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Compared to offline shopping, the online shopping experience may be viewed as lacking human warmth and sociability as it is more impersonal, anonymous, automated and generally devoid of face-to-face interactions. Thus, understanding how to create customer loyalty in online environments (e-Loyalty) is a complex process. In this paper a model for e-Loyalty is proposed and used to examine how varied conditions of social presence in a B2C e-Services context influence e-Loyalty and its antecedents of perceived usefulness, trust and enjoyment. This model is examined through an empirical study involving 185 subjects using structural equation modeling techniques. Further analysis is conducted to reveal gender differences concerning hedonic elements in the model on e-Loyalty.

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BackgroundPatients have been increasingly seeking and using Internet health information to become more active in managing their own health in a partnership with their physicians. This trend has both positive and negative effects on the interactions between patients and their physicians. Therefore, it is important to understand the impact that the increasing use of Internet health information has on the patient-physician relationship and patients’ compliance with their treatment regimens.ObjectiveThis study examines the impact of patients’ use of Internet health information on various elements that characterize the interactions between a patient and her/his physician through a theoretical model based on principal-agent theory and the information asymmetry perspective.MethodsA survey-based study consisting of 225 participants was used to validate a model through various statistical techniques. A full assessment of the measurement model and structural model was completed in addition to relevant post hoc analyses.ResultsThis research revealed that both patient-physician concordance and perceived information asymmetry have significant effects on patient compliance, with patient-physician concordance exhibiting a considerably stronger relationship. Additionally, both physician quality and Internet health information quality have significant effects on patient-physician concordance, with physician quality exhibiting a much stronger relationship. Finally, only physician quality was found to have a significant impact on perceived information asymmetry, whereas Internet health information quality had no impact on perceived information asymmetry.ConclusionsOverall, this study found that physicians can relax regarding their fears concerning patient use of Internet health information because physician quality has the greatest impact on patients and their physician coming to an agreement on their medical situation and recommended treatment regimen as well as patient’s compliance with their physician’s advice when compared to the impact that Internet health information quality has on these same variables. The findings also indicate that agreement between the patient and physician on the medical situation and treatment is much more important to compliance than the perceived information gap between the patient and physician (ie, the physician having a higher level of information in comparison to the patient). In addition, the level of agreement between a patient and their physician regarding the medical situation is more reliant on the perceived quality of their physician than on the perceived quality of Internet health information used. This research found that only the perceived quality of the physician has a significant relationship with the perceived information gap between the patient and their physician and the quality of the Internet health information has no relationship with this perceived information gap.