Consumer Perceptions in the Adoption of the Electronic Health Records in Australia: A Pilot Study

Mathai, Neethu; Shiratuddin, Mohd Fairuz; Sohel, Ferdous; Wang, Xuequn

doi:10.5130/acis2018.cc

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…The adoption of TAM2 is also validated by similar recent studies using the framework, which is needed to accommodate similar complexity. This includes investigations into consumer perceptions of electronic health records in Australia [ 21 ], clinician adoption of internet-based health applications for pediatrics [ 22 ], and behavioral intentions of clinical staff to use radio frequency identification technology in hospitals [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

Evaluating Staff Attitudes, Intentions, and Behaviors Related to Cyber Security in Large Australian Health Care Environments: Mixed Methods Study

Dart¹,

Ahmed²

2023

JMIR Hum Factors

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Background Previous studies have identified that the effective management of cyber security in large health care environments is likely to be significantly impacted by human and social factors, as well as by technical controls. However, there have been limited attempts to confirm this by using measured and integrated studies to identify specific user motivations and behaviors that can be managed to achieve improved outcomes. Objective This study aims to document and analyze survey and interview data from a diverse range of health care staff members, to determine the primary motivations and behaviors that influence their acceptance and application of cyber security messaging and controls. By identifying these issues, recommendations can be made to positively influence future cyber security governance in health care. Methods An explanatory sequential mixed methods approach was undertaken to analyze quantitative data from a web-based staff survey (N=103), with a concurrent qualitative investigation applied to data gathered via in-depth staff interviews (N=9). Data from both stages of this methodology were mapped to descriptive variables based on a modified version of the Technology Acceptance Model (TAM; TAM2). After normalization, the quantitative data were verified and analyzed using descriptive statistics, distribution and linearity measures, and a bivariate correlation of the TAM variables to identify the Pearson coefficient (r) and significance (P) values. Finally, after confirming Cronbach α, the determinant score for multicollinearity, and the Kaiser-Meyer-Olkin measure, and applying the Bartlett test of sphericity (χ2), an exploratory factor analysis (EFA) was conducted to identify the primary factors with an eigenvalue (λ) >1.0. Comments captured during the qualitative interviews were coded using NVivo software (QSR International) to create an emic-to-etic understanding, which was subsequently integrated with the quantitative results to produce verified conclusions. Results Using the explanatory sequential methodology, this study showed that the perceived usefulness of security controls emerged as the most significant factor influencing staff beliefs and behaviors. This variable represented 24% of all the variances measured in the EFA and was also the most common category identified across all coded interviews (281/692, 40.6%). The word frequency analysis showed that systems, patients, and people represented the top 3 recurring themes reported by the interviewees. Conclusions To improve cyber security governance in large health care environments, efforts should be focused on demonstrating how confidentiality, integrity, availability, policies, and cloud or vendor-based controls (the main contributors of usefulness measured by the EFA) can directly improve outcomes for systems, staff, and patients. Further consideration also needs to be given to how clinicians should share data and collaborate on patient care, with tools and processes provided to support and manage data sharing securely and to achieve a consistent baseline of secure and normalized behaviors.

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Section: Methodsmentioning

confidence: 99%

Evaluating Staff Attitudes, Intentions, and Behaviors Related to Cyber Security in Large Australian Health Care Environments: Mixed Methods Study

Dart¹,

Ahmed²

2023

JMIR Hum Factors

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“…SIHA application is a form of integrated recording and reporting based on electronic medical records. An application can be said as qualified if it has complete and accurate data (Mathai et al, 2017), so that it can produce output that can be used as a basis for decision making (Nelsonet al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Does Accreditation Status Affect Job Performance of the Electronic Medical Record Clerks at Community Health Center?

