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Cited by 250Electronic Health Records SystemsTechnology Adoption and User BehaviourTelemedicine and Telehealth Implementation

Health Care Provider Adoption of eHealth: Systematic Literature Review

Open access
Li, Junhua, Talaei-Khoei, Amir, Seale, Holly, Ray, Pradeep, MacIntyre, C Raina·2013·interactive Journal of Medical Research
DOI 10.2196/ijmr.2468PMC PMC3628149
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Abstract

BACKGROUND: eHealth is an application of information and communication technologies across the whole range of functions that affect health. The benefits of eHealth (eg, improvement of health care operational efficiency and quality of patient care) have previously been documented in the literature. Health care providers (eg, medical doctors) are the key driving force in pushing eHealth initiatives. Without their acceptance and actual use, those eHealth benefits would be unlikely to be reaped. OBJECTIVE: To identify and synthesize influential factors to health care providers' acceptance of various eHealth systems. METHODS: This systematic literature review was conducted in four steps. The first two steps facilitated the location and identification of relevant articles. The third step extracted key information from those articles including the studies' characteristics and results. In the last step, identified factors were analyzed and grouped in accordance with the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS: This study included 93 papers that have studied health care providers' acceptance of eHealth. From these papers, 40 factors were identified and grouped into 7 clusters: (1) health care provider characteristics, (2) medical practice characteristics, (3) voluntariness of use, (4) performance expectancy, (5) effort expectancy, (6) social influence, and (7) facilitating or inhibiting conditions. CONCLUSIONS: The grouping results demonstrated that the UTAUT model is useful for organizing the literature but has its limitations. Due to the complex contextual dynamics of health care settings, our work suggested that there would be potential to extend theories on information technology adoption, which is of great benefit to readers interested in learning more on the topic. Practically, these findings may help health care decision makers proactively introduce interventions to encourage acceptance of eHealth and may also assist health policy makers refine relevant policies to promote the eHealth innovation.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review synthesized 93 papers on health care providers’ acceptance of eHealth and identified 40 factors grouped into 7 clusters using the Unified Theory of Acceptance and Use of Technology (UTAUT). It concludes that UTAUT is useful for organizing the literature but has limitations because health care contexts involve factors and correlations not covered by the model.

Key findings

  • From 93 included papers, 40 factors were identified and grouped into 7 clusters: health care provider characteristics, medical practice characteristics, voluntariness of use, performance expectancy, effort expectancy, social influence, and facilitating or inhibiting conditions.
  • Most studies were conducted in North America (72/93, 77%), followed by Europe (9/93, 10%) and Asia (7/93, 8%); quantitative methods predominated (57/93 studies).
  • EHR/EMR was the most studied eHealth application (57/93 studies), followed by telemedicine/telehealth (7/93 studies); most studies focused on physicians (68/93), while nurses and other health workers were recruited in 25 projects.
  • The mapping showed UTAUT did not cover half of the health care provider characteristics (years in practice, role, and race) or medical practice characteristics; perceived usefulness had the strongest impact on health care providers’ behavioral intention in one cited study.

Methods

  • Four-step systematic literature review: identification of resources, selection of relevant papers, data extraction, and data analysis/validation.
  • Searches were run between October and November 2011 in 8 databases (Medline, Cinahl, Web of Science, PubMed, PsychInfo, ERIC, ProQuest Science Journals, EMBASE), yielding 3315 papers, 420 duplicates, 2895 unrepeated papers, and finally 93 relevant papers.
  • Data analysis initially extracted 49 factors, combined closely related factors into 40, grouped them initially into 9 clusters, then regrouped into 7 clusters using UTAUT constructs and a validity procedure.

Limitations

  • Stated: some papers may have been missed due to selected search phrases; database selection may have missed relevant work; mapping factors against UTAUT can be subjective.
  • Evident from the text: most included studies were from the United States, and some factors are context sensitive (e.g., types of third-party payers reflect the US insurance context), limiting global generalizability.
  • Evident from the text: findings include contradicting results across studies (e.g., on practice size and EMR use), and the review is a synthesis of existing studies rather than new primary data.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2196/ijmr.2468

Cites

117 of 117 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 87 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Half of the health care provider characteristics (years in practice, role, and race) and medical practice characteristics identified in the review have not yet been covered in UTAUT.

    “Nevertheless, it was found that half of the health care provider characteristics (years in practice, role, and race) as well as medical practice characteristics identified from this literature review have not yet been covered in the UTAUT.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.
  • Findingown data

    The most applied model was the Technology Acceptance Model (TAM).

