Clinicians’ Acceptance of Interactive Health Technologies to Support Patient Self-Management

[摘要] Background: The use of interactive health technologies (IHTs) by patients and clinicians may promote self-management behaviors, and thus help prevent, detect and treat complications. Yet, clinicians’ acceptance of IHTs is low and not well understood. The purpose of this study was to identify the factors that influence clinicians’ intention to use IHTs.Methods: A conceptual model of factors thought to influence clinicians’ intention to use IHTs was generated from the literature and evaluated using a mixed-methods design. Clinicians completed a survey on-line to measure the relationships between concepts of the proposed model. The data were analyzed using partial least squares structural equation modeling. Purposive, criterion sampling was used to select a representative subgroup of clinicians for follow-up interviews. Thematic analysis was used to summarize the interview data. Findings of the surveys and interviews were integrated using importance-performance matrix analyses (IPMA).Results: The sample included 82 clinicians; 70% female, 17% physicians, 40% transplant clinicians, and ages ranged from 25-65 years. Perceived usefulness was the only direct predictor of intention to use (b= 0.52, p <.001; R2=.64). Subjective norms, views of other colleagues, (b= 0.25, p <.001) and compatibility with work style (b= 0.66, p <.001) were significant predictors of perceived usefulness. Perceived ease of use (b= 0.54, p <.001) and facilitating conditions (e.g., organizational support, b= 0.27, p <.001) significantly influenced compatibility. Clinicians’ beliefs about patient self-management (b= 0.46, p <.001) significantly influenced subjective norms. The interviews (n=6) confirmed and further explained the survey findings. Three distinct groups of clinicians emerged from the qualitative analysis and the IPMA. Nurses and care coordinators were more concerned about details in IHTs and the availability of adequate organizational resources. Physicians were more interested in the overall picture and the compatibility of IHTs with their workflow. Advanced practice providers were willing to follow patients on a daily basis but only in the ambulatory setting.Conclusions: The usefulness and compatibility with clinicians’ workflow are among the top priorities for successful deployment of IHTs. Future IHTs should be tailored for different types of clinicians. These findingshave implications for policy makers, healthcare organizations, designers and researchers.

[发布机构] the University of Pittsburgh