Seha

Tamtomo

Sulaeman

2018

J HEALTH POLICY MANAGE

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Background: Primary care doctors and other staff working in primary care require comprehensive and accurate data on patients at the point-of-care if they are to provide high quality health services to their patients. Electronic patient records are an effective method of achieving this objective, by dispensing with the need to use difficult to access, and often illegible, paper-based records. This study aimed to analyze the effect of accreditation status on job performance of the electronic medical record clerks at community health center. Subjects and Method:This was an analytic observational study with a cross-sectional design. The study conducted for 25 puskesmas (community health centers), in Yogyakarta, from March to June 2018. A sample of 200 patient medical records was selected by simple random sampling. The dependent variables were completeness and accuracy of medical record. The independent variables were tenure and multi task as level 1 in the multilevel model (MLM). Accreditation status of puskesmas was taken as level 2 in the MLM. The data were collected by questionnaire and analyzed by MLM. Result: Longer tenure (b= 1.03; 95% CI= 0.30 to 1.77; p= 0.006) and single task occupation (b= 4.21; 95% CI= 6.23 to 2.20; p<0.001)were positively associated with completeness of electronic medical record. Likewise, longer tenure (b= 0.54; 95% CI= 0.079 to 1.01; p= 0.022) and single task occupation (b= 2.14; 95% CI= 3.42 to 0.87; p= 0.001) were positively associated with accuracy of medical record medical record. Accreditation status of puskesmas showed negligible contextual effect on completeness (ICC= 0.36%) and accuracy (ICC= 1.17%) of the electronic medical record. Conclusion: Longer tenure and single task occupation are positively associated with completeness and accuracy of medical record. Accreditation status of puskesmas shows negligible contextual effect on completeness and accuracy of the electronic medical record.

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Evaluating Staff Attitudes, Intentions, and Behaviors Related to Cyber Security in Large Australian Health Care Environments: Mixed Methods Study (Preprint)

Dart¹,

Ahmed²

2023

Preprint

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BACKGROUND Previous studies have identified that the effective management of cyber security in large healthcare environments is likely have a significant dependence on human and social factors, as much as technical controls. However, there have been limited attempts to confirm this with measured and integrated studies focussed on users in order to understand their motivations and behaviours. OBJECTIVE This study aimed to gather data from a variety of users working within large Australian healthcare provider (LAHP) environments, to record and verify their motivations in understanding and applying essential cyber security messaging and operational controls. METHODS An explanatory sequential mixed-methods approach was undertaken, gathering quantitative data via a user survey (n=103), with variables mapped to the extended Technology Acceptance Model (TAM2) and results scrutinized via an exploratory factor analysis. A parallel qualitative review was also undertaken via in-depth interviews with staff (n=9), which were also encoded to the TAM2 model and examined for thematic frequency. The coded comments were analysed to create an emic-to-etic understanding, which was integrated with the quantitative results to produce verified conclusions. RESULTS Via both the quantitative and qualitative investigations, users prioritised the TAM2 Perceived usefulness of cyber security measures, and the operational subjective norms of their professional peers as being the main influences on their knowledge and behaviours. CONCLUSIONS To pragmatically manage and improve cyber security governance in large healthcare environments, efforts should be focussed on demonstrating how controls can benefit staff and patients without getting in the way of complex treatments. Further consideration needs to be given to how clinicians need to share data and collaborate on patient care, with tools and processes provided to support and manage this securely.

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Consumer Perceptions in the Adoption of the Electronic Health Records in Australia: A Pilot Study

Cited by 3 publications

References 19 publications

Evaluating Staff Attitudes, Intentions, and Behaviors Related to Cyber Security in Large Australian Health Care Environments: Mixed Methods Study

Evaluating Staff Attitudes, Intentions, and Behaviors Related to Cyber Security in Large Australian Health Care Environments: Mixed Methods Study

Does Accreditation Status Affect Job Performance of the Electronic Medical Record Clerks at Community Health Center?

Evaluating Staff Attitudes, Intentions, and Behaviors Related to Cyber Security in Large Australian Health Care Environments: Mixed Methods Study (Preprint)

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