    “The most applied model was the TAM, which proposed a method of evaluating user acceptance through his/her beliefs, attitudes, intentions, and actual technology adoption behavior.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.
  • Findingown data

    The factors were regrouped into seven clusters: health care provider characteristics, medical practice characteristics, voluntariness of use, performance expectancy, effort expectancy, social influence, and facilitating or inhibiting conditions.

    “The factors were regrouped into 7 clusters:”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.
  • Findingown data

    The review included 93 papers that studied health care providers' acceptance of eHealth.

    “This study included 93 papers that have studied health care providers’ acceptance of eHealth.”
    • Also stated in: § Selection of Relevant Articles · plain
      “Finally, 93 relevant papers were selected.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The search strategy and selected databases identified all or a representative set of relevant eHealth adoption studies.
  • Findingnone given

    Some studies showed significant correlations among the identified eHealth acceptance factors.

    “Further, some studies also showed significant correlations among the identified factors.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.
  • May combine two claims. 19
  • Classified as probably not a substantial claim. 31

  • May combine two claims.

    Findingown data

    The majority of studies (68/93) focused on physicians; nurses and other health workers were recruited in 25 research projects.

    “The majority of the studies (ie, 68/93) focused on physicians. Nurses and other health workers were recruited in 25 research projects on eHealth adoption and acceptance.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The literature search found 3315 papers, of which 420 were duplicated, producing a list of 2895 papers.

    “In summary, a total of 3315 papers were found, of which 420 papers were duplicated. The selection process excluded the repeated papers from the archive and produced a list of 2895 papers.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The search strategy and selected databases identified all or a representative set of relevant eHealth adoption studies.

  • May combine two claims.

    Findingown data

    The majority of studies (72/93, 77%) were conducted in North America, followed by Europe (9/93, 10%) and Asia (7/93, 8%).

    “The majority of the studies (72/93, 77%) were conducted in North America, followed by Europe (9/93, 10%), and Asia (7/93, 8%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Quantitative methodology was predominately used by 57/93 studies, nearly twice as many as qualitative studies.

    “Quantitative methodology was predominately used by 57/93 studies. The number was nearly twice as large as that of qualitative studies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The review initially extracted 49 eHealth adoption/acceptance factors and combined closely relevant factors into 40 factors.

    “Based on the terminologies or terms utilized in the papers, 49 eHealth adoption/acceptance factors were initially extracted.”
    • Also stated in: § Data Analysis and Validation · plain
      “Factors with close relevance were combined, generating a list of 40 factors.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.

  • May combine two claims.

    Findingown data

    Apart from the four core constructs and four moderators, another cluster of eHealth adoption factors could not be mapped against UTAUT, so factors were initially grouped into 9 clusters.

    “Apart from the 4 core constructs and 4 moderators, another cluster of eHealth adoption factors, which could not be mapped against the UTAUT, was identified. Accordingly, the factors were initially grouped into 9 clusters (Figure 1).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.

  • May combine two claims.

    Findingcitation

    A small percentage of the 93 studies applied models or theories on individual acceptance of information technology, and the results supported the models in predicting adoption behavior in the health care context.

    “A small percentage applied models or theories on individual acceptance of information technology (eg, Technology Acceptance Model, TAM [116-118]). The results supported the models in predicting the adoption behavior in the health care context.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [116] source

      Not checked in the free run.

    • cites [117] source

      Not checked in the free run.

    • cites [118] source

      Not checked in the free run.

    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.

  • May combine two claims.

    Findingown data

    The review identified 40 factors influential to health care providers' acceptance of eHealth and grouped them into 7 clusters.

    “From these papers, 40 factors were identified and grouped into 7 clusters: (1) health care provider characteristics, (2) medical practice characteristics, (3) voluntariness of use, (4) performance expectancy, (5) effort expectancy, (6) social influence, and (7) facilitating or inhibiting conditions.”
    • Also stated in: § eHealth Acceptance Factors · plain
      “Through the data analysis and validation process, 40 factors were identified to be influential to the health care providers’ acceptance of eHealth and grouped into 7 clusters (Figure 3 and Table 2).”
    • Also stated in: § Data Analysis and Validation · plain
      “Factors with close relevance were combined, generating a list of 40 factors.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.

  • May combine two claims.

    Findingown data

    The growth in publications was not linear, with a dramatic rise in the number of papers published after 2005.

    “The growth represented by the curve was not linear, with a dramatic rise in the number of papers published after 2005.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the 93 papers, 57 targeted EHR/EMR, and telemedicine/telehealth was the second most popular application studied (7/93).

