Year

2013

Degree Name

Doctor of Philosophy

Department

School of Information Systems and Technology

Abstract

The overall aim of this study is twofold, firstly to explore the phenomenon of teleconsultation acceptance in Malaysia and then to develop an understanding of the important aspects constituting the phenomenon. This study seeks to identify the main issues concerning teleconsultation acceptance particularly in which the technology utilization takes place in the public health care facilities and the technology operates over a nation-wide network. This also entails an understanding of the complexities of human behaviour confined in the health care environment and work practice.

The study was conducted based on the mixed methods concurrent triangulation design involving qualitative and quantitative data. These entailed interviews with key informants and questionnaires survey of health care providers who practiced in the participating hospitals in Malaysia. Thematic analysis involving hierarchical coding was conducted on qualitative data whilst several procedures were performed on quantitative data involving descriptive statistics, testing for mean differences between groups and correlation testing. Subsequently, both data were merged, compared and interpreted. In particular this study utilized a qualitative priority such that a superior emphasis was placed on the qualitative method. Thus, the qualitative method was used to conclude the overall result.

Based on theory-driven and prior-research approach, a conceptual framework was developed and used to facilitate the data collection and analysis processes. The underlying framework derived from a combination of several aspects adopted from three theoretical models couple with contextual factors. These models were Technology Acceptance Model, Unified Theory of Acceptance and Use of Technology and Theory of Planned Behavior. The framework derived from the reviews of four areas of concerns and these being (1) general teleconsultation and health Information Technology perspective, (2) contextual Malaysian perspective, (3) developing countries perspective and (4) theoretical perspective. In turn, nine factors from seven respective themes appeared to be important in describing and understanding the teleconsultation acceptance phenomenon in Malaysia. These factors were behavioral intention, attitude, perceived usefulness, perceived ease of use, service need, facilitating conditions, perceived behavioral control, trust in technology and demographic influence. Whilst prior technology acceptance research both in general technology and health Information Technology has put more attention on the centrality of perceived attributes of technology such as perceived usefulness and ease of use, this study revealed that the central issues of teleconsultation acceptance in the government hospitals in Malaysia were more focused on actionable and actual aspects rather than the perceived attributes of the technology. These aspects were service need, contextual facilitating conditions, trust in technology and demographic influence.

The success of teleconsultation use does not happen in isolation. Understanding the overall stage of teleconsultation technology use in the participating hospitals is crucial to further explain teleconsultation acceptance. Even though technology acceptance was often discussed at the individual level, this study provided important information concerning acceptance of the technology at the organizational level. Thus this study demonstrated the importance of understanding teleconsultation core activity, processes in teleconsultation use, functions of stakeholders, procedures in the environment, teleconsultation work flow, requirements in conducting teleconsultation and interplay between dimensions and stages in teleconsultation acceptance. In turn, the study suggested that the strategies for environment, implementation, technological and individual should need broader and long-term perspectives to ensure the sustainability of teleconsultation initiatives.

The outcome of this study increases understanding concerning teleconsultation technology acceptance and adoption thus contributes to both researches in telemedicine management and technology adoption in hospitals. Research limitations and future directions for researchers with similar research interests are also discussed.

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