort to investigate the key factors that drive blockchain adoption and propose a research model that could be used to inform blockchain adoption by SMEs in the context of South Africa. Drawing on the innovation diffusion theory and technological, organizational and environmental factors a model was proposed. Quantitative study was carried out; survey data was collected from 167 SMEs. SPSS was used to analyze the collected data and AMOS to fit the model. The results revealed that organizational readiness, trading partner pressure, perceived benefits, complexity, top management support, and compatibility could significantly influence the adoption of blockchain. However, in the South African context, competitive pressure and government regulations & support were found to be insignificant.
- Book Chapter
- 10.4018/979-8-3693-0405-1.ch002
- Jan 17, 2024
This study explores the factors that impact the adoption of blockchain in supply chain financing (SCF). Blockchain's unique features make it a good solution to the current problems in SCF. However, given that both blockchain and SCF are relatively new, there are almost no commercially viable large-scale implementations yet in this area. Research in the factors that drive the adoption of blockchain in SCF, is also scarce. Of the six identified determinants of adoption of blockchain in SCF, the study found four to be significant. Relative advantage, compatibility, organization readiness, and environment readiness influence the adoption of blockchain in SCF. Complexity and technology readiness are insignificant determinants, indicating a technically mature industry capable of handling current blockchain implementations in SCF and associated changes. The authors also found that trust has a mediating effect between compatibility and adoption and between environment readiness and adoption.
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