Critical Factors Influencing the Acceptance and Usage of Electronic Medical Records System in Malaysian Public Hospitals Based on A Multi-Criteria Perspective Analysis
In the current medical field, Electronic Medical Record system (EMRS) is considered as one of the main e-health applications. Its application has been known to enhance healthcare quality and thus lead to minimized errors in the medical field. Despite this claim, healthcare professionals in the Malay...
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| Format: | Thesis |
| Language: | en_US |
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| Summary: | In the current medical field, Electronic Medical Record system (EMRS) is considered as one of the main e-health applications. Its application has been known to enhance healthcare quality and thus lead to minimized errors in the medical field. Despite this claim, healthcare professionals in the Malaysian context have a difficult time putting their trust in the system, as evidenced by the fact that only 15.2% of the public hospitals in the country are implementing it. In addition, studies that addressed EMR acceptance, particularly its application in context of privacy and security concerns on the basis of a multi-criteria perspective in Malaysian hospitals are still lacking. Moreover, studies that applied Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) in context of EMR acceptance are still low especially in privacy and security context. Hence, the present study aimed to investigate the influence of privacy, security and individual factors on the EMR acceptance and usage on the basis of the multi-criteria perspective in the context of Malaysian healthcare professionals. Understanding and comparing the perspectives of each user group in EMR is essential to the successful implementation of EMR system. Moreover, these factors can also be used for predicting and analyzing users' preferences toward future EMR systems. The study developed a conceptual model adopted from Unified UTAUT2 to explain the relationship between privacy and security factors and EMR system acceptance and use in the context of Malaysian healthcare professionals. The methodology comprised of four phases, where in the first two phases, investigate sub-factors of privacy, security and individual that could have influence on EMR acceptance and usage. This is followed by the identification of the sub-factors through the uniform multi-criteria perspective to develop a decision matrix that gathers the sub-factors and the perspective on the basis of individual uniform. The third phase entailed the development of a new multi-criteria perspective decision-making based on integrated technique for order of preference by similarity to ideal solution (TOPSIS) and analytic hierarchy process (AHP) method in order to ranking each group of factors, then applied K-mean clustering in order to determine the critical factors in each group as well. The fourth entailed the examination of the influence of privacy, security and individual factors on the acceptance of EMR, with trust as mediating variable. Based on the results, indicated the flowing six factors namely; data integrity, confidentiality, non-repudation, facilitating conditions, and effort expectancy found directly and significantly positive impacted on EMR acceptance and usage. Other three factors namely, Unauthorization, error and secondary use found directly and significantly negative influenced on EMR acceptance and usage, other three factors namely; Authentication, performance expectancy and habit had insignificant influence on behavioral intention to use EMR. The finding of this study has led to the enhancement of the theoretical knowledge of UTAUT2 application in the health informatics domain. Consequently, the findings can assist decision makers in formulating EMRS acceptance and use strategies in Malaysia. |
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