Investigating Factors Influencing Medical Practitioners’ Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study
BackgroundThe swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have foc...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-07-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2023/1/e46621 |
| _version_ | 1797733949571596288 |
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| author | Wenhao Deng Tianan Yang Jianwei Deng Ran Liu Xueqin Sun Gang Li Xinmei Wen |
| author_facet | Wenhao Deng Tianan Yang Jianwei Deng Ran Liu Xueqin Sun Gang Li Xinmei Wen |
| author_sort | Wenhao Deng |
| collection | DOAJ |
| description |
BackgroundThe swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners.
ObjectiveThis study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework.
MethodsA mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model.
ResultsOn the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=−.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms.
ConclusionsThis study investigated the factors that facilitate or hinder medical practitioners’ resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity. |
| first_indexed | 2024-03-12T12:36:02Z |
| format | Article |
| id | doaj.art-2d1573557cf04144b054cfb3aedb527b |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T12:36:02Z |
| publishDate | 2023-07-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-2d1573557cf04144b054cfb3aedb527b2023-08-29T00:08:56ZengJMIR PublicationsJournal of Medical Internet Research1438-88712023-07-0125e4662110.2196/46621Investigating Factors Influencing Medical Practitioners’ Resistance to and Adoption of Internet Hospitals in China: Mixed Methods StudyWenhao Denghttps://orcid.org/0000-0003-3316-6691Tianan Yanghttps://orcid.org/0000-0001-6994-354XJianwei Denghttps://orcid.org/0000-0001-5846-9715Ran Liuhttps://orcid.org/0009-0006-9412-8815Xueqin Sunhttps://orcid.org/0009-0002-0162-9356Gang Lihttps://orcid.org/0000-0003-0988-962XXinmei Wenhttps://orcid.org/0009-0006-7260-2248 BackgroundThe swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners. ObjectiveThis study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework. MethodsA mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model. ResultsOn the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=−.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms. ConclusionsThis study investigated the factors that facilitate or hinder medical practitioners’ resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.https://www.jmir.org/2023/1/e46621 |
| spellingShingle | Wenhao Deng Tianan Yang Jianwei Deng Ran Liu Xueqin Sun Gang Li Xinmei Wen Investigating Factors Influencing Medical Practitioners’ Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study Journal of Medical Internet Research |
| title | Investigating Factors Influencing Medical Practitioners’ Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study |
| title_full | Investigating Factors Influencing Medical Practitioners’ Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study |
| title_fullStr | Investigating Factors Influencing Medical Practitioners’ Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study |
| title_full_unstemmed | Investigating Factors Influencing Medical Practitioners’ Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study |
| title_short | Investigating Factors Influencing Medical Practitioners’ Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study |
| title_sort | investigating factors influencing medical practitioners resistance to and adoption of internet hospitals in china mixed methods study |
| url | https://www.jmir.org/2023/1/e46621 |
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