The Technology Acceptance Model: Its past and its future in health care
Open accessAbstract
Increasing interest in end users' reactions to health information technology (IT) has elevated the importance of theories that predict and explain health IT acceptance and use. This paper reviews the application of one such theory, the Technology Acceptance Model (TAM), to health care. We reviewed 16 data sets analyzed in over 20 studies of clinicians using health IT for patient care. Studies differed greatly in samples and settings, health ITs studied, research models, relationships tested, and construct operationalization. Certain TAM relationships were consistently found to be significant, whereas others were inconsistent. Several key relationships were infrequently assessed. Findings show that TAM predicts a substantial portion of the use or acceptance of health IT, but that the theory may benefit from several additions and modifications. Aside from improved study quality, standardization, and theoretically motivated additions to the model, an important future direction for TAM is to adapt the model specifically to the health care context, using beliefs elicitation methods.
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Written from the paper’s full text.
TL;DR
This review examines how the Technology Acceptance Model (TAM) has been applied to clinician use of health information technology, covering 16 datasets from 22 studies. It finds TAM predicts a meaningful share of acceptance/use, but the evidence is uneven and the model needs standardization, more complete testing, and healthcare-specific contextualization.
Key findings
- Across 16 datasets, perceived usefulness was significantly related to intention/use in all 16 tests; perceived behavioral control was significant in all 5 tests; attitude-to-intention was significant in 5 of 6 tests; perceived ease of use-to-perceived usefulness in 10 of 12; perceived usefulness-to-attitude in 3 of 3; perceived ease of use-to-attitude in 1 of 2.
- Some paths were inconsistent: perceived ease of use-to-intention was significant in only 7 of 13 tests, and subjective norm-to-intention in only 4 of 8. Only two studies tested intention-to-actual-use; one found a significant relationship, while the other found it for only one of two use behaviors.
- TAM explained a substantial portion of variance in intention or use, but the authors did not pool estimates because studies differed greatly in samples, settings, technologies, models, construct definitions, and measures. No single study tested the same model.
- The authors recommend contextualizing TAM for healthcare through beliefs elicitation, because generic definitions of usefulness, ease of use, and social influence may miss clinically relevant dimensions and actionable causes.
Methods
- Critical review of quantitative studies testing TAM or closely related models (TAM2, UTAUT, TPB) in health care, published on or before July 2008, focused on clinician end users of health IT for direct patient care. Exclusions included qualitative studies, studies not testing TAM relationships, patient or non-medical users, organizational adoption, web-based learning, adverse event reporting, and unpublished dissertations.
- Searches used PubMed/MEDLINE and ABI/INFORM Global with TAM/TAM2/UTAUT keywords plus health, physician, and nurse terms, followed by reference checking. The review included 16 datasets analyzed in 22 studies.
- No meta-analysis was performed because of heterogeneity; the authors reported variance explained (R² or equivalent) descriptively and cautioned against overinterpreting it.
Limitations
- Stated: heterogeneity in samples, technologies, models, and measures prevented meta-analysis and limits comparability; many relationships were infrequently assessed; actual use was rarely measured; longitudinal research was lacking; moderators were seldom tested; construct definitions and operationalizations were often mismatched or generic; some studies lacked formal definitions; profession effects were sometimes confounded with sex and age.
- Stated: publication, language, and library-access restrictions applied, and excluded studies may still offer useful insight.
- Evident from the text: the small evidence base of 16 datasets and non-standardized models mean conclusions about inconsistent paths, such as perceived ease of use and subjective norm, remain tentative, and no formal effect-size synthesis was possible.
Model-written summary. Check it against the paper before relying on it.
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Cites
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Claims the paper makes
0 of 140 cited sources checked · 0 supported · 0 flagged
- Findingnone given
The reviewed studies varied greatly in samples, settings, health ITs studied, research models, relationships tested, and construct operationalization.
“Studies differed greatly in samples and settings, health ITs studied, research models, relationships tested, and construct operationalization.”
Quote in the paperSubstantial claim - Findingcitation
In one reviewed study, the relationship between behavioral intentions and actual use was significant.
“In one study, the relationship was significant [110].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [110] Chen, 2007, Obstacles to the adoption of radio frequency identification technology in the emergency rooms of hospitals, Int J Electron Healthcare source
Not checked in the free run.
- Findingown data
The effect of subjective norm on intention was significant in only four of eight tests.
“The effect of subjective norm on intention was similarly questionable, significant in only four of eight tests.”
Quote in the paperNot a substantial claim - Findingown data
All 16 tests of the relationship between perceived usefulness and intention to use were significant.
“Every one of the 16 tests of the relationship between PU and intention to use was significant.”
Quote in the paperSubstantial claim - Findingown data
The relationship between perceived ease of use and intention was significant in only seven of 13 tests.
“The PEOU-intention relationship was much more inconsistent, significant in only seven of 13 tests.”
Quote in the paperSubstantial claim
- Findingown data
Of the 16 data sets analyzed using TAM and related models, 7 analyzed data from all-physician samples.
“Of the 16 data sets analyzed using TAM and related models, 7 analyzed data from all-physician samples.”
Quote in the paperNot a substantial claim - Findingown data
Only two reviewed studies tested the relationship between behavioral intentions and actual use.
“Only two studies tested the relationship between behavioral intentions and actual use [102,110].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [102] Rawstorne P, Jayasuriya R, Caputi P. Issues in predicting and explaining usage behaviors with the technology acceptance model and the theory of planned behavior when usage is mandatory. In: Proceedings of the 21st international conference on information systems; 2000. p. 35–44.
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- cites [110] Chen, 2007, Obstacles to the adoption of radio frequency identification technology in the emergency rooms of hospitals, Int J Electron Healthcare source
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- Findingcitation
The relationship between perceived usefulness and attitude was significant in three of three tests.
“PU-ATT was significant in three of three [32,101,105]”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [32] Hu, 1999, Examining the technology acceptance model using physician acceptance of telemedicine technology, J Manag Inform Syst source
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- cites [101] Paré, 2006, The effects of creating psychological ownership on physicians’ acceptance of clinical information systems, J Am Med Inform Assoc source
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- cites [105] Schaper, 2007, ICTs & OTs: a model of information and communications technology acceptance and utilisation by occupational therapists (part 2), Stud Health Technol Inform
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- Findingcitation
In another reviewed study, the relationship between behavioral intentions and actual use was significant for only one of two types of use behavior.
“In another, the relationship was only significant for one of two types of use behavior [102].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [102] Rawstorne P, Jayasuriya R, Caputi P. Issues in predicting and explaining usage behaviors with the technology acceptance model and the theory of planned behavior when usage is mandatory. In: Proceedings of the 21st international conference on information systems; 2000. p. 35–44.
Not checked in the free run.
- Findingown data
The relationship between perceived ease of use and perceived usefulness was significant in 10 out of 12 tests.
“The original TAM also specified that PEOU and PU are related, and this was the case in 10 out of 12 tests.”
Quote in the paperNot a substantial claim - Findingown data
The effect of attitude on intention to use was significant in five out of six tests.
“The effect of ATT on intention to use, as specified by the original TAM, was significant in five out of six tests.”
Quote in the paperNot a substantial claim - Findingown data
All five tests of the relationship between perceived behavioral control and intention were significant.
“In contrast, all five tests of the PBC-intention relationship were significant.”
Quote in the paperNot a substantial claim - Findingcitation
The relationship between perceived ease of use and attitude was significant in one of two tests.
“PEOU-ATT was significant in one of two tests [101]”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [101] Paré, 2006, The effects of creating psychological ownership on physicians’ acceptance of clinical information systems, J Am Med Inform Assoc source
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- Findingown data
Several key TAM relationships were rarely assessed in the reviewed studies.
“Several key relationships were infrequently assessed.”
Quote in the paperSubstantial claim - Findingown data
Some reviewed studies asked about outcomes of use including quicker task completion, easier work, increased quality of care or work, improved efficiency, more accurate or objective task accomplishment, support of critical tasks, increased chances to get a raise, greater control over work, better evidence-based decisions, and improved patient care.
“Indeed, some studies asked questions specifically about the following outcomes of use: quicker task completion; easier work; increased quality of care or quality of work; improved efficiency; more accurate or more objective accomplishment of tasks; support of critical tasks; increased chances to get a raise; greater control over work; better evidence-based decisions; and improved patient care.”
Quote in the paperNot a substantial claim - Findingown data
The reviewed studies yield some consistently significant relationships.