    “The 93 papers addressed a wide range of eHealth applications. 57 targeted the EHR/EMR, which was defined as computerized medical information systems that collect, store, and display patient information [24].”
    • Also stated in: § Characteristics of Selected Studies · plain
      “Telemedicine/Telehealth was the second most popular application studied (addressed by 7/93 studies).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] source

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    In this 4-step literature review, 40 factors were identified to be influential to health care providers' acceptance of eHealth and organized in accordance with the UTAUT model.

    “In this 4-step literature review, 40 factors were identified to be influential to health care providers’ acceptance of eHealth and organized in accordance with the UTAUT model.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Russell et al found that health care providers in large practices were not more likely to use an EMR.

    “Russell et al found that health care providers in large practices were not more likely to use an EMR [112].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [112] Russell, SC, 2004, Tenn Med

      Not checked in the free run.

    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    A validity procedure was applied to search for convergence among multiple sources of information and methods of data collection and analysis.

    “To search for convergence among multiple sources of information and methods of data collection and analysis, a validity procedure was applied [22,23].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [22] Patton, MQ, 2002, Qualitative research and evaluation methods

      Not checked in the free run.

    • cites [23] Creswell, JW, 2000, Theory into Practice source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    EMR/EHR consists of patient health related information and forms the core of eHealth systems.

    “This is because the EMR/EHR consists of patient health related information and forms the core of eHealth systems [8].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [8] Li, J, 2008, A Report of Joint Project of IEEE and United Nations Foundation

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The eight databases used were thought to be the most likely to publish eHealth adoption related work.

    “These databases were thought to be the most likely to publish eHealth adoption related work [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] LiJLandLRayPEvaluation criteria for frameworks in e-health domain2009The 15th American Conference on Information Systems2009 6-9 AugustSan Francisco, California United States

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    UTAUT accounts for 70% of the variance in usage intention, a substantial improvement over the original 8 models and their extensions.

    “This model accounts for 70% of the variance in usage intention—a substantial improvement over any of the original 8 models and their extensions.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Venkatesh, V, 2003, MIS Quarterly source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    UTAUT posits three core constructs (performance expectancy, effort expectancy, social influence) impacting behavioral intention and use behavior, a fourth (facilitating conditions) directly impacting use behavior, and four moderators (gender, age, voluntariness of use, experience).

    “Within the UTAUT, 3 core constructs that impact on behavioral intention, and consequently use behavior, are performance expectancy, effort expectancy, and social influence, whereas the other core construct facilitating conditions has a direct impact upon use behavior. Four moderators (ie, gender, age, voluntariness of use, and experience) have also been incorporated in the UTAUT.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Venkatesh, V, 2003, MIS Quarterly source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The grouping results demonstrated that the UTAUT model is useful for organizing the literature but has limitations.

    “The grouping results demonstrated that the UTAUT model is useful for organizing the literature but has its limitations.”
    • Also stated in: § Comparative and Gap Analysis · boosted
      “The mapping work demonstrated that the UTAUT model is a useful framework for applying and organizing literature, which is of great benefit to readers interested in learning more on the topic [119].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [119] Hennington, AH, 2007, Communications of the Association for Information Systems source

      Not checked in the free run.

    • Rests on an assumption: The findings extracted from the 93 included papers are valid and comparable enough to synthesize.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The eHealth adoption factors were reanalyzed within and across clusters to ensure consistency and independence.

    “First, the eHealth adoption factors were reanalyzed within and across the clusters to ensure consistency and independence.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Electronic patient records form the core of any other eHealth applications, and the success of these applications is very much dependent on EHR/EMR adoption.

    “Li et al explained that electronic patient records form the core of any other eHealth applications and thus the success of these is very much dependent on the EHR/EMR adoption [114].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [114] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    There is a need to synthesize insights on eHealth adoption to provide decision makers with a holistic view.

    “Hence, there is a need to synthesize those insights and provide decision makers with a holistic view of eHealth adoption.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review was conducted following guidelines originally proposed by [17,18] and already applied in several systematic reviews.

    “In light of the guidelines originally proposed by [17,18] and already applied in several systematic reviews (eg, [19]), we conducted a systematic literature review on eHealth adoption.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [17] Kitchenham B20042013-03-27Procedures for performing systematic reviewshttp://www.researchgate.net/publication/228756057_Procedures_for_performing_systematic_reviews6FQuFqucY

      Not checked in the free run.

    • cites [18] source

      Not checked in the free run.

    • cites [19] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    eHealth implementation represents a disruptive change in the health care workplace.

    “eHealth implementation represents a disruptive change in the health care workplace.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The examination process for selecting relevant articles had two iterations.

