An empirical Study of Physician Behavior

Intention to accept and use of Information

Technology in Malaysian Government Hospital

Prof. Dr. Ahmed Bakeri Abu Bakar

Kulliyyah of Information & Communication Technology
International Islamic University Malaysia
Jalan Gombak, 53100 Kuala Lumpur

Mohd Daud bin Rajab

Kulliyyah of Information & Communication Technology
International Islamic University Malaysia
Jalan Gombak, 53100 Kuala Lumpur

ABSTRACT

The user technology acceptances have being applied along the decades. From these studies
there are clear evident that the behavior intention has become the most determinate factor
or as the gateways of user to acceptance or reject any technologies. Some of the
determinant that influenced behavior intention provided weightage to the use behavior or
actual use. Some of these factors were tested and retested in numerous previous
researches and the findings from these researches confirm that they have significant
influence on the behavior intention, which resulted in the use behavior or actual use. These
factors are perceived usefulness, ease of use, social influence, facilitating conditions,
compatibility, self anxiety, self efficacy, attitude, perceived technology control and others.
KEYWORDS
Behaviour Intention, Use Behaviour, Implementation, Technological and Individual Contexts

1. INTRODUCTION
Information Technology has emerged as a very important element and a success factor in most
sectors of the business industries nowadays. This Information Technology (IT) application has brought a lot
of benefits and advantages to the end-users and the organizations.

This research will focus on intention of the physician’s behavior towards the use and acceptance of
information technology applications. In health care for instances, the information technology applications
were specifically designed to improve the quality in patients medical management. Theoretically, the
involvement of information technology (IT) applications will enhance the physician’s capabilities during pre
and post health care management services. The Information Technology (IT) applications will also provide
the most sufficient patient data management compared to conservative paper based data collection has been
applied previously.

The groups of healthcare organization are divided into Medical Groups, Management and Policies
Groups, Support Groups and Facilities Support Groups. The groups that will be the main target or focus in
this research study are the medical groups. For the purpose of this research, this medical groups is assumed
have directly involved with patients care under their supervision and treatment. These medical groups consist
of the medical officer right up to the consultant that is directly involved in the treatment of the patients.

This research will identify and analysis major factors that influence physicians’ behavior intention
towards the use and acceptance of information technology application such as the computer based system or
any information technology system applications. A modified user technology acceptance model was
proposed as a framework for implementing technological changes in the Information Technology
applications.

2. BACKGROUND

2.10 Definition of terms

2.11 Information Technology Applications (ITAs)

For the purpose of the study, the scope of the Information Technology Applications will be includ in
the Electronic Claims (EC), Online Eligibility and Authorizations (OEA), Internet Application (IA), Online
or Internet Based Scheduling (OIBS), Online Results Reporting (ORR), Online Access to Clinical
Information (OACI), Automated Clinical Information (ACI), Automated Clinical Decision Support (ACDS),
Access to Patient Satisfaction Data (APSD), E-mail, Voice Recognition(VR), Automated Dictation (AD),
Disease Management (DM), Electronic Medical Record (EMR), Wireless and hand Held Devices, Common
Practice Management System (CPMS) and others(HISS, 2000). As stated above, the focus of these studies is
to understand the physicians’ behavior intention (BI) towards information technology applications.
2.12 Organizational Context

Organizational context refers to those essential characteristics of any organizations that are related to the
usage of the system applications. An organizational context may have quite similar from one organization to
another organization. Some of the characteristics are the financial and cost capability, management support,
accessibility and training.

2.13 Implementation Context

The implementation context refers to the particular setting or specific environment or location where the
individual works. The environment or location is where the individual professional works with a specified
technology, to do their jobs and making the most appropriate decision. In this specified location or
environment there are some factors that will be significant factors to the end user.

2.14 Technological Context

The technology context refers to the end-user computing technologies under study. These
technologies are information systems applications, communications systems, and as per define in the early
paragraph.

2.15 Individual Context

Individual context is referring to the individual personnel trait and characteristics. Some of this
individual context are computer anxiety, computer self-efficacy and computer attitude.

2.16 Behavioral Intention

The purpose of a person will acting upon or engaging a behavior is called behavior intention (Ajzen
and Fishbien.1980). According to Taylor and Todd (1995) the link from behvioural intention to behaviour is
significant in TAM and TPB. It was reported the (Fishbien & Ajzen, 1975) that the Behaviour Intention act
as important the mediator factors for predictive power on behaviour. The absence of this mediating
behaviour intention factors will cause significant decreased in the predictive power.