“On average, the reviewed studies yield (1) reasonably high R2 values, (2) frequently large effect sizes (not reported) for relationships between study variables, and (3) some consistently significant relationships.”
Quote in the paperSubstantial claim - Findingreasoning
TAM has been widely applied to explain health care providers' reactions to health IT.
“From the preceding review, it is evident that TAM has had widespread application in explaining health care providers’ reactions to health IT.”
Quote in the paperSubstantial claim - Findingcitation
Only one reviewed study addressed whether social influence operates through compliance, identification, or internalization processes.
“Another open question is whether the social influence is having its effect through compliance, identification, or internalization processes [119], a point that was addressed in only one reviewed study [99].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [119] Kelman, 1958, Compliance, identification, and internalization: three process of attitude change, J Confl Resolut source
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- cites [99] Yi, 2006, Understanding information technology acceptance by individual professionals: toward an integrative view, Inform Manag source
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- Findingcitation
One reviewed study used two questions about the helpfulness and support of the hospital and management that did not appear to follow from the study's stated definition of social influence.
“Notably, one study [108] used two questions—about the helpfulness and support of the hospital and management—that did not appear to follow from the study’s stated definition of social influence.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [108] Duyck, 2008, User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting, Methods Inf Med source
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- Findingown data
It was not uncommon for a study's definition of a construct to not match its operationalization.
“In general, it was not uncommon that a study’s definition for a construct did not match its operationalization.”
Quote in the paperNot a substantial claim - Findingcitation
There was variation in the health IT studied, including telemedicine technology, picture archiving and communications systems, and computerized provider order entry.
“There was variation in the health IT that served as the focus of the study, including telemedicine technology [32], picture archiving and communications systems [108, 109], and computerized provider order entry (CPOE) [101] (see Table 2 for full list).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [32] Hu, 1999, Examining the technology acceptance model using physician acceptance of telemedicine technology, J Manag Inform Syst source
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- cites [108] Duyck, 2008, User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting, Methods Inf Med source
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- cites [109] Wu, 2007, Mobile computing acceptance factors in the healthcare industry: a structural equation model, Int J Med Inform source
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- Findingown data
PEOU was assessed on dimensions including easy to use, clear and understandable, easy to become skillful, easy to get the system to do what one wanted, easy to learn, flexible, requiring low mental effort, easy to do tasks, not demanding much care and attention, easy navigation, and easy to remember tasks.
“PEOU was variously assessed on these dimensions: easy to use; clear and understandable; easy to become skillful with system; easy to get the system to do what one wanted; easy to learn to operate; flexible; requiring low mental effort; easy to do what one wants when using the system; easy to do tasks when using the system; clear; understandable; not demanding of much care and attention; easy nav”
Quote in the paperNot a substantial claim - Findingown data
How constructs were operationalized differed greatly between reviewed studies.
“How constructs were operationalized differed greatly between studies, as can be seen in Table 4.”
Quote in the paperNot a substantial claim - Findingown data
Only two reviewed studies had questions mentioning effort specifically.
“Despite the PEOU definitions given in Section 3.4 above, only two studies had questions mentioning effort specifically [96, 97].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [96] Barker, 2003, Evaluating a spoken dialogue system for recording clinical observations during an endoscopic examination, Med Inform Internet Med source
Not checked in the free run.
- cites [97] Chismar WG, Wiley-Patton S. Test of the technology acceptance model for the internet in pediatrics. In: Proceedings of the annual symposium of the American medical informatics association; 2002. p. 155–9.
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- Findingcitation
Among the reviewed studies, only one of the four studies with a significant SN effect had an all-physician sample.
“Indeed, only one of the four studies with a significant SN effect had an all-physician sample [99].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [99] Yi, 2006, Understanding information technology acceptance by individual professionals: toward an integrative view, Inform Manag source
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- Findingown data
No reviewed study used a broader definition of usefulness that included making performance easier and more satisfying, increasing efficiency and lowering costs, or improving quality and safety of care.
“Notably, no study used a broader definition of usefulness, despite the notion that health IT might be useful for not only enhancing performance, but also making performance easier and more satisfying, increasing efficiency and lowering costs, improving quality and safety of care, and more [113-115].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [113] RAND Corporation. Health information technology: can HIT lower costs and improve quality?; 2005.
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- cites [114] Chaudhry, 2006, Systematic review: impact of health information technology on quality, efficiency, and costs of medical care, Ann Intern Med source
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- cites [115] Shekelle, 2006
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- Findingown data
The referent's identity in SN measures varied widely, from people whose opinions I value to important others to pediatricians who influence my behavior to colleagues, supervisors, and subordinates.
“What varied widely was the referent’s identity, from “People whose opinions I value” to “People who are important to me” to “Pediatricians who influence my behavior” to “Colleagues,” “Supervisors,” and “Subordinates,” as well as other similar permutations.”
Quote in the paperNot a substantial claim - Findingown data
Studies varied slightly in how key variables were conceptualized.
“Studies varied slightly in how key variables were conceptualized, as depicted in Table 3.”
Quote in the paperNot a substantial claim - Findingreasoning
The relationship between perceived usefulness and intention to use or actual use of health IT is significant in every test in the reviewed studies.
“Perhaps most impressive is that the relationship between PU and intention to use or actual use of health IT is significant in every test, suggesting that to promote use and acceptance, the health IT must be perceived as useful.”
Quote in the paperSubstantial claim - Findingown data
Across the reviewed studies, the percentage of variance explained in behavioral intentions or actual use is reasonably high.
“Generally speaking, however, the percentage of variance explained in behavioral intentions (or actual use) is reasonably high.”
Quote in the paperNot a substantial claim - Findingnone given
The reviewed studies frequently yield large effect sizes for relationships between study variables.
“On average, the reviewed studies yield (1) reasonably high R2 values, (2) frequently large effect sizes (not reported) for relationships between study variables, and (3) some consistently significant relationships.”
Quote in the paperNot a substantial claim - Findingnone given
On average, the reviewed studies yield reasonably high R2 values.
“On average, the reviewed studies yield (1) reasonably high R2 values, (2) frequently large effect sizes (not reported) for relationships between study variables, and (3) some consistently significant relationships.”
Quote in the paperNot a substantial claim - Findingown data
Among the reviewed studies, non-significant PEOU-ATT or PEOU-BI relationships were more common in studies involving physician users.
“Indeed, of the seven studies with non-significant PEOU-ATT or PEOU-BI relationships, six involved physician users. Of the eight studies with significant relationships, one had an all-physician sample [101], one had a sample of occupational therapists [105], two had all-nurse samples [102,103] and the remaining five had mixed (mostly-non-physician) samples.”
Quote in the paperSubstantial claim - Findingreasoning
The reviewed studies did not test a single, uniformly specified model of relationships between TAM variables.
“The studies mentioned did not test a single, uniformly specified model of relationships between TAM variables.”
Quote in the paperSubstantial claim - Findingreasoning
Across the reviewed studies, there is some evidence that limited exposure to the IT is linked to non-significant PEOU-ATT and PEOU-BI relationships.
“Looking across the reviewed studies, there appears to be some evidence for the first explanation, that lack of exposure appears to be associated with non-significant PEOU-ATT and PEOU-BI relationships.”
Quote in the paperNot a substantial claim - Findingown data
SN measures were similar in that almost all asked about the degree to which some referents thought the clinician should use the system.
“SN measures were similar to one another in that almost all asked about the degree to which some referents thought the clinician should use the system.”
Quote in the paperNot a substantial claim - Findingown data
PU was most commonly measured by asking about usefulness to the job or a specific task, increased productivity, or increased job effectiveness.
“PU was most commonly measured by asking about how much the health IT was “useful to the job” or to a specific task, how much it increased productivity, or how much it increased job effectiveness.”
Quote in the paperNot a substantial claim - Findingcitation
Actual use has been too infrequently measured in the reviewed studies, precluding tests of several important relationships, such as the one between intention and actual use.
“First, certain variables such as actual use have been too infrequently measured, precluding tests of several important relationships, such as the one between intention and actual use [102, 110].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [102] Rawstorne P, Jayasuriya R, Caputi P. Issues in predicting and explaining usage behaviors with the technology acceptance model and the theory of planned behavior when usage is mandatory. In: Proceedings of the 21st international conference on information systems; 2000. p. 35–44.
Not checked in the free run.
- cites [110] Chen, 2007, Obstacles to the adoption of radio frequency identification technology in the emergency rooms of hospitals, Int J Electron Healthcare source
Not checked in the free run.
