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Similar to Does the perception of trust in the usefulness or ease of use of a HIS (Health Information System), influence end-user HIS usage_
Similar to Does the perception of trust in the usefulness or ease of use of a HIS (Health Information System), influence end-user HIS usage_ (20)
Does the perception of trust in the usefulness or ease of use of a HIS (Health Information System), influence end-user HIS usage_
- 1. Research Question: “Does the perception of trust in the usefulness or ease of use of a HIS (Health Information System), influence end- user HIS usage?” Introduction: Our research question wished to examine if and how two elements influenced Health Information System (HIS) usage by healthcare professionals. HIS or PCIS usage frequency is associated with beneficial patient outcomes via reduction of medial error. We conducted a statistical analysis that is presented further down in this paper. Correlation and Descriptive Statistics, and the Levene’s Test which outlines the significance of differences between variances - and the T-Test for equality of means were all analysed. We have opted not to use the Lambda test because of the nature of our variables and the fact that the data was gathered using interval/ratio constructs. The statistical tests were used to measure three variables and examine the relationships (if any) between them We looked at three variables: the relationship between two independent variables – and how each respectively influenced a dependent variable. • the first variable was independent (IV1). The perceived trust in the usefulness (PTU) of an HIS system by the end-user*, • the second variable was also independent (IV2): The perceived trust in the ease of use (PTEU) of the HIS system by the end-user, and • the last variable, a dependent variable (DV1): HIS (Health information System) usage by the end-user. o The DV1 is classified as a discrete variable as this variable is measured in whole units. o The units of measurement for the DV1 are the number of times that the end-user (health-care professional) uses the HIS via insertion of patient data. This data was provided by the hospitals’ respective IT departments over a 30-day period in August 2013. *End-users are comprised of nurses using the HIS in a hospital setting. Our demographic data pointed to a greater number of females than males, with the
- 2. overall ethnicity represented were New Zealand Europeans. For the purposes of our study, we applied a weighting scale to ensure equal representation. Structure of the Results: Sample: Our sample size was 1811 (n=1811) (n>100) that has a significant chance of being a sample that is representative of the population. Our total respondent rate was 65%. Description of Sample: Our sample was comprised of nurses in three major hospitals in New Zealand: Auckland Central, Wellington (Newtown) and Christchurch (Addington). The respective hospital finance/payroll departments graciously provided a list of the names nurses with their consent. We also received assistance by the HR department to ascertain the gender of the sample respondents in cases where the names were not clear as male or female names and as a result without clarification could not lead to immediate classification of gender. Methodology: Mixes of both qualitative and quantitative methods were used in this study. Qualitative methods involved a questionnaire sent to the respondents with 5 items with the choice of answers (Likert scale) ranging as follows: • Strongly disagree • Somewhat disagree • Disagree • Neither disagree nor agree • Agree • Somewhat agree • Strongly agree Quantitative methods were the measurement of the number of times each respondent used the hospital HIS/PCIS system to input patient information over a 30 day period. The numbers were then fed into a system and correlated per total respondent and then correlated per gender.
- 3. Analysis of the measure that was developed for this study: We developed three different constructs in our study to measure the following: • The separate influence (if any) that the IV 1 and IV 2 had on the DV 1. • In addition, whether there was a correlation that existed at all between the two IV variables– and if so, whether that correlation was a negative or a positive one and, • The effect of gender on the DV 1 and its influence on both IV 1 and IV 2. Data Compilation An interval level questionnaire of 5 items was developed. The respondents were asked to answer each question using a 7-point Likert scale. The questionnaire was sent via email to a designated email of all respondents and the response was returned via an independent email address that was not affiliated with the hospital. A request was also made that the questionnaire be returned within 7 days. A reminder email was sent through to all study participants on the sixth day. A total of 1811 questionnaires were returned which represented 65% of the overall total number of respondents. The DV1 construct data was imputed through counting the number of times the respondents used the HIS (Health Information System) to enter patient information and data during a 30-day period. It was decided to use multiple regression as a method of measurement as it would appear to be the method of choice to measure the influence of both independent variables on the dependent variable. (Fan-Yun & Kai-I, 2011),(King & He, 2006), (Kummer, 2013). Additionally, the variable of gender was also measured to understand the influence of gender as a moderating variable on the dependent variable (Gefen & Straub, 1997).
