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Background: Healthcare wearable devices (HWDs) enable continuous monitoring of consumers' health signals and have great potential to improve the efficiency and quality of healthcare. However, factors influencing consumer acceptance of HWDs are not well understood. Moreover, extant studies seem to fail to consider whether an HWD has appropriate functions to fit the requirements of consumers' healthcare activities., Objectives: The objective of this study was to develop and empirically test a model by integrating the Unified Theory of Acceptance and Usage of Technology (UTAUT) and Task-Technology Fit (TTF) models to understand how consumers accept HWDs., Methods: A self-administered questionnaire was designed based on validated measurement scales. Data from 406 valid samples were analyzed using partial least squares structural equation modeling., Results: The results indicated that performance expectancy, effort expectancy, facilitating conditions, social influence, and task-technology fit positively affected consumers' behavioral intention to use HWDs, and together accounted for 68.0 % of its variance. Both task and technology characteristics were significant determinants of task-technology fit and exerted impacts on behavioral intention through the mediating roles of task-technology fit and effort expectancy., Conclusions: The key findings showed that consumer acceptance of HWDs was affected by both users' perceptions (i.e., performance expectancy, effort expectancy, social influence and facilitating conditions) and the task-technology fit. The theoretical and practical implications and contributions were provided for future researchers and practitioners to increase consumers' use of HWDs in their healthcare activities., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

With the emergence of an always-on culture and the private smartphones always within reach, professional and recreational contexts overlap. Little empirical knowledge is available on prevailing online habits among healthcare personnel and whether gender matters in this context. To investigate health technology-related preferences, we conducted an online survey among a purposive sample of employees and students at the Medical University of Vienna, Austria. In total, 905 participants (59.0%, 540/905, females) provided self-reported information on use of online services and mobile health applications (apps) as well as respective gender-specific internal and external apperceptions. Mann-Whitney U tests and binary regression analysis assessed respective gender differences. The structured German questionnaire was validated by principal component analysis. The study found a moderate familiarity with health technologies. As for gender differences, prevailing health app use was high among both male and female participants (39, 141/365, and 42%, 229/540, respectively), with apps for tracking activity and nutrition habits most commonly used. Approval for monitoring health and lifestyle parameters, eHealth and telemedicine knowledge levels, and online health information retrieval predicted health app use, whereas gender did not. Socio-demographic attributes including gender influence not only private online habits of users, but might also affect acceptance of health technologies and their professional use in a clinical setting. Thus, addressing the gender dimension already in concept stages of digital devices and services for healthcare and lifestyle could speed up private and public adoption of health technologies., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background and Purpose: After investing billions of dollars in an integrated Electronic Medical Records (physicians) and Personal Health Records (patients) system to allow both parties to manage and communicate through e-health innovative technologies, Canada is still making slow adoption progress. In an attempt to bridge the human and technological perspectives by developing and testing a holistic model, this study purports to predict patients' behavioral intentions to use e-health applications., Methods: An interdisciplinary approach labelled as a techno-humanism model (THM) is testing twelve constructs identified from the technological, sociological, psychological, and organizational research literature and deemed to have a significant effect upon and positive relationship with patients' e-health applications adoption. Subjects were Canadians recruited in a mall-intercept mode from a region representing a demographically diverse population, including rural and urban residents. The SmartPLS measurement tool was used to evaluate the reliability and validity of study constructs. The twelve constructs were separately tested with quantitative data such as factor analysis, single, multiple, and hierarchical multiple regression., Results: The hierarchical multiple regression analysis process led us to formulate four models, each hinged on a combination of interdisciplinary variables. Model 1 consisted of the technological predictors and explained 62.3% (p < .001) of variance in the behavioral intention to use e-health. Model 2 added the sociological predictors to the equation and explained 72.3% (p < .001) of variance. Model 3 added the psychological predictors to Model 2 and explained 72.8% (p < .001). Finally, Model 4 included all twelve predictors and explained 73% (p < .001) of variance in the behavioral intention to use e-health applications., Conclusions: One of the greatest barriers to applying e-health records in Canada resides in the lack of coordination among stakeholders. The present study implies that healthcare policy makers must consider the twelve variables with their findings and implications as a whole. The techno-humanist model (THM) we are proposing is a more holistic and continuous approach. It pushes back to a breakdown of the various technological, sociological, psychological, and managerial factors and stakeholders that are at the root cause of behavioral intentions to use e-health, as opposed to merely observing behavioral outcomes at the end of the "assembly line". Active participation and coordination of all stakeholders is a key feature., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background and Purpose: In health care, information technologies (IT) hold a promise to harness an ever-increasing flow of health related information and bring significant benefits including improved quality of care, efficiency, and cost containment. One of the main tools for collecting and utilizing health data is the Electronic Health Record (EHR). EHRs implementation can face numerous barriers to acceptance including attitudes and perceptions of potential users, required effort attributed to their implementation and usage, and resistance to change. Various theories explicate different aspects of technology deployment, implementation, and acceptance. One of the common theories is the Technology Acceptance Model (TAM), which helps to study the implementation of different healthcare IT applications. The objectives of this study are: to understand the barriers of EHR implementation from the perspective of physicians; to identify major determinants of physicians' acceptance of technology; and develop a model that explains better how EHRs (and technologies in general) are accepted by physicians., Methods: The proposed model derives from a cross-sectional survey of physicians selected through multi-stage cluster sampling from the hospitals of Yerevan, Armenia. The study team designed the survey instrument based on a literature review on barriers of EHR implementation. The analysis employed exploratory structural equation modeling (ESEM) with a robust weighted least squares (WLSMV) estimator for categorical indicators. The analysis progressed in two steps: appraisal of the measurement model and testing of the structural model., Results: The derived model identifies the following factors as direct determinants of behavioral intention to use a novel technology: projected collective usefulness; personal innovativeness; patient influence; and resistance to change. Other factors (e.g., organizational change, professional relationships, administrative monitoring, organizational support and computer anxiety) exert their effects through projected collective usefulness, perceived usefulness, and perceived ease of use. The model reconciles individual-oriented and environment-oriented theoretical approaches and proposes a Tripolar Model of Technology Acceptance (TMTA), bringing together three key pillars of the healthcare: patients, practitioners, and provider organizations. The proposed TMTA explains 85% of variance of behavioral intention to use technology., Conclusions: The current study draws from the barriers of EHR implementation and identifies major determinants of technology acceptance among physicians. The study proposes TMTA as affording stronger explanative and predictive abilities for the health care system. TMTA paves a long overlooked gap in TAM and its descendants, which, in organizational settings, might distort construal of technology acceptance. It also explicates with greater depth the interdependence of different participants of the healthcare and complex interactions between healthcare and technologies., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: One of the most important factors for the success of health information technology (IT) implementation is users' acceptance and use of that technology. Thailand has implemented the national universal healthcare program and has been restructuring the country's health IT system to support it. However, there is no national data available regarding the acceptance and use of health IT in many healthcare facilities, including community health centers (CHCs). This study employed a modified Unified Theory of Acceptance and Use of Technology (UTAUT) structural model, to understand factors that influence health IT adoption in community health centers in Thailand and to validate this extant IT adoption model in a developing country health care context., Methods: An observational research design was employed to study CHCs' IT adoption and use. A random sample of 1607 regionally stratified CHC's from a total of 9806 CHCs was selected. Data collection was conducted using a cross-sectional survey by means of self-administered questionnaire with an 82% response rate. The research model was applied using the partial least squares (PLS) path modeling., Results: The data showed that people who worked in CHCs exhibited a high degree of IT acceptance and use. The research model analyses suggest that IT acceptance is influenced by performance expectancy, effort expectancy, social influence and voluntariness. Health IT use is predicted by previous IT experiences, intention to use the system, and facilitating conditions., Conclusions: Health IT is pervasive and well adopted by CHCs in Thailand. The study results have implications for both health IT developmental efforts in Thailand and health informatics research. This study validated the UTAUT model in the field context of a developing country's healthcare system and demonstrated that the PLS path modeling works well in a field study and in exploratory research with a complex model.