- Findingnone given
Most measures in the reviewed studies were generic and not health care-specific.
“Nevertheless, most measures were generic and not health care-specific.”
Quote in the paperSubstantial claim - Findingreasoning
Some reviewed studies used measures that did not fit TAM definitions and were not typically included in TAM studies.
“Sometimes study investigators used measures that did not fit with the definitions and measures that are not typically included in studies of TAM.”
Quote in the paperSubstantial claim - Findingcitation
Reviewed studies varied in the stage of health IT studied, including prototypes, trial systems, to-be-implemented systems, and implemented systems of different ages.
“Another is the stage of the health IT; some studies reviewed here studied prototypes [96], trial systems [107], or to-be-implemented systems [108], whereas others studied implemented systems that had been around for different lengths of times.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [96] Barker, 2003, Evaluating a spoken dialogue system for recording clinical observations during an endoscopic examination, Med Inform Internet Med source
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- cites [107] Liu, 2006, Perceived system performance: a test of an extended technology acceptance model, Database Adv Inform Syst source
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- cites [108] Duyck, 2008, User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting, Methods Inf Med source
Not checked in the free run.
- Findingreasoning
Longitudinal research is greatly lacking in the reviewed studies.
“When the target IT is not yet implemented at the time of the study, measuring variables such as actual use may require longitudinal research, something that is greatly lacking in the reviewed studies.”
Quote in the paperSubstantial claim - Findingown data
The added variable approach was commonly taken in the reviewed studies to better understand causes of behavioral intentions or actual use of health IT, or causes of other TAM factors such as attitudes, PEOU, and PU.
“Such an approach was commonly taken in the reviewed studies, in order to either better understand the factors that might cause behavioral intentions or actual use of health IT, or to understand the causes of other factors in TAM, such as attitudes or PEOU and PU.”
Quote in the paperSubstantial claim - Findingnone given
Almost every reviewed study added variables to TAM to better understand antecedents of acceptance or health IT use behavior.
“Finally, almost every studied added variables to TAM in an attempt to better understand the antecedents of acceptance or health IT use behavior.”
Quote in the paperNot a substantial claim - Findingcitation
Variables related to compatibility between health IT and clinical work processes were commonly added in the reviewed studies.
“For example, the common addition of variables related to compatibility between the health IT and clinical work processes in the reviewed studies [48, 49, 98, 103, 105, 106, 109] is in line with growing interest in the concept of “fit” as a critical need for successful IT design [131, 132], especially in health care [21, 28, 57, 62, 72, 100, 133-135].”
Quote in the paperNot a substantial claim0 of 7 sources checked- cites [48] Chau, 2001, Information technology acceptance by individual professionals: a model comparison approach, Decision Sci source
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- cites [49] Chau, 2002, Examining a model of information technology acceptance by individual professionals: an exploratory study, J Manag Inform Syst source
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- cites [98] Horan TA, Tulu B, Hilton B, Burton J. Use of online systems in clinical medical assessments: an analysis of physician acceptance of online disability evaluation systems. In: Proceedings of the 37th Hawaii international conference on system sciences; 2004. p. 1–10. source
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- cites [103] Tung, 2008, An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry, Int J Med Inform source
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- cites [105] Schaper, 2007, ICTs & OTs: a model of information and communications technology acceptance and utilisation by occupational therapists (part 2), Stud Health Technol Inform
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- cites [106] Liang, 2003, PDA usage in healthcare professionals: testing an extended technology acceptance model, Int J Mobile Commun source
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- cites [109] Wu, 2007, Mobile computing acceptance factors in the healthcare industry: a structural equation model, Int J Med Inform source
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- Findingcitation
Some reviewed studies incorporated health care-specific measures of usefulness, such as increased quality of care.
“Thus, some studies incorporate measures of increased quality of care [97, 106] and similar health care-specific measures of usefulness [32, 104].”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [97] Chismar WG, Wiley-Patton S. Test of the technology acceptance model for the internet in pediatrics. In: Proceedings of the annual symposium of the American medical informatics association; 2002. p. 155–9.
Not checked in the free run.
- cites [106] Liang, 2003, PDA usage in healthcare professionals: testing an extended technology acceptance model, Int J Mobile Commun source
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- cites [32] Hu, 1999, Examining the technology acceptance model using physician acceptance of telemedicine technology, J Manag Inform Syst source
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- cites [104] Van Schaik, 2002, Clinical acceptance of a low-cost portable system for postural assessment, Behav Inf Technol source
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- Findingcitation
Few reviewed studies assessed moderators.
“Few studies assessed moderators [97, 100, 105], despite their importance in recent writings on TAM [36, 38, 51, 127].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [97] Chismar WG, Wiley-Patton S. Test of the technology acceptance model for the internet in pediatrics. In: Proceedings of the annual symposium of the American medical informatics association; 2002. p. 155–9.
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- cites [100] Han, 2005
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- cites [105] Schaper, 2007, ICTs & OTs: a model of information and communications technology acceptance and utilisation by occupational therapists (part 2), Stud Health Technol Inform
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- Findingreasoning
Theoretical details about perceived usefulness did not systematically transfer to the reviewed studies.
“For example, there is work looking at the meaning and makeup of PU [50], and other work suggesting that useful outcomes can be seen at multiple level—e.g., IT that is useful for the individual versus for the organization [129]—but these theoretical details did not systematically transfer to the studies reviewed here”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [50] Venkatesh, 2000, A theoretical extension of the technology acceptance model: four longitudinal field studies, Manag Sci source
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- cites [129] DeLone, 2003, The DeLone and McLean model of information systems success: a ten-year update, J Manag Inform Syst source
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- Findingnone given
There was great variability in measures used within and between reviewed studies, despite similarly defined constructs and the existence of established and validated questionnaires.
“Overall, there was great variability in measures used within and between studies, despite the constructs being similarly defined and the existence of established and validated questionnaires.”
Quote in the paperSubstantial claim - Interpretationown data
TAM accounts for a substantial share of health IT use or acceptance.
“Findings show that TAM predicts a substantial portion of the use or acceptance of health IT, but that the theory may benefit from several additions and modifications.”
Quote in the paperSubstantial claim - Interpretationreasoning
TAM may need additions and modifications.
“Findings show that TAM predicts a substantial portion of the use or acceptance of health IT, but that the theory may benefit from several additions and modifications.”
Quote in the paperSubstantial claim - Interpretationreasoning
If used in its generic form, TAM may not capture or may contradict some unique contextual features of computerized health care delivery.
“If used in its generic form, TAM may not capture—or indeed may contradict—some of the unique contextual features of computerized health care delivery.”
Quote in the paperSubstantial claim - Interpretationcitation
A meta-analysis would have been inappropriate because of significant heterogeneity among studies in sample characteristics, specific technologies studied, and functions of those technologies.
“As others who have reviewed health IT research have pointed out, a meta-analysis would have been inappropriate because of the significant heterogeneity among studies in terms of sample characteristics, specific technologies studied, and functions of those technologies [93, 94].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [93] Berlin, 2006, A taxonomic description of computer-based clinical decision support systems, J Biomed Inform source
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- cites [94] Door, 2007, Informatics systems to promote improved care for chronic illness: a literature review, J Am Med Inform Assoc source
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- Study design and conductcitation
In the reviewed studies, differences in profession between samples were sometimes confounded with differences in sex and age.
“Note that sample differences in profession were sometimes confounded with sex and age differences (e.g., compare one physician sample of 70% males and 80% in their 40s and 50s [100] to one allfemale nurse sample with 98% less than 35 years old [103]).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [100] Han, 2005
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- cites [103] Tung, 2008, An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry, Int J Med Inform source
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- Study design and conductcitation
Almost every reviewed study used well validated questionnaire items from previous studies.
“Almost every study used well validated questionnaire items from previous studies, something that has been discussed as a major benefit of the penetration of TAM in IT research [32], and of the use of theory in health IT research, generally [28].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [32] Hu, 1999, Examining the technology acceptance model using physician acceptance of telemedicine technology, J Manag Inform Syst source
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- cites [28] Holden, 2009, A theoretical model of health information technology usage behaviour with implications for patient safety, Behav Inf Technol source
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- Interpretationreasoning
Using TAM and UTAUT definitions resulted in a limited and generic way of thinking about constructs such as usefulness and social influence.
“At the same time, using TAM and UTAUT definitions resulted in a limited and generic way of thinking about constructs such as usefulness and social influence.”
Quote in the paperSubstantial claim - Interpretationreasoning
There is strong evidence that perceived usefulness of an IT has some impact on whether clinicians accept and subsequently use a health IT.
