Health information technology use and the decisions of altruistic physicians

Abstract

Rationale, aims and objectives: Knowledge is the basis and mediator of medical care. Health information technology (HIT) can help in improving care only if physicians faithfully apply their knowledge during its use. A measure of judicious HIT use has recently been proposed. Behavioural research and the oft-cited technology acceptance model suggest that beliefs/perceptions may also represent decision factors. This paper proposes a perception scale and an alternative measure of judicious HIT use. Methods: Statistical analyses were performed on a subset of survey data collected for developing an eHealth success model. This paper focuses on deriving a structural equation model that can explain the associations among intent to use HIT, professional concerns and perceptions about the impacts of HIT on care benefits. Results:The statistical results show that altruism, autonomy, the physician-patient relationship, (subconscious) autonomy, efficiency and efficacy significantly associate with each other to different extents. Only altruism and efficacy appear to be significant determinants of intent to use at p<0.01 and p<0.05, respectively. The scaled 2 difference test shows that this model is not significantly different from Tsang's model. Conclusion: Physician performance cannot be reliably evaluated and monitored when based purely on direct observations. The statistical results indicate that professional concerns associate with physicians' perceptions about the impacts of HIT and influence intent to use HIT. This paper shows a tendency of physicians to internalise factors that cannot be directly observed in the evaluation of HIT use. The study is advanced as of use in deriving policies that aim at coalescing evidencebased medical practice with humanism and thus as a significant contribution to the advancement of person-centered healthcare.

A task-fit measure of health information technology use

“…Altruism was the sole significant determinant of itU at P<0.001. The quantitative results were slightly different from those presented in Tsang [10], as a different subset of data was used.…”

“…Recently, introducing professional concerns into the evaluation of HIT use has been proposed [9,10]. Since medical practice is an intellectual, human and moral exercise [4], clinical reasoning draws upon a gamut of factors as part of diagnosis and decision-making [11].…”

“…† The 26 items that operationalise the intent to use and physician attributes constructs have been published in Tsang [9,10]. The Spanish version is available on request.…”

“…The more experienced physicians showed less satisfaction with the digestibility of the information and less dependence on HIT for consultation. Further details are available elsewhere [9,10].…”