Purpose: This paper appraises empirical studies examining the impact of clinical information-retrieval technology on physicians and medical students., Methods: The world literature was reviewed up to February 2004. Two reviewers independently identified studies by scrutinising 3368 and 3249 references from bibliographic databases. Additional studies were retrieved by hand searches, and by searching ISI Web of Science for citations of articles. Six hundred and five paper-based articles were assessed for relevance. Of those, 40 (6.6%) were independently appraised by two reviewers for relevance and methodological quality. These articles were quantitative, qualitative or of mixed methods, and 26 (4.3%) were retained for further analysis. For each retained article, two teams used content analysis to review extracted textual material (quantitative results and qualitative findings)., Results: Observational studies suggest that nearly one-third of searches using information-retrieval technology may have a positive impact on physicians. Two experimental and three laboratory studies do not reach consensus in support of a greater impact of this technology compared with other sources of information, notably printed educational material. Clinical information-retrieval technology may affect physicians, and further research is needed to examine its impact in everyday practice.

Despite the growing interest in adopting information technology (IT) in healthcare, the degree of technology sophistication varies among healthcare organizations. Changes in the health care sector and continuous pressure to improve the quality of care have driven the evolution of IT in hospitals. This paper provides an overview of clinical IT sophistication in a sample of U.S. hospitals, and compares clinical IT capacities in this sample with a sample of Canadian hospitals. The instrument used for the comparison measures three clinical dimensions of IT sophistication: functional sophistication, technological sophistication and integration level. Clinical areas that were considered include patient management, patient care activities and clinical support activities. The comparison between hospitals in Iowa and Canada shows differences in clinical IT sophistication between the two settings. Hospitals in Iowa appear to have more technologies but fewer computerized processes and integration of patient management activities. Technological sophistication however, was low in both samples. Our findings confirm the construct validity of the measurement instrument and show initial evidence of its generalizability. More initiatives using the instrument would lead to enhancement in IT assessment tools that can be used for evaluation of IT in relation to patient management and quality outcomes.