“There is strong evidence to conclude that the perceived usefulness of an IT will have some impact on whether clinicians accept and subsequently use a health IT.”
Quote in the paperSubstantial claim - Premisecitation
Adding variables is common in research on TAM and on more general theories of human behavior.
“The tradition of adding variables is common in research on TAM [51, 136, 137] and on more general theories of human behavior [138, 139].”
Quote in the paperNot a substantial claim0 of 5 sources checked- cites [51] Venkatesh, 2003, User acceptance of information technology: toward a unified view, MIS Q source
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- cites [136] Moore, 1991, Development of an instrument to measure the perceptions of adopting an information technology innovation, Inform Syst Res source
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- cites [137] Venkatesh, 2000, Determinants of perceived ease of use: integrating control, intrinsic motivation, and emotion into the technology acceptance model, Inform Syst Res source
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- cites [138] Langdridge, 2007, Analyzing additional variables in the theory of reasoned action, J Appl Soc Psychol source
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- cites [139] Conner, 1998, Extending the theory of planned behavior: a review and avenues for further research, J Appl Soc Psychol source
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- Premisecitation
Davis and colleagues used beliefs elicitation to fit general behavioral theory to the context of IT use to form TAM.
“As a matter of fact, beliefs elicitation was the process that Davis and colleagues used in order to fit general behavioral theory to the context of IT use, to form TAM [40].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [40] Davis, 1989, User acceptance of computer technology: a comparison of 2 theoretical models, Manag Sci source
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- Interpretationreasoning
The variability in measures challenges the degree to which the different tests of TAM were actually similar enough to compare.
“Evidence of variability certainly challenges the degree to which the different tests of TAM were actually similar enough to compare.”
Quote in the paperSubstantial claim - Interpretationreasoning
In the absence of health IT-specific definitions and measures for usefulness, different health IT researchers may differently interpret what is useful about health IT.
“Different health IT researchers may differently interpret what is “useful” about health IT, in the absence of health IT-specific definitions of and measures for usefulness (see Table 4).”
Quote in the paperSubstantial claim - Interpretationreasoning
The variability in measures indicates deeper problems with TAM, at least as it is used in health care.
“It also indicates to us deeper problems with TAM, at least as it is used in health care.”
Quote in the paperSubstantial claim - Interpretationreasoning
The variability in how reviewed studies interpreted and operationalized TAM constructs could be attributed to the lack of systematic contextualization of TAM to health care settings, users, and tasks.
“We suggested that the variability could be attributed to the lack of systematic contextualization of TAM to health care settings, health care users, and health care tasks.”
Quote in the paperSubstantial claim - Study design and conductreasoning
Other cases of measurement misspecification in the reviewed studies involve a lack of correspondence between construct definitions and operationalizations.
“Other cases of misspecification have to do with the lack of correspondence between construct definitions and operationalizations, discussed in Section 3.5.”
Quote in the paperNot a substantial claim - Premisecitation
The strength of relationships between perceived ease of use (or other variables) and attitudes, behavioral intentions, or actual use depends on factors such as subject type and technology type.
“There is also evidence that how strongly PEOU, or other variables for that matter, is related to attitudes, behavioral intentions, or actual use depends on factors such as subject type and technology type [36].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [36] Yousafzai, 2007, Technology acceptance: a meta-analysis of the TAM: part 2, J Modell Manag source
Not checked in the free run.
- Study design and conductcitation
There were cases of measurement misspecification in the reviewed studies, such as using a single-item measure or a heightened enjoyment scale for attitude.
“There were, however, cases of measurement misspecification, for example the use of a single-item measure in one study [105], or the measure of the attitude construct using a “heightened enjoyment” scale in another [101], reflecting a common misunderstanding of attitude theory [122].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [105] Schaper, 2007, ICTs & OTs: a model of information and communications technology acceptance and utilisation by occupational therapists (part 2), Stud Health Technol Inform
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- cites [101] Paré, 2006, The effects of creating psychological ownership on physicians’ acceptance of clinical information systems, J Am Med Inform Assoc source
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- cites [122] Ajzen, 2001, Nature and operation of attitudes, Annu Rev Psychol source
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- Premisecitation
Beliefs elicitation is the preferred method for contextualizing theories of behavior to a specific setting, population, and behavior.
“The process is called beliefs elicitation [42, 142-145], and it is the preferred method for contextualizing theories of behavior to a specific setting (health care), with a new population (clinicians), and a new behavior of interest (health IT use) [102].”
Quote in the paperSubstantial claim0 of 6 sources checked- cites [42] Ajzen, 1980
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- cites [142] Francis, 2004
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- cites [143] Darker, 2007, Are beliefs elicited biased by question order? A theory of planned behaviour belief elicitation study about walking in the UK general population, Br J Health Psychol source
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- cites [144] Sutton, 2003, Eliciting salient beliefs in research on the theory of planned behaviour: the effect of question wording, Curr Psychol source
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- cites [145] Downs, 2005, Elicitation studies and the theory of planned behavior: a systematic review of exercise beliefs, Psychol Sports Exerc source
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- cites [102] Rawstorne P, Jayasuriya R, Caputi P. Issues in predicting and explaining usage behaviors with the technology acceptance model and the theory of planned behavior when usage is mandatory. In: Proceedings of the 21st international conference on information systems; 2000. p. 35–44.
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- Premisecitation
The US National Research Council concluded in 2009 that current health IT is not designed to adequately support the cognitive work of clinicians.
“With the US National Research Council concluding in 2009 that current health IT is not designed to adequately support the cognitive work of clinicians [149], the time to begin uncovering specific, contextualized, and actionable constructs is now.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [149] 2009
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- Premisecitation
Guides on how to carry out beliefs elicitation work are readily available.
“Yet guides on how to carry out such work are readily available [42, 142, 146].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [42] Ajzen, 1980
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- cites [142] Francis, 2004
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- cites [146] Ajzen I. Constructing a TpB questionnaire: conceptual and methodological considerations; 2002 [cited 2005 May 27]. Available from: http://people.umass.edu/aizen/pdf/tpb.measurement.pdf.
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- Classified as probably not a substantial claim. 28
- May combine two claims. 41
- The quote only partly states this claim. 2
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Findingnone givenPerceived usefulness was defined as health IT use leading to enhancement or gains in job performance.
“Perceived usefulness (PU) was defined as health IT use leading to enhancement or gains in job performance.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingcitationThe physician specialties covered in reviewed studies were endoscopy, pediatrics, disability care, and a mix of specialists and general practitioners.
“The physician specialties covered were endoscopy [96], pediatrics [97], disability care [98], and some mix of specialists and general practitioners [32, 99-101].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [96] Barker, 2003, Evaluating a spoken dialogue system for recording clinical observations during an endoscopic examination, Med Inform Internet Med source
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- cites [97] Chismar WG, Wiley-Patton S. Test of the technology acceptance model for the internet in pediatrics. In: Proceedings of the annual symposium of the American medical informatics association; 2002. p. 155–9.
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- cites [98] Horan TA, Tulu B, Hilton B, Burton J. Use of online systems in clinical medical assessments: an analysis of physician acceptance of online disability evaluation systems. In: Proceedings of the 37th Hawaii international conference on system sciences; 2004. p. 1–10. source
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FindingcitationSome reviewed studies had participants who were nurses, physiotherapists, or occupational therapists.
“In a few studies, participants were nurses [102, 103], and physio- [104] or occupational [105] therapists.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [102] Rawstorne P, Jayasuriya R, Caputi P. Issues in predicting and explaining usage behaviors with the technology acceptance model and the theory of planned behavior when usage is mandatory. In: Proceedings of the 21st international conference on information systems; 2000. p. 35–44.
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- cites [103] Tung, 2008, An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry, Int J Med Inform source
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- cites [104] Van Schaik, 2002, Clinical acceptance of a low-cost portable system for postural assessment, Behav Inf Technol source
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May combine two claims.
Findingown dataSome TAM relationships were consistently significant across reviewed studies, while others were inconsistent.
“Certain TAM relationships were consistently found to be significant, whereas others were inconsistent.”
Quote in the paperSubstantial claimThe quote only partly states this claim.
Findingnone givenIn total, 16 datasets have been analyzed using TAM and related models in health care.
“In total, 16 datasets have been analyzed, and TAM has fared much better in later tests.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataReviewed studies were set in Taiwan, Hong Kong, the UK, Australia, the mainland US, Hawaii, Belgium, Finland, and Quebec.
