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

The DOI matches its Crossref record; 117 of the 119 references it cites were found in a registry or an index; none of the 87 sources its claims cite is checked for support yet.

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

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.

Overview

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.

Verification

Claims the paper makes

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

Show all 44 claims

  • It may state two separate claims as one. 19
  • Probably not a substantial claim. 31
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

Citations

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
  6. Djamasbi, S, 2009, Journal of Information Technology Theory and Application, 10, 41
  7. Pagliari, C, 2005, Inform Prim Care, 13, 97
  8. Guida, K, 2011, Minn Med, 94, 33
  9. Holden, RJ, 2010, Dissertation International: Section B: The Sciences and Engineering, 4413
  10. Kaushal, R, 2009, Inform Prim Care, 17, 7
  11. Menachemi, N, 2006, J Healthc Inf Manag, 20, 79
  12. Terry, AL, 2008, Can Fam Physician, 54, 730
  13. Terry, AL, 2009, Fam Med, 41, 508
  14. Ludwick, D, 2010, Can Fam Physician, 56, 40
  15. Samoutis, G, 2007, Inform Prim Care, 15, 207
  16. Siracuse, M, 2010, Journal of the American Pharmacists Association, 50, 249
  17. Hing, E, 2010, Natl Health Stat Report, 1
  18. Menachemi, N, 2006, Inform Prim Care, 14, 101
  19. Stream, GR, 2009, Inform Prim Care, 17, 145
  20. Gagnon, MP, 2010, Inform Prim Care, 18, 31
  21. Morton, ME, 2010, Perspect Health Inf Manag, 7, 1c
  22. Bennani, A, 2008, Communications of the IBIMA, 3, 1943
  23. Bhattacherjee, A, 2008, Journal of Computer Information Systems, 48, 69
  24. Morton, ME, 2009, Perspect Health Inf Manag, 6, 1a
  25. 10.1177/1460458207076468 · DOI · Paper page
  26. Gómez ReynosoJMTuluBElectronic Medical Records Adoption Challenges in Mexico2007AMIA 2007 Symposium Proceedings2007 Nov 10-14CHICAGO IL, United States1093
  27. Granlien, MF, 2008, Stud Health Technol Inform, 136, 419
  28. Elekwachi, AO, 2008, Dissertation International Section A: Humanities and Social Sciences, 793
  29. Ross, S, 2009, J Med Pract Manage, 24, 254
  30. Nash, K, 2009, Urology times, 37, 34
  31. Russell, SC, 2004, Tenn Med, 97, 457
  32. Burt, CW, 2005, Adv Data, 1
  33. Mattocks, K, 2007, Conn Med, 71, 27
  34. Kamadjeu, EM, 2005, Inform Prim Care, 13, 179
  35. Darroch, K, 2003, Community Practitioner, 76, 53

Cited by

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Metadata

Authors
Li, J., Talaei-Khoei, A., Seale, H., Ray, P., & MacIntyre, C. R.
Affiliations
UNSW Sydney (AU)
Corresponding author
Li, Junhua
Venue
interactive Journal of Medical Research
Published
2013-04-16
Volume
2
Issue
1
Pages
e7
ISSN
1929-073X (ISSN-L)
OpenAlex
W1530367293
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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