Assessing the performance of long-term care information systems and the continued use intention of users
Introduction
The social problems caused by aging populations pose formidable challenges for both developing and developed countries. In the United Kingdom, the proportion of people aged over 80 years is estimated to increase by 82% in 2031 compared with that in 2011, and the population of disabled elderly people who require home care is expected to exceed 3.5 million in 2041 (Wittenberg et al., 2008). The potential results of such an increase are nursing staff shortages at long-term care (LTC) facilities and increased financial burdens for governments (Yu et al., 2009).
Demands for LTC in Taiwan have increased from 24% in 2001 to 36% in 2011 (Li et al., 2011), with the number of LTC facilities increasing from 74 in 1997 to 1056 in 2012. Because of the top-ten ranking of Taiwan’s e-government over the past consecutive 10 years (Waseda University International E-Government Ranking, 2013) hospitals have expedited the adoption rate of electronic medical records. However, in contrast to hospitals linking hospital information systems (HIS) to their daily operations for reimbursements, most LTC facilities install the long-term care information system (LTCIS) to attain accreditation credits.
In other words, the use of the LTCIS is infrequent, although the LTCIS is relatively mature and provides functions that support operations management, evaluation assistance, nursing care, nursing projects, nutrition care, social work services, rehabilitation therapy, health management, drug management, quality management, facility management, financial management, and resident management. The topic of users’ cognition regarding the match between the system and their work, the system performance, and user satisfaction of the LTCIS requires further ortaresearch. Consequently, this study applied the theories of task-technology fit (TTF), system satisfaction, and postacceptance model of IS continuance to evaluate the system performance and continued use intentions of facilities that employ the LTCIS. The results can provide a foundation for LTC facilities to enhance the use of the LTCIS.
Section snippets
Theoretical constructs
In the domain of information management, many well-known models have been applied in investigating the impact of IS on the healthcare industry. The TTF model has been used to evaluate the successful implementation of IS in organizations. The TTF model emphasizes the importance of fit between information technology and user tasks, and the influence of this fit on user performance (Goodhue and Thompson, 1995). Junglas et al. (2009) applied the TTF model to investigate the relationship of the
Research model and hypothese
The research framework of this study is based on the theory of TTF, the information system success model (ISSM), user satisfaction, and intentions of continued use and is shown in Fig. 1. Hypotheses that corresponded to the research framework were developed, and a questionnaire was adapted based on the dimensions, variables, and items from the related theories.
The theoretical construct of TTF in TTF model (Goodhue and Thompson, 1995) can be considered as beliefs related to using IS. Both the
Data collection
The questionnaire items in this study were firstly developed based on a literature review of relevant research. The construct of TTF was evaluated according to eight indicators: data quality, locatability of data, authorization to access data, data compatibility, training and ease of use, production timeliness, systems reliability, and the relationship of the IS personnel with users which were modified from Goodhue and Thompson (1995). Items of utilization impact were adopted from Junglas et
Reliability and validity analysis
A questionnaire reliability analysis was conducted using SmartPLS 2.0M3. Based on Nunnally (1978), a Cronbach’s α coefficient below 0.35 indicates low reliability, between 0.5 and 0.7 indicates an acceptable reliability, and above 0.7 indicates high reliability. Constructs with an average variance extracted (AVE) exceeding the benchmark of 0.5 (Fornell and Larcker, 1981), a factor loading (FL) exceeding 0.5, and a composite reliability (CR) higher than 0.7 demonstrate satisfactory reliability
Findings
In contrast to the electronic medical records used in the hospital with official regulations or incentives to promote the use, the continued use intention of the LTCIS is considered voluntarily. The LTCIS was designed to support nurses in evaluation assistance, nursing care, nursing projects, nutrition care, rehabilitation therapy, health management, drug management, and directors of support operations management, quality management, facility management, financial management, and resident
Acknowledgement
The authors would like to thank the Editor-in-Chief, Dr. Jan Servaes, and the anonymous referees for their helps and valuable comments to improve this paper. This research was supported by the Ministry of Science and Technology of the Republic of China under the Grants NSC100-2622-H-194-005-CC3 and 103-2410-H-194-071-MY2.
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