“Several studies were set in Taiwan [103, 109, 110], Hong Kong [32, 48, 49], the UK [96, 104], Australia [102, 111], and the mainland US [98, 99, 106, 107] and Hawaii [97]. Others were set in Belgium [108], Finland [100], and Quebec [101].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [103] Tung, 2008, An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry, Int J Med Inform source
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- cites [109] Wu, 2007, Mobile computing acceptance factors in the healthcare industry: a structural equation model, Int J Med Inform source
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- cites [110] Chen, 2007, Obstacles to the adoption of radio frequency identification technology in the emergency rooms of hospitals, Int J Electron Healthcare source
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May combine two claims.
FindingcitationOnly one set of reviewed studies focused on electronic medical records, and it evaluated only a trial system temporarily.
“Surprisingly, only one set of studies focused on EMR [107], although it was only a trial system that was temporarily evaluated by study participants.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [107] Liu, 2006, Perceived system performance: a test of an extended technology acceptance model, Database Adv Inform Syst source
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May combine two claims.
FindingcitationThe added variables in reviewed studies included perceived IT system characteristics, personal characteristics of users, organizational characteristics, and psychological variables such as ownership and trust.
“The list of added variables includes various perceived IT system characteristics such as how well the system performs [96, 107, 112] and how relevant it is to one’s job [106], personal characteristics of users [98, 105, 106], characteristics of the organization such as readiness for IT or technical support [98, 105, 106, 109], and psychological variables such as ownership [101] and trust [103].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [96] Barker, 2003, Evaluating a spoken dialogue system for recording clinical observations during an endoscopic examination, Med Inform Internet Med source
Not checked in the free run.
- cites [107] Liu, 2006, Perceived system performance: a test of an extended technology acceptance model, Database Adv Inform Syst source
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- cites [112] Liu, 2005, The impact of service level on the acceptance of application service oriented medical records, Inform Manag source
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May combine two claims.
FindingcitationPerceived ease of use may not be as likely to affect acceptance, but it appears to correlate with perceived usefulness.
“Whether the IT is perceived to be easy to use may not be as likely to affect acceptance, but it does appear to correlate with usefulness, perhaps reflecting the notion that IT that is difficult to use cannot possibly be perceived as useful [40].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [40] Davis, 1989, User acceptance of computer technology: a comparison of 2 theoretical models, Manag Sci source
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May combine two claims.
FindingcitationOne reviewed study tested TAM2, two tested UTAUT, and two tested a hybrid of UTAUT, TAM, and TPB.
“One study tested TAM2 [97], two tested UTAUT [108, 110], and two tested some hybrid of UTAUT, TAM and TPB [99, 105].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [97] Chismar WG, Wiley-Patton S. Test of the technology acceptance model for the internet in pediatrics. In: Proceedings of the annual symposium of the American medical informatics association; 2002. p. 155–9.
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- cites [108] Duyck, 2008, User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting, Methods Inf Med source
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- cites [110] Chen, 2007, Obstacles to the adoption of radio frequency identification technology in the emergency rooms of hospitals, Int J Electron Healthcare source
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May combine two claims.
FindingcitationMost reviewed studies began with TAM as a conceptual framework and either removed or added predictor variables.
“Most studies began with TAM as a conceptual framework and removed [32, 102, 104] or added predictor variables [49, 96, 98, 100, 101, 103, 106, 107, 109].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [32] Hu, 1999, Examining the technology acceptance model using physician acceptance of telemedicine technology, J Manag Inform Syst source
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- cites [102] Rawstorne P, Jayasuriya R, Caputi P. Issues in predicting and explaining usage behaviors with the technology acceptance model and the theory of planned behavior when usage is mandatory. In: Proceedings of the 21st international conference on information systems; 2000. p. 35–44.
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- cites [104] Van Schaik, 2002, Clinical acceptance of a low-cost portable system for postural assessment, Behav Inf Technol source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
FindingcitationFive reviewed studies collected data from a mix of physicians, nurses, pharmacists, and medical technicians.
“Five studies collected data from a mix of physicians, nurses, pharmacists, and medical technicians [106-110].”
Quote in the paperNot a substantial claim0 of 5 sources checked- cites [106] Liang, 2003, PDA usage in healthcare professionals: testing an extended technology acceptance model, Int J Mobile Commun source
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- cites [107] Liu, 2006, Perceived system performance: a test of an extended technology acceptance model, Database Adv Inform Syst source
Not checked in the free run.
- cites [108] Duyck, 2008, User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting, Methods Inf Med source
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- cites [109] Wu, 2007, Mobile computing acceptance factors in the healthcare industry: a structural equation model, Int J Med Inform source
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- cites [110] Chen, 2007, Obstacles to the adoption of radio frequency identification technology in the emergency rooms of hospitals, Int J Electron Healthcare source
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Probably not a substantial claim: may not pass S3 (load-bearing).
Findingnone givenSubjective norm was consistently defined with respect to the opinions of important others about an individual's use of health IT.
“Subjective norm (SN), or social influence, was consistently defined with respect to the opinions of important others about an individual’s use of health IT.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
FindingcitationSome reviewed studies compared TAM to another model, such as TPB.
“Sometimes, the researchers compared TAM to another model, for example, TPB [48, 102].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [48] Chau, 2001, Information technology acceptance by individual professionals: a model comparison approach, Decision Sci source
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- cites [102] Rawstorne P, Jayasuriya R, Caputi P. Issues in predicting and explaining usage behaviors with the technology acceptance model and the theory of planned behavior when usage is mandatory. In: Proceedings of the 21st international conference on information systems; 2000. p. 35–44.
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May combine two claims.
Findingown dataThe measures of PU followed the conventional definition of PU as enhancing personal job performance, with productivity and effectiveness dimensions dominating over other outcomes such as efficiency and quality.
“Those measures followed the conventional definition of PU as enhancing (personal) job performance, although the productivity and effectiveness dimensions dominated, compared to other useful health IT use outcomes that could be measured, such as efficiency, quality, and so on.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAmong the reviewed studies, voluntary IT use was more common in studies with non-significant SN effects, while mandatory IT use was more common in studies with significant SN effects.
“In opposition to that hypothesis, in three of four studies with non-significant SN effects, IT use was voluntary [49,97] or was perceived to be voluntary [108], and IT use was mandatory in two of four studies with significant SN effects [102,110].”
Quote in the paperNot a substantial claim0 of 5 sources checked- cites [49] Chau, 2002, Examining a model of information technology acceptance by individual professionals: an exploratory study, J Manag Inform Syst source
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- cites [97] Chismar WG, Wiley-Patton S. Test of the technology acceptance model for the internet in pediatrics. In: Proceedings of the annual symposium of the American medical informatics association; 2002. p. 155–9.
Not checked in the free run.
- cites [108] Duyck, 2008, User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting, Methods Inf Med source
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- cites [102] Rawstorne P, Jayasuriya R, Caputi P. Issues in predicting and explaining usage behaviors with the technology acceptance model and the theory of planned behavior when usage is mandatory. In: Proceedings of the 21st international conference on information systems; 2000. p. 35–44.
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- cites [110] Chen, 2007, Obstacles to the adoption of radio frequency identification technology in the emergency rooms of hospitals, Int J Electron Healthcare source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
FindingcitationSome PEOU dimensions reflect specific aspects of usability such as learnability and memorability.
“It is notable that some of those dimensions reflect specific aspects of usability such as learnability and memorability [117].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [117] Nielsen, 1993
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May combine two claims.
FindingcitationDefinitions based on Davis's original TAM focused on personal performance, while those based on UTAUT did not, but neither explicitly referred to performance benefits for other care team members, referring specialists, or patients' families.
“Whereas definitions based on those of Davis’s original TAM [39, 40] focused on personal performance, those based on UTAUT [51] did not, but they also did not explicitly refer to performance benefits for other members of the care team, referring specialists, or patients’ families.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [39] Davis, 1989, Perceived usefulness, perceived ease of use, and user acceptance of information technology, MIS Q source
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- cites [40] Davis, 1989, User acceptance of computer technology: a comparison of 2 theoretical models, Manag Sci source
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- cites [51] Venkatesh, 2003, User acceptance of information technology: toward a unified view, MIS Q source
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingnone givenPerceived ease of use was defined either as the lack of physical or mental effort or simply as 'ease of use.'
“Perceived ease of use (PEOU) was either defined as the lack of (physical or mental) effort or simply as “ease of use.””