    “This examination process had two iterations.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Study design and conductnone given

    Inclusion of EMR/EHR papers increased the validity of the findings.

    “The inclusion of those papers increased the validity of the findings.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The clusters were given labels and reviewed for consistency, with reassessment and relabelling repeated until consensus was reached.

    “The clusters were then given labels and reviewed once more for consistency. Reassessment and relabelling were performed for some papers. This step was repeated until a consensus was reached on the labels for clusters.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Low eHealth adoption rates can be attributed to both macro-level factors and micro-level barriers from health care providers' perspective.

    “Past experience of eHealth adoption in the United States, for example, informed us that the low adoption rate could be attributed to both macro-level factors (eg, supportive policies) from the perspective of the public, health care organization, and system, and micro-level barriers from the perspective of health care providers (eg, physicians’ perception about technological complexity, [9]).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Legal and regulatory changes can be required to address eHealth adoption related issues.

    “Legal and regulatory changes can be required to address eHealth adoption related issues [130,132].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [130] source

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    • cites [132] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Workflow is associated with routine processes, characterized by a fixed definition of tasks and an order of execution.

    “Workflow is associated with routine processes, characterized by a fixed definition of tasks and an order of execution [126].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [126] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Some research papers on health care providers' acceptance of eHealth applications may not have been identified due to selected search phrases.

    “Although efforts were made to include all research papers on health care providers’ acceptance of various eHealth applications, some may not have been identified due to selected search phrases.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Some papers may have been missed because of the selection of databases.

    “Although they are the outlets that were deemed most likely to publish eHealth acceptance-related work, some papers may have been missed.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The selected databases are the outlets most likely to publish eHealth acceptance-related work.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All selected databases were searched to their full extent.

    “We tried to compensate for this potential loss by ensuring that all selected databases were searched to their full extent.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The electronic prescribing and dispensing process has been additional and separate to the already existing paper-based process.

    “These amendments came into effect from March 1, 2007 and the electronic prescribing and dispensing process has been additional and separate to the already existing paper-based process.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Li, J, 2008, A Report of Joint Project of IEEE and United Nations Foundation

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductnone given

    Mapping the identified eHealth adoption factors against the UTAUT model can be subjective.

    “Mapping the identified eHealth adoption factors against the UTAUT model can be subjective.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    $77.8 billion USD could be saved annually by interoperable clinical information exchange among key stakeholders in the health care delivery system.

    “According to a recent analysis, $77.8 billion USD could be saved annually by interoperable clinical information exchange among key stakeholders in the health care delivery system [131].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [131] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Interoperability between eHealth applications and seamless and reliable clinical information exchange is a key to making EHR use a cornerstone of practice.

    “Bates commented that the interoperability between eHealth applications and seamless and reliable clinical information exchange is a key to making EHR use a cornerstone of practice [130].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [130] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The authors applied a validity procedure to maximize the accuracy and appropriateness of their mapping work.

    “We attempted to maximize the accuracy and appropriateness of our mapping work by applying the validity procedure.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    These amendments came into effect from March 1, 2007.

    “These amendments came into effect from March 1, 2007 and the electronic prescribing and dispensing process has been additional and separate to the already existing paper-based process.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Li, J, 2008, A Report of Joint Project of IEEE and United Nations Foundation

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Health care providers' participatory process is essential to fine-tune the eHealth system's capabilities after thorough workflow analysis.

    “After the workflow is analyzed thoroughly with health care providers’ involvement, their participatory process is also essential to fine-tune the system’s capabilities [128].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [128] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Certification of eHealth vendor products would minimize health care providers' uncertainty over the selection of a viable and sustainable product from hundreds of IT vendors in the market.

    “The certification effort would also minimize health care providers’ uncertainty over the selection of a viable and sustainable product from hundreds of IT vendors in the market [68,106].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [68] Menachemi, N, 2006, Inform Prim Care

      Not checked in the free run.

    • cites [106] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The supplementary search keywords "EHR" and "EMR" were both used.

    “In order to at least include those papers, which can help us increase the validity of the findings, the supplementary search keywords “EHR” and “EMR” were both used as previously discussed.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A feedback mechanism allows health care providers to document a problem they are having with the system and then receive prompt feedback.

    “A feedback mechanism (eg, online help) allows health care providers to document a problem that they are having with the system and then to receive prompt feedback [13,125].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [13] source

      Not checked in the free run.

    • cites [125] Lee, F, 1996, J Am Med Inform Assoc source

      Not checked in the free run.

42 of 42

  • The paper relies on this without support.

