Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic

Abstract

BackgroundConsumer e-Health is a potential solution to the problems of accessibility, quality and costs of delivering public healthcare services to patients. Although consumer e-Health has proliferated in recent years, it remains unclear if patients are willing and able to accept and use this new and rapidly developing technology. Therefore, the aim of this research is to study the factors influencing patients’ acceptance and usage of consumer e-health innovations.MethodsA simple but typical consumer e-health innovation – an e-appointment scheduling service – was developed and implemented in a primary health care clinic in a regional town in Australia. A longitudinal case study was undertaken for 29 months after system implementation. The major factors influencing patients’ acceptance and use of the e-appointment service were examined through the theoretical lens of Rogers’ innovation diffusion theory. Data were collected from the computer log records of 25,616 patients who visited the medical centre in the entire study period, and from in-depth interviews with 125 patients.ResultsThe study results show that the overall adoption rate of the e-appointment service increased slowly from 1.5% at 3 months after implementation, to 4% at 29 months, which means only the ‘innovators’ had used this new service. The majority of patients did not adopt this innovation. The factors contributing to the low the adoption rate were: (1) insufficient communication about the e-appointment service to the patients, (2) lack of value of the e-appointment service for the majority of patients who could easily make phone call-based appointment, and limitation of the functionality of the e-appointment service, (3) incompatibility of the new service with the patients’ preference for oral communication with receptionists, and (4) the limitation of the characteristics of the patients, including their low level of Internet literacy, lack of access to a computer or the Internet at home, and a lack of experience with online health services. All of which are closely associated with the low socio-economic status of the study population.ConclusionThe findings point to a need for health care providers to consider and address the identified factors before implementing more complicated consumer e-health innovations.

Providers’ perceptions of the implementation of a performance measurement system for substance abuse treatment: A process evaluation of the Service Quality Measures initiative

“…This finding is encouraging, as the acceptability of a healthcare system innovation is highly predictive of its adoption. [14] While the vast majority of participants reported that the SQM system was feasible to implement as part of standard practice in their resource-constrained settings, they did identify barriers to implementation and areas where the implementation protocols could be refined to facilitate ease of use. They highlighted how the current practice of introducing patients to the SQM system on their first contact with the treatment facility deterred patient participation.…”

Assessing the Online Outpatient Booking System

“…Dissimilarity of the results could be because the samples under study included online appointment booking systems and in cases where several hospitals used an integrated system of online making appointments, only one appointment booking system was calculated. Making necessary reports to clients has been proposed as one of the important features of webbased appointment-making systems (21) and consideration of this feature in designing online appointment booking systems will lead to the desired results, such as avoiding clients' congestion and wasting time of physicians and patients (22). Offers of appropriate information could encourage more people to use this system and facilitate its application (6,35,36).…”

“…This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited time and any place, allowing the user to see the physicians' appointments (9), selection of the desired option, editing the recorded information, more favorable relationship between physician and patient, improvement of the efficiency and effectiveness of care (5), cost reduction (11)(12)(13)(14), reduction of the number and volume of employees (7), saving patient information for use in subsequent appointments (11), and reduction of the number of missed appointments (9,11,(13)(14)(15)(16)(17)(18). However, despite the importance of this system, a few studies have been done on its evaluation and existing researches in this field have investigated topics, such as designing a web-based appointment system (19), patient satisfaction of online appointment booking systems (4,20), development of information technology acceptance model for an online appointment booking system in hospitals (21)(22)(23), implementation and use of the online appointment booking system in clinics (15,20), and improving the management of appointments (24,25). There are limited studies in Iran on the need for smart systems to prepare an optimized program for patients and investigating the appointment-making system of private physicians' offices (5,22).…”

“…However, despite the importance of this system, a few studies have been done on its evaluation and existing researches in this field have investigated topics, such as designing a web-based appointment system (19), patient satisfaction of online appointment booking systems (4,20), development of information technology acceptance model for an online appointment booking system in hospitals (21)(22)(23), implementation and use of the online appointment booking system in clinics (15,20), and improving the management of appointments (24,25). There are limited studies in Iran on the need for smart systems to prepare an optimized program for patients and investigating the appointment-making system of private physicians' offices (5,22). Increased satisfaction of the clients of healthcare centers is an important pillar of the "health transformation scheme" implemented by the ministry of health and Medical education.…”

Mediating Effect of Personal Characteristics on the Relationship between Diffusion and Adoption of Telecentre with Value Creation

“…On the other hand, Dahalin et al, (2015) specifically did not discuss the effect of personal characteristics but deliberates on technology adoption and diffusion within the context of teaching and learning. There are also related works on the adoption and diffusion of Information Technology that examine the effect of personal characteristics on health (Butler et al, 2013;Zhang et al, 2015). Both studies found usage experience and age influence diffusion and adoption.…”