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationSome reviewed studies did not provide formal construct definitions, although all clearly referred to the original TAM or UTAUT and probably had similar definitions.
“Some studies did not provide formal construct definitions [32, 97, 98, 102], although all clearly referred to the original TAM or UTAUT, and probably had definitions similar to the above.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [32] Hu, 1999, Examining the technology acceptance model using physician acceptance of telemedicine technology, J Manag Inform Syst source
Not checked in the free run.
- cites [97] Chismar WG, Wiley-Patton S. Test of the technology acceptance model for the internet in pediatrics. In: Proceedings of the annual symposium of the American medical informatics association; 2002. p. 155–9.
Not checked in the free run.
- cites [98] Horan TA, Tulu B, Hilton B, Burton J. Use of online systems in clinical medical assessments: an analysis of physician acceptance of online disability evaluation systems. In: Proceedings of the 37th Hawaii international conference on system sciences; 2004. p. 1–10. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingreasoningSome dimensions of usefulness referred to the process of performance, while others referred to the outcome.
“Some of those dimensions of usefulness referred to the process of performance (e.g., easier work process) and others to the outcome (e.g., better quality of care).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe direct route of social influence was almost always the same, but the source of social influence varied in specificity and type.
“Thus, the direct route of social influence—through others having an influential opinion about another’s health IT use—was almost always the same, but the source of social influence varied in specificity (e.g., “important others” versus “important other pediatricians”) and type (e.g., “colleagues” versus “subordinates”).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
FindingcitationIt was unclear from the definitions whether usefulness referred to enhanced performance process or enhanced performance outcomes.
“It was unclear from either definitions whether usefulness referred to enhanced performance process (e.g., fewer steps, more information for decision making) or enhanced performance outcomes (e.g., faster care, more accurate decisions) [116].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [116] Karsh, 2006, A human factors engineering paradigm for patient safety—designing to support the performance of the health care professional, Qual Saf Health Care source
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Findingown dataStudies of TAM in health care have been conducted in a wide variety of countries.
“Interestingly, studies of TAM in health care have been conducted in a wide variety of countries.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingnone givenEach construct was typically assessed with four or five items.
“Each construct was typically assessed with four or five items.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
FindingcitationPerceived behavioral control was defined variously as perceptions of existing infrastructure, internal and external resource constraints, or skills, resources, and opportunities necessary to use the system.
“Perceived behavioral control (PBC), or facilitating conditions, was defined variously as perceptions of existing (a) infrastructure, (b) internal and external resource constraints, or (c) skills, resources, and opportunities necessary to use the system.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingreasoningMany relationships specified by TAM have been repeatedly validated in health care settings, and fairly large proportions of variance in intention to use or actual use have been explained.
“The recent increase in the use of TAM appears justified, with many of the relationships specified by TAM repeatedly validated in health care settings and fairly large proportions of variance explained in the dependent variable (be it intention to use or actual use).”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingcitationThe definitions of perceived ease of use were somewhat limited and generic, not accounting for difficulty of low-effort but highly repetitive tasks or specific components of usability.
“As with PU, the definitions were somewhat limited (e.g., they do not account for the difficulty of low-effort but highly repetitive tasks) and generic (e.g., not referring to specific components of usability [117]).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [117] Nielsen, 1993
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FindingcitationPBC measures varied, with some asking about availability of knowledge or technical assistance, others about being able to use the system at work or for patient care, and one using a question about controllability.
“PBC measures varied as well. Some measures asked about the availability of knowledge or technical assistance for using the system. Others asked generally about being able to use the system at work or for patient care. One study used a question about the dimension of PBC referred to as controllability by psychological theorists [120], which in the case of IT refers to the degree to which using the”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [120] Ajzen, 2002, Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior, J Appl Soc Psychol source
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May combine two claims.
FindingreasoningIn some reviewed studies, added variables were treated as independent predictors of intention to use or actual use of health IT; in others, added variables were used to predict TAM variables such as PEOU and PU.
“In some cases, added variables were treated as independent predictors of intention to use or actual use of health IT, and in other cases added variables were used to predict TAM variables such as PEOU and PU.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationThe two reviewed studies with relatively strong perceived ease of use effects both had young, mostly non-physician samples in Taiwanese medical centers who had hands-on experience with the IT.
“Indeed, the two studies with relatively strong PEOU effects both had young, mostly non-physician samples in Taiwanese medical centers who had hands-on experience with the IT [103, 109].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [103] Tung, 2008, An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry, Int J Med Inform source
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- cites [109] Wu, 2007, Mobile computing acceptance factors in the healthcare industry: a structural equation model, Int J Med Inform source
Not checked in the free run.
May combine two claims.
FindingreasoningSome relationships in the reviewed studies have been inconsistent or consistently weak, raising the possibility of moderating effects or other theoretically important differences between studies.
“Some relationships have been inconsistent (or consistently weak), raising the possibility of moderating effects or other theoretically important differences between studies.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingnone givenIn the reviewed studies, language is not always standardized, with adoption and acceptance used interchangeably and incorrectly.
“Even the language used in the reviewed studies is not always standardized, with the terms adoption and acceptance used interchangeably and incorrectly.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationIn some reviewed studies, the effect of perceived ease of use is as strong as that of perceived usefulness, or stronger.
“Perhaps so, but in some studies, the effect of PEOU is as strong as that of PU [103], if not much stronger [109].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [103] Tung, 2008, An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry, Int J Med Inform source
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- cites [109] Wu, 2007, Mobile computing acceptance factors in the healthcare industry: a structural equation model, Int J Med Inform source
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May combine two claims.
FindingcitationMany reviewed studies included a variety of health care professionals, and some compared the groups.
“Many studies included a variety of health care professionals, and some compared the groups [108].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [108] Duyck, 2008, User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting, Methods Inf Med source
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May combine two claims.
FindingcitationThe study by Yi et al. is one of few reviewed studies finding an effect of subjective norm, and it used three survey items referring to specific sources of social influence rather than general questions.
“For example, the study of Yi et al [99] is one of few that find an effect of SN, and the authors used three survey items that referred to specific sources of social influence, colleagues, superiors, and subordinates rather than asking general questions (see Table 4).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [99] Yi, 2006, Understanding information technology acceptance by individual professionals: toward an integrative view, Inform Manag source
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May combine two claims.
FindingcitationFew studies have done beliefs elicitation work with respect to health IT, and none to the authors' knowledge have revised TAM based on such work.
“Few have done this kind of beliefs elicitation work with respect to health IT [70, 72, 76, 96, 102], and none to our knowledge have revised TAM based on such work.”
Quote in the paperSubstantial claim0 of 5 sources checked- cites [70] Van Schaik, 2004, The acceptance of a computerised decision-support system in primary care: a preliminary investigation, Behav Inf Technol source
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- cites [72] Karsh, 2006, Toward a theoretical approach to medical error reporting system research and design, Appl Ergon source
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- cites [76] Gagnon, 2003, An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians, Int J Med Inform source
Not checked in the free run.
- cites [96] Barker, 2003, Evaluating a spoken dialogue system for recording clinical observations during an endoscopic examination, Med Inform Internet Med source
Not checked in the free run.
- cites [102] Rawstorne P, Jayasuriya R, Caputi P. Issues in predicting and explaining usage behaviors with the technology acceptance model and the theory of planned behavior when usage is mandatory. In: Proceedings of the 21st international conference on information systems; 2000. p. 35–44.
Not checked in the free run.
Classified as probably not a substantial claim.
InterpretationreasoningPercentage variance explained values must be interpreted with caution because of substantial variability across studies.
“Those values must be interpreted with caution, because of the substantial variability in studies.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S4 (based).
Premisenone givenTAM was not developed specifically in or for the health care context.
“Yet, the TAM is not a model developed specifically in or for the health care context.”
Quote in the paperNot a substantial claimThe quote only partly states this claim.
Interpretationown dataTAM has fared much better in later tests than in the initial Hong Kong studies.
“In total, 16 datasets have been analyzed, and TAM has fared much better in later tests.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationcitationDefinitions of perceived behavioral control differed, consistent with disagreement and variation in the psychological literature.
“It is not surprising that definitions differed, given some of the disagreement and variation in how the construct is defined in the psychological literature [120, 121].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [120] Ajzen, 2002, Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior, J Appl Soc Psychol source
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- cites [121] Armitage, 1999, Distinguishing perceptions of control from self-efficacy: predicting consumption of a low-fat diet using the theory of planned behavior, J Appl Soc Psychol source
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Classified as probably not a substantial claim.