2.17 Use behaviour

Use behavior is a voluntary activity, this mean that the usage of any specific technologies will
depend on the user desires. This highlighted that the level of usage of the technologies depending on the user
wills or needs. This will demonstrate that there is very close relationship between behaviour intention and use
behaviour.

2.18 Malaysian Government Hospital

This is an empirical study to be conducted at Selayang Hospital (SH), Putrajaya Hospital (PJH),
Kuala Lumpur Hospital (KLH) and National University hospital (NUH). The research will be focus on the
government hospitals in Klang Valley and thus; facilities and supports provided by these hospitals.

2.20 Problem statements

User technology acceptance research is a mature field in Information System Research, (Venkatesh
et. al. 2003), amounting to more that 101 research journal articles, (Younghwa Lee,2003). But little research
has been accomplished and studied in a health care environment (Hu et al.,1999, Chau and Hu,2002a; Chau
and Hu,2002b; Chismar and Patton, 2003; which resulted a major significant gap in knowledge in the actual
user technology acceptances.

The knowledge and information in the healthcare industries professional especially related to the physician’s
behavior intention on IT acceptance can contribute a better understanding of the information and knowledge
in this area of research thereby enhancing the quality and performance of information technology application
in health organization. The purpose of the use of the information technology applications in the hospital
environment and organizations are to improve the quality of patient care services. For this purpose it is
important to understand the factors that influence the behavior intention of physicians towards the use and
acceptance of Information Technology applications. By understanding these influencing factors to behavior
intention, it may help the researcher or policymakers to develop a better understanding of physicians’
technology acceptance in the coming strategic information technology planning.

The purpose of the research is to provide an empirical analysis for a model of physician’s behavior
intention and acceptance of information technology applications and to identify the major factor that
influenced physician’s intention in acceptance information system in Malaysian government hospitals
context. The research questions are based on technology acceptance literature as well as information
technology or information system and medical research journal.

2.30 Research objectives

i. To investigate the level to use of information technology by physicians in Malaysian

Government Hospitals.

ii. To determine factors that influence physicians’ behavior intention to use information
technology applications in Malaysian Government Hospitals.

iii. To examine the joint effect among organizational context, technology context, individual
context and the implementation context of technology acceptance on behavior intention to
use information technology in Malaysian Government Hospitals?

2.40 Research questions

1. What is the level of use of the information technology by physicians in the Malaysian Government
Hospital?

2. What are the factors that influence physician intention to use information technology applications?
i. Does organization context influence the physicians’ behavior intention to use
information technology applications?
ii. Does implementation context influence the physicians’ behavior intention to
use information technology applications?
iii. Does technology context influence the physicians’ behavior intention to use
information technology applications?; and
iv. Does individual context influence the physicians’ behavior intention to use
information technology applications?

3. Is there a joint effect among the contexts on physicians’ behavior intention to use information
technology applications in Malaysian Government Hospitals?
2.50 Expected contribution to academic research

1) From the viewpoint of technology acceptance theories, the study attempts to extend the
technology acceptance model antecedent and additional context of belief ( i.e., organization
context).

2) Since this study will be carried out in Malaysia context, the study extended the exiting body of
knowledge related to technology acceptance model antecedent. Indirectly, the study examines
the applicable and robustness of the theory in its ability to predict adoption intention within
different sampling frames.

3) The modified technology acceptance model will enhance the existing model.

4) The study provide an important sample of study culminating in the identification of the
antecedents found meaningful for this individual professional need or requirements in
acceptancing information technology compare to others user group.
 2.60 Propose research model
Organizational
Context

Management Support
Financial & Cost
Accessibility
Task Fit
Training

Implementation
Context

Social Influence

Facilitating
Condition

Compatibility

Technology
Context
Behaviour Use
Performance
Expectancy Intention Behavior

Effort
Expectancy

Individual
Context
Anxiety
Self Efficacy
Attitude
Personal
Innovativeness
Perceived Technology
Control
Age
Gender
Experience
Voluntariness
3. CONCLUSION
The research is conducted to identify the factors that influence the physician behavior intention
toward the use and acceptance of Information Technology Applications. especially at their workplaces.
Besides that, the research also to identify the most significant contexts and factors that will provide additional
knowledge on the interaction and collaboration among contexts which can use in individual to accept the
information technology application for the organization benefit and success. For intentional purpose, the
study also will identified some crucial factors that strongly influenced behaviour intention to produce
determined behavior which will caused the use behavior or actual use.

Crucial
External BEHAVIOUR DETERMINED USE
Factors INTENTION BEHAVIOUR BEHAVIOUR

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