    Health care providers' acceptance and actual use are necessary for eHealth benefits to be realized.

    “Without their acceptance and actual use, those eHealth benefits would be unlikely to be reaped.”

  • The paper relies on this without support.

    The search strategy and selected databases identified all or a representative set of relevant eHealth adoption studies.

    “A literature search was conducted between October and November 2011 using 8 online databases: Medline, Cinahl, Web of Science, PubMed, PsychInfo, ERIC, ProQuest Science Journals, and EMBASE.”
    “Finally, 93 relevant papers were selected.”

  • The paper relies on this without support.

    The findings extracted from the 93 included papers are valid and comparable enough to synthesize.

    “The key information was extracted from the 93 papers.”
    “Relevant text was extracted or retyped verbatim and was added to a database.”

  • The paper relies on this without support.

    The selected databases are the outlets most likely to publish eHealth acceptance-related work.

    “Although they are the outlets that were deemed most likely to publish eHealth acceptance-related work, some papers may have been missed.”

  • The paper relies on this without support.

    In small or independent medical practices, there is a lack or absence of internal capacity for system maintenance.

    “In small or independent medical practices, there is lack or absence of internal capacity for system maintenance; eHealth vendors alternatively provide all these services but often charge high fees.”

  • The paper relies on this without support.

    eHealth vendors provide system maintenance services but often charge high fees.

    “In small or independent medical practices, there is lack or absence of internal capacity for system maintenance; eHealth vendors alternatively provide all these services but often charge high fees.”

  • The paper relies on this without support.

    The Medicines Regulations (1984) and the Misuse of Drugs Regulations (1977) in New Zealand required indelible text and practitioners' handwritten signature for a legitimate prescription.

    “For example, the Medicines Regulations (1984) and the Misuse of Drugs Regulations (1977) in New Zealand, which governs respectively the form of medication prescriptions and controlled substances, stated that indelible text and practitioners’ handwritten signature was required for a legitimate prescription.”

  • The paper relies on this without support.

    The states and territories have continuously been taking steps to remove any legal barriers to the adoption of the electronic process in each jurisdiction.

    “The states and territories have continuously been taking steps to remove any legal barriers to the adoption of the electronic process in each jurisdiction.”
8 of 8

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?

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.

  • A 2005 reference is cited for an increase after 2005

    Minor

    The cited reference was published in 2005 and concerns data from 2001-03, so it cannot document the stated increase after 2005.

1 of 1

Cites

Flagged first, then by citations

2 of the 119 references couldn’t be matched to a known paper.

Research works printed but not linked: 35

  1. SilberDEuropean Commission, Information Society, eHealth Conference20032013-03-21Atlanta, BelgiumThe case for ehealthhttp://ec.europa.eu/information_society/eeurope/ehealth/conference/2003/doc/the_case_for_eHealth.pdf6FIViFwJR
  2. Thakkar, M, 2006, Perspect Health Inf Manag, 3, 5
  3. Li, J, 2008, A Report of Joint Project of IEEE and United Nations Foundation
  4. Wallis, K, 2006, Technology and health information privacy: consumers and the adoption of digital medical records technology
  5. LiJLandLRayPEvaluation criteria for frameworks in e-health domain2009The 15th American Conference on Information Systems2009 6-9 AugustSan Francisco, California United States
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Cited by

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Related

Authors
Li, J., Talaei-Khoei, A., Seale, H., Ray, P., & MacIntyre, C. R.
Affiliations
UNSW Sydney (AU)
Corresponding author
Li, Junhua
ORCID
Venue
interactive Journal of Medical Research
Publisher
JMIR Publications Inc.
Published
2013-04-16
Volume
2
Issue
1
Pages
e7
ISSN
1929-073X (ISSN-L)
DOI
10.2196/ijmr.2468
PMC
PMC3628149
OpenAlex
W1530367293
Semantic Scholar
4e4da7116216b38f8aa25c15039f6922a7a1d1ea
Cited by
250
References
119
Citations by year
2026: 15 · 2025: 13 · 2024: 18 · 2023: 26 · 2022: 29 · 2021: 22 · 2020: 21 · 2019: 15 · 2018: 22 · 2017: 31 · 2016: 12 · 2015: 12 · 2014: 10 · 2013: 3
FWCI
1.99
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Interactive Journal of Medical Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UTS ePRESS (University of Technology Sydney) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Social Sciences › Decision Sciences › Information Systems and Management › Technology Adoption and User Behaviour
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
digital health adoption, healthcare workers, technology acceptance, UTAUT, information technology adoption, performance expectancy, effort expectancy, social influence, facilitating conditions, eHealth policy

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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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