InterpretationreasoningFor physicians, social influence might come from patients, patient families, professional groups, regulatory agencies, employing organizations, insurance providers, fellow physicians, referring physicians, nurses, bosses, and others.
“For a physician, social influence might come from patients, patient families, professional groups, regulatory agencies, employing organizations, insurance providers, fellow physicians, referring physicians, nurses, bosses, and others.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningThe generic definitions of TAM were differently interpreted in the reviewed studies, a potential sign of lacking theoretical explication of the constructs.
“The generic definitions of TAM were differently interpreted, a potential sign of lacking theoretical explication of the constructs.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationTAM was developed outside of health care, and therefore some of its core concepts and measures may not appear relevant to health care investigators.
“TAM was developed outside of health care, and therefore some of its core concepts and measures may not appear relevant to health care investigators [32].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [32] Hu, 1999, Examining the technology acceptance model using physician acceptance of telemedicine technology, J Manag Inform Syst source
Not checked in the free run.
May combine two claims.
InterpretationreasoningThe focus on personal productivity as a measure of usefulness may not be meaningful, and certainly not sufficient, in a health care context.
“For example, the focus on personal productivity as a measure of usefulness may not be meaningful, and certainly not sufficient, in a health care context.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationDavis and colleagues found that the two key beliefs were PEOU and PU, and defined them based on what was important to their test population of college students, such as defining PU in reference to personal productivity rather than patient outcomes.
“They found out, based on this preliminary work, that the two key beliefs were PEOU and PU, and they defined those based on what was important to their test population; thus, for example, PU was defined in reference to improvements to personal productivity, as opposed to improvements in patient outcomes, because the participants in Davis’ study were college students, not clinicians.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [40] Davis, 1989, User acceptance of computer technology: a comparison of 2 theoretical models, Manag Sci source
Not checked in the free run.
May combine two claims.
InterpretationreasoningTAM investigators in health care differently interpreted constructs defined the same way, suggesting lacking agreement or exposure.
“At the very least, even if there are theoretic positions on and explanations of constructs, there may be lacking agreement or exposure, because TAM investigators in health care differently interpreted constructs defined the same way.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningThe sources and possibly the route of social influence may be different in health care compared to the other industries where TAM was developed and refined.
“Similarly, the sources and maybe even the route of social influence may be different in health care compared to in the other industries where TAM was developed and refined.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductreasoningLimited number of studies and missing information about measures in several studies make it difficult to formally assess the suspicion about poor match between construct operationalization and context.
“It is difficult to formally assess our suspicion given the limited number of studies and missing information about measures in several studies.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductreasoningThe variety in model specification across reviewed studies was so great that no single study tested the same model, and this greatly limits quantitative or qualitative comparison across studies.
“At the same time, the variety in model specification—so great that not a single study tested the same model—greatly limits quantitative or qualitative comparison across studies.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductcitationSome reviewed studies aggregated data across professions, making comparisons possible but not carried out.
“Although individual or profession-specific differences may not have been possible to study in homogeneous samples, such as those comprised of only young physicians [99, 109], all-females [103], or all-males [96], there were studies in which comparisons were possible but not carried out, such as the study aggregating data from physicians, nurses, and information systems department staff [110], one”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [110] Chen, 2007, Obstacles to the adoption of radio frequency identification technology in the emergency rooms of hospitals, Int J Electron Healthcare source
Not checked in the free run.
- cites [106] Liang, 2003, PDA usage in healthcare professionals: testing an extended technology acceptance model, Int J Mobile Commun source
Not checked in the free run.
- cites [107] Liu, 2006, Perceived system performance: a test of an extended technology acceptance model, Database Adv Inform Syst source
Not checked in the free run.
May combine two claims.
InterpretationreasoningIn different contexts, the variables needed to understand IT use and acceptance may differ, and the meaning of variables such as PU and PEOU may be drastically different.
“In a different context, not only may there be differences in the variables needed to understand IT use and acceptance, but also the meaning of variables such as PU and PEOU may be drastically different.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationPhysicians and other health care providers differ from users of IT in other TAM studies, and the general health care context differs from the industries where TAM originated.
“Those in health care who advocate the use of TAM commonly point out how different physicians and other health care providers are from the users of IT in other studies of TAM, and how the general health care context differs from that of the industries where TAM originated [30, 32, 58, 61, 96, 98, 100].”
Quote in the paperSubstantial claim0 of 7 sources checked- cites [30] Yarbrough, 2007, Technology acceptance among physicians, Med Care Res Rev source
Not checked in the free run.
- cites [32] Hu, 1999, Examining the technology acceptance model using physician acceptance of telemedicine technology, J Manag Inform Syst source
Not checked in the free run.
- cites [58] Hennington, 2007, Information systems and healthcare XVI: physician adoption of electronic medical records: applying the UTAUT model in a healthcare context, Commun Assoc Inform Syst
Not checked in the free run.
- cites [61] Succi MJ, Walter ZD. Theory of user acceptance of information technologies: an examination of health care professionals. In: Proceedings of the 32nd Hawaii international conference on system sciences; 1999. p. 1–7. source
Not checked in the free run.
- cites [96] Barker, 2003, Evaluating a spoken dialogue system for recording clinical observations during an endoscopic examination, Med Inform Internet Med source
Not checked in the free run.
- cites [98] Horan TA, Tulu B, Hilton B, Burton J. Use of online systems in clinical medical assessments: an analysis of physician acceptance of online disability evaluation systems. In: Proceedings of the 37th Hawaii international conference on system sciences; 2004. p. 1–10. source
Not checked in the free run.
- cites [100] Han, 2005
Not checked in the free run.
May combine two claims.
Study design and conductnone givenReviewed studies tended to report psychometric properties of scale items, which were usually reasonable and did not differ substantially between studies.
“Studies also tended to report the psychometric properties of scale items, which were usually reasonable and did not differ substantially between studies.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationOver the life course of an IT, the relationships in TAM may change; for example, ease of use may be critical at first and less important as time goes by.
“Studies of TAM have shown that over the life course of an IT, the relationships in the model may change; for example, ease of use may be critical at first and less important as time goes by [51, 100, 128].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [51] Venkatesh, 2003, User acceptance of information technology: toward a unified view, MIS Q source
Not checked in the free run.
- cites [100] Han, 2005
Not checked in the free run.
- cites [128] Agarwal, 1997, The role of innovation characteristics and perceived voluntariness in the acceptance of information technologies, Decision Sci source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningA beliefs elicitation approach is compatible with the added variable approach because elicitation studies can suggest and support additional model variables.
“Note that a beliefs elicitation approach is compatible with the added variable approach because elicitation studies can suggest and support additional model variables.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationcitationEmpirical work may be necessary to determine whether new variables are relevant to health care and to contextualize them.
“Although a purely theory-based approach—which might for instance add the compatibility variable from Rogers’ Innovation Diffusion Theory [63]—can be useful, empirical work may still be necessary to (a) determine whether those variables are relevant to health care, and (b) contextualize these new variables in order to determine, for example, what “compatibility” means in health care [57, 135].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [63] Rogers, 1995
Not checked in the free run.
- cites [57] Ammenwerth E, Iller C, Mahler C. IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study. BMC Med Inform Decis Mak, 2006; 6. Available from: http://www.biomedcentral.com/1472-6947/6/3. source
Not checked in the free run.
- cites [135] Kaplan, 2001, Evaluating informatics applications—some alternative approaches: theory, social interactionism, and call for methodological pluralism, Int J Med Inform source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable).
InterpretationcitationKnowing the reasons for health IT use beliefs permits designers, policy makers, and others to take action and make changes.
“This has practical implications because knowing the reasons for health IT use beliefs permits designers, policy makers, and others to take action and make changes, a benefit recognized by the authors of two studies reviewed here:”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable). May combine two claims.
Interpretationnone givenThere is great interest in TAM in health care and ample opportunity for its success.
“Overall, there is great interest in TAM in health care4 and ample opportunity for its success, but whether TAM evolves into a theory of health IT, as opposed to a theory for health IT, is still to be seen.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningTAM did a fair job predicting, and perhaps explaining, clinician end-user acceptance and use of health IT, but there is much room for improvement.
“Although TAM did a fair job predicting, and perhaps explaining, clinician end-user acceptance and use of health IT, there is much room for improvement.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningContextualization uncovers the specific and actionable meaning and causes of generic variables such as usefulness and ease of use, and helps determine the important others of subjective norms and the actual barriers and facilitators to IT use.