- 4. Table 1 Overview of constructs Definition _____________________________________________________________________ Trust in the perception of usefulness TPU Trust (faith and expectation) that the system will be useful to the healthcare professional to advance their career and/or accomplish his or her tasks. Reference of origin (Venkatesh & Morris, 2000),(Gefen, 2004) --------------------------------------------------------------------------------------------------------- Trust in the perception of ease of use TPEU Trust (faith and expectation) that the system will be easy to use. Reference of origin (Gefen, 2004) --------------------------------------------------------------------------------------------------------- HIS system usage HSU Amount of times that the Health information system (HIS) or patient care information (PCIS) system is used to input patient information over a 30-day period. Reference (F. D. Davis, 1989),(Venkatesh & Morris, 2000) ______________________________________________________________________ Statistical analysis Pearson’s correlation coefficients were used in order to provide an understanding of the relationship between all variables. The study respondents’ answers were tested all gleaned from the questions emanating from the three constructs. As clearly demonstrated by the results of the Correlations Table, the PTU (IV1) and PTEU (IV2) variables are correlated positively with the HIS Usage (DV1). Perceived trust of usefulness (IV1) and HIS Usage (DV1) are significantly correlated, r= 0.085, p< 0.01. There was a significant correlation of 0.804 (p< 0.01) between IV2 (PTEU) and DV1 (HIS Usage).
- 5. Females (M= 3.64, SD= .60) reported significantly higher HIS Usage (DV1) than males (M= 3.44, SD= .60), t(1803) = -6.75, p< .01. Females (M= 3.82, SD= 1.04) and males (M= 4.06, SD= 1.03) did differ significantly on Perceived Trust in Usefulness (PTU), t(1414) = 4.05, p<.01. Females (M= 5.30, SD= 0.68) and males (M= 5.13, SD= 0.68) did differ significantly on Perceived Trust in Ease of Use (PTEU), t(1795) = -5.09, p<.01. Results Descriptive Statistics: The descriptive statistics, with the inferential statistics t-test results allow us to examine the relationship influences due to the fact that we have interval and ratio data imputation. The statistics indicate that the constructs are significantly and positively correlated. Further the p-value is significant – due to the fact that correlation coefficients are 0.085, and 0.804 and the p-value less than 0.01. The descriptive finding demonstrates that the study respondents practice high HIS usage if they trust that the system is useful and easy to use. T-test results: T-tests were used to compare the differences between males and females on the constructs of (IV1) PTU and (IV2) PTEU, and (DV1) HIS usage. We may conclude that gender is significantly affecting all three aforementioned variables. Multiple regression: Multiple regression was chosen as a way of measuring and predicting the level of influence of several independent variables and in relation to the dependent variable (Fusilier, Durlabhji, & Cucchi, 2008). Discussion: • The most obvious aspect of the Correlation table is that DV1 is highly influenced by both independent variables. This is the main finding. • IV2 is highly correlated with DV1 (a result of .804 of IV2). • Gender has a significant effect on all three variables. • The most interesting/unusual feature of the results that we can conclude that people prefer technology that is easy to use rather than whether if is perceived as useful. • Our main findings were that the perceived level of trust (that is faith and belief that the expectation of the HIS/PCIS) is useful and easy to use- are both positive influences in system usage by healthcare professionals.
- 6. (Sun & Zhang, 2006), (Fusilier et al., 2008; Holden & Karsh, 2010), (Gefen, 2004) – but that the IV2 (PTEU) is a greater influence in usage of the Healthcare system by the healthcare professional. Conclusions: We found that the ease of use truly influences the frequency of system use in hospitals, our findings were supported in the literature (C. Davis, 2011; Venkatesh, Morris, Davis, & Davis, 2003) (Fan-Yun & Kai-I, 2011). In future, this information can benefit the way HIS/PCIS technology is developed. Our results indicate if workers perceive that a system is easy to use, they will use it more often. By identifying one of the strong determinants that leads to high HIS use by healthcare professionals and using this determinant as a strong characteristic and goal when developing systems – the systems may be used to a much higher frequency level. This can also lead to an outcome of lower medical error – which in turn leads to lower mortality rates and better healthcare in hospitals (Ash, Berg, & Coiera, 2004). Further study that could also be recommended would be to examine from an organisational psychological perspective as to how those perceptions of trusting that a system is easy to use -is influenced by an individual’s perception of how others in their working environment view what is useful and what is easy to use and how that perspective influences the individuals’ use frequency of HIS/PCIS systems. It is well known that organisational acceptance is a “subjective norm concerns a person’s perception that most people who are important to him/her think s/he should or should not perform the behaviour in question (Venkatesh et al., 2003).” Indeed, what is acceptable in a group will also have an influence on both variables that have been discussed in this paper and also provide positive peer pressure to use a system by overcoming any perception that it may not be easy to use because one’s peers believe differently. Thus, an additional recommendation to examine how organisational team structure collectively influences the individual in this way. How that collective way of thinking is developed in the perception of an industrial setting with regard to HIS usage is perhaps worth exploring.