“That is, contextualization uncovers the specific and, importantly, actionable meaning and causes of generic variables such as usefulness and ease of use, helps determine who are the “important others” of subjective norms and what are the actual barriers and facilitators to IT use.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
InterpretationreasoningBeliefs elicitation can develop an evolved model of health IT use and acceptance.
“A final benefit of beliefs elicitation is its ability to develop what we call an evolved model of health IT use and acceptance.”
Quote in the paperSubstantial claim
The paper relies on this without support.
The 16 datasets analyzed in the review are representative of all studies of TAM in health care.
“We reviewed 16 data sets analyzed in over 20 studies of clinicians using health IT for patient care.”
“here we review a larger set of 16 data sets analyzed in 22 studies, including ones that were missed by the earlier review and ones that have been published since.”
The paper relies on this without support.
The significance counts across reviewed studies are comparable enough to aggregate despite heterogeneity.
“Table 5 summarizes which relationships specified by TAM and related models (Fig. 1) were significant and non-significant across the studies reviewed here.”
“Certain TAM relationships were consistently found to be significant, whereas others were inconsistent.”
The paper relies on this without support.
The reviewed studies' measures of TAM constructs are valid enough to test the theory.
“How constructs were operationalized differed greatly between studies, as can be seen in Table 4.”
“In general, it was not uncommon that a study’s definition for a construct did not match its operationalization.”
The paper relies on this without support.
TAM is a well regarded theory of technology acceptance and use that has been widely researched outside of health care and has lately become an important theoretical tool for health IT research.
“TAM is a well regarded theory of technology acceptance and use that has been widely researched outside of health care and has lately become an important theoretical tool for health IT research.”
The paper relies on this without support.
TAM has a strong track record in numerous industries.
“TAM has a strong track record in numerous industries; will it be a useful theoretical tool in health care?”
The paper relies on this without support.
TAM was developed outside of health care.
“TAM was developed outside of health care, and therefore some of its core concepts and measures may not appear relevant to health care investigators [32].”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Once healthcare professionals have a positive attitude towards the AI system, they are more likely to intend to use it.
“Once healthcare professionals have a positive attitude towards the AI system, they are more likely to intend to use it.”
From Generative AI in healthcare: an implementation science informed translational path on application, integration and governance (2024) · cites this paper as [57]
Section 1.1 states that attitude toward using IT influences intention to use it, and Section 3.6 reports that this relationship was significant in five of six tests in the health-care studies reviewed. The paper addresses health IT generally, not AI systems specifically, so it does not establish the claim for that technology. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIf healthcare professionals perceive the AI system as useful and easy to use, they are likely to develop a positive attitude towards using it.
“If healthcare professionals perceive the AI system as useful and easy to use, they are likely to develop a positive attitude towards using it.”
From Generative AI in healthcare: an implementation science informed translational path on application, integration and governance (2024) · cites this paper as [57]
The Discussion (§4.1; page unavailable) finds strong evidence that perceived usefulness affects clinicians’ acceptance and use of health IT. It says ease of use is less likely to affect acceptance and does not establish that the two perceptions lead to a positive attitude toward an AI system specifically. (LLM, conf=0.88)
Experimental — accuracy not yet measuredClinician preferences were incorporated into Sepsis Watch to optimize ease of use and utility for end users.
“Clinician preferences were incorporated to optimize the ease of use and utility for end users [39].”
From Integrating a Machine Learning System Into Clinical Workflows: Qualitative Study (2020) · cites this paper as [39]
The Discussion (§4.1; page not provided) recommends designing health IT to be useful and not difficult to use, supporting the stated design goal. It does not say that clinician preferences were incorporated into Sepsis Watch or establish that this design step occurred. (LLM, conf=0.84)
Experimental — accuracy not yet measuredHOCOS is an evidence-based and theory-based psychosocial coping skills program based on CBT principles and the Technology Acceptance Model.
“Hand Therapy Online Coping Skills (HOCOS) is an evidence-based and theory-based psychosocial coping skills program based on CBT principles [37] and the Technology Acceptance Model [54].”
External factors like social influence and facilitating conditions can influence the acceptance and use of a new technology.
“In addition to these factors, the model also suggests that external factors like social influence and facilitating conditions can influence the acceptance and use of a new technology [57, 59].”
From Generative AI in healthcare: an implementation science informed translational path on application, integration and governance (2024) · cites this paper as [57]
Perceived usefulness and perceived ease of use typically explain about 40% of an individual's intention to use a technology in a variety of contexts.
“Systematic reviews have shown that these 2 variables typically explain about 40 percent of an individual’s intention to use a technology in a variety of contexts [20-22].”
High level of professional experience improves self-efficacy on the technology and task, is negatively related to mental workload, and could increase task performance.
“According to the technology acceptance model (TAM) [22] and study on the influence of individual characteristics on the evaluation of hospital information system from Chen [23], high level of professional experience improves self-efficacy on the technology and task, and is negatively related to mental workload and could increase task performance.”
From Workflow interruption and nurses’ mental workload in electronic health record tasks: An observational study (2023) · cites this paper as [22]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Study 109 has incompatible descriptions of its sample
MinorOne passage groups study 109 with samples consisting only of young physicians; another describes its sample as mostly non-physicians.
“such as those comprised of only young physicians [99, 109], all-females [103], or all-males [96]”
“Indeed, the two studies with relatively strong PEOU effects both had young, mostly non-physician samples in Taiwanese medical centers who had hands-on experience with the IT [103, 109].”
Significant-study categories add up to nine, not eight
MinorThe listed categories contain 1 + 1 + 2 + 5 = 9 studies, although the sentence says there were eight.
Reported 8 · recomputed 9
“Of the eight studies with significant relationships, one had an all-physician sample [101], one had a sample of occupational therapists [105], two had all-nurse samples [102,103] and the remaining five had mixed (mostly-non-physician) samples.”
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“New to the UTAUT, but not to IT acceptance research generally [52], is the modeling of facilitating conditions as one determinant of BI.”
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The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview
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A Systematic Review of the Technology Acceptance Model in Health Informatics
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“In addition to these factors, the model also suggests that external factors like social influence and facilitating conditions can influence the acceptance and use of a new technology [57, 59].”
BackgroundMethodSystematic review of smartphone-based passive sensing for health and wellbeing
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“Other theoretical models were considered for this review, including the technology acceptance model [81] and the HCI models and theories [82].”
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“Behavioral intention is conceptualized as the acceptance towards technology (Holden and Karsh, 2010).”
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"The human body is a black box": supporting clinical decision-making with deep learning
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An investigation on physicians’ acceptance of hospital information systems: A case study
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“Hand Therapy Online Coping Skills (HOCOS) is an evidence-based and theory-based psychosocial coping skills program based on CBT principles [37] and the Technology Acceptance Model [54].”
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- Authors
- Holden, R. J., & Karsh, B.-T.
- Affiliations
- University of Wisconsin–Madison (US)
- Corresponding author
- Holden, Richard J.
- ORCID
- Holden, Richard J.
- Venue
- Journal of Biomedical Informatics
- Publisher
- Elsevier BV
- Published
- 2010-02
- Volume
- 43
- Issue
- 1
- Pages
- 159-172
- ISSN
- 1532-0464 (ISSN-L)
- PMC
- PMC2814963
- OpenAlex
- W2059146912
- Cited by
- 2,669
- References
- 160
- Citations by year
- 2026: 289 · 2025: 312 · 2024: 226 · 2023: 221 · 2022: 223 · 2021: 192 · 2020: 171 · 2019: 182 · 2018: 145 · 2017: 160 · 2016: 123 · 2015: 113 · 2014: 92 · 2013: 90 · 2012: 64
- FWCI
- 8.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Biomedical Informatics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Wisconsin-Madison
- National Institutes of Health
- Agency for Healthcare Research and Quality (R01 HS013610, T32 HS000083-11, HS000083)
- U.S. National Library of Medicine (R01LM008923)
- National Center for Research Resources (TL1RR025013)
- Topics
- Social Sciences › Decision Sciences › Information Systems and Management › Technology Adoption and User Behaviour
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Sociology and Political Science › Information Systems Theories and Implementation
- Keywords
- technology acceptance model, health information technology, health information technology adoption, end-user acceptance, health technology
- MeSH terms
- Algorithms, Attitude to Computers, Diffusion of Innovation, Health Services Research, Hospital Information Systems, Humans, Medical Informatics, Medical Laboratory Science, Medical Records Systems, Computerized, Biomedical Technology, PubMed
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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