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Critical Factors for the Adoption of Mobile Nursing Information Systems in Taiwan: the Nursing Department Administrators’ Perspective

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Abstract

The trend towards point-of-care and the advance in mobile technologies bring the potential to employ Mobile Nursing Information Systems (MNIS) in nursing care routines. However, adopting the MNIS is not simply a case of purchasing the required hardware and software, but rather a social interaction process between users, organizations, and the environment. Therefore, this study developed a framework of twelve factors affecting the decision to adopt/not to adopt the MNIS in the nursing department, and tested it from the perspective of the nursing administrators. A mail survey was conducted to collect the opinions of 84 nursing administrators, and a discriminant analysis was used to identify the critical factors for the adoption/non-adoption of the MNIS. Business competition, external suppliers’ support, and internal needs were identified as being significantly associated with the adoption of MNIS. Potential adopters can apply the results of this study as a reference when making the adoption decision regarding MNIS, while non-adopters and vendors can examine the resistance to MNIS.

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References

  1. Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., and Silber, J. H., Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. J. Appl. Nurs. Res. 288(16):1987–1993, 2002.

    Google Scholar 

  2. Ammenwerth, E., Buchauer, A., Bludau, B., and Haux, R., Mobile information and communication tools in the hospital. Int. J. Med. Inform. 57(1):21–40, 2000 doi:10.1016/S1386-5056(99)00056-8.

    Article  Google Scholar 

  3. Aspinwall, J., Installing, troubleshooting and repairing wireless networks. The McGraw-Hill, New York, 2003.

    Google Scholar 

  4. Banitsas, K., Istepanian, R. S. H., and Tachakra, S., Applications of medical wireless LAN systems (MedLAN). Int. J. Med. Mark. 2(2):136–143, 2002 doi:10.1057/palgrave.jmm.5040067.

    Article  Google Scholar 

  5. Beath, C. M., Supporting the information technology champion. MIS Q. 15(3):355–371, 1991 doi:10.2307/249647.

    Article  Google Scholar 

  6. Buchauer, A., Pohl, U., Kurzel, N., and Haux, R., Mobilizing the health professional’s work station- results of an evaluation study. Int. J. Med. Inform. 54(2):105–114, 1999 doi:10.1016/S1386–5056(98)00170–1.

    Article  Google Scholar 

  7. Burke, D. E., Wang, B. B. L., Wan, T. T. H., and Diana, M. L., Exploring hospitals’ adoption of information technology. J. Med. Syst. 26(4):349–355, 2002 doi:10.1023/A:1015872805768.

    Article  Google Scholar 

  8. Chaiken, B. P., Evidence-based medicine: a tool at the point of care. Nurs. Econ. 19(5):234–235, 2001.

    Google Scholar 

  9. Chen, E. S., Mendonca, E. A., McKnight, L. K., Stetson, P. D., Lei, J., Cimino, J. J., et al, A wireless handheld application for satisfying clinician information needs. J. Am. Med. Inform. Assoc. 11(1):19–28, 2003 doi:10.1197/jamia.M1387.

    Article  Google Scholar 

  10. Chen, Y. C., Chiu, H. C., Tsai, M. D., Chang, H., and Chong, C. F., Development of a personal digital assistant-based wireless application in clinical practice. Comput. Methods Programs Biomed. 85(2):181–184, 2007 doi:10.1016/j.cmpb.2006.11.001.

    Article  Google Scholar 

  11. Choi, J., Chun, J., Lee, K., Lee, S., Shin, D., Hyun, S., et al, MobileNurse: hand-held information system for point of nursing care. Comput. Methods Programs Biomed. 74(3):245–254, 2004 doi:10.1016/j.cmpb.2003.07.002.

    Article  Google Scholar 

  12. Doll, W. J., and Torkzadej, G., Discrepancy model of end-user computing involvement. Manage. Sci. 35(10):1151–1171, 1989.

    Article  Google Scholar 

  13. Farrell, M., Mcgrath, I., D’arcy, M., and Abaloz, E., Improving patient health outcomes in acute care hospital units using mobile wireless technology and handheld computers, CIN: Computers, Informatics. Nursing. 25(5):308–309, 2007.

    Google Scholar 

  14. Fischer, S., Steward, T. E., Mehta, S., Wax, R., and Lapinsky, S. E., Handheld computing in medicine. J. Am. Med. Inform. Assoc. 10(2):139–149, 2003 doi:10.1197/jamia.M1180.

    Article  Google Scholar 

  15. Frenzel, J. C., Data security issues arising from integration of wireless access into healthcare networks. J. Med. Syst. 27(2):163–175, 2003 doi:10.1023/A:1021865011765.

    Article  Google Scholar 

  16. Gemmill, G., and Wilemon, D., The hidden side of leadership in technical team management. Res. Technol. Manag. 37(6):25–32, 1994.

    Google Scholar 

  17. Gillette, B., Wireless technology serves as next logical step in care service. Manag. Healthc. Exec. 14(6):54–55, 2004.

    Google Scholar 

  18. Grover, G., Identification of factors affecting the implementation of data warehousing. Unpublished Ph.D. Dissertation, Auburn University at Montgomery, 1998.

  19. Grover, V., and Goslar, M. D., The initiation, adoption, and implementation of telecommunications technologies in US organizations. J. Manage. Inf. Syst. 10(1):141–163, 1993.

    Google Scholar 

  20. Hair, J. F., Anderson, R. E., Tatham, R. L., and Black, W. C., Multivariate data analysis, 5th edition. Prentice-Hall International, New Jersey, 1998.

    Google Scholar 

  21. Hartwick, J., and Barki, H., Explaining the role of user participation in information system use. Manage. Sci. 40(4):409–430, 1994.

    Article  Google Scholar 

  22. Hauser, S. E., Demner-Fushman, D., Jacobs, J. L., Humphrey, S. M., Ford, G., and Thoma, G. R., Using wireless handheld computers to seek information at the point of care: an evaluation by Clinicians. J. Am. Med. Inform. Assoc. 14(6):807–815, 2007 doi:10.1197/jamia.M2424.

    Article  Google Scholar 

  23. Hwang, H. G., Chang, I. C., and Liu, C. F., Current states of development of electronic medical record in healthcare organizations–a national-wide investigationDepartment of Health, Taiwan, 2005.

    Google Scholar 

  24. Jason, K., and Yen, D. C., Breaking the barriers of connectivity:an analysis of the wireless LAN. Comput. Stand. Interfaces. 24(1):5–20, 2002 doi:10.1016/S0920-5489(01)00101-5.

    Article  Google Scholar 

  25. Kimberly, J. R., and Evanisko, M. J., Organizational innovation: the influence of individual, organizational, and contextual factors on hospital adoption of technological and administrative innovations. Acad. Manage. J. 24(4):689–713, 1981 doi:10.2307/256170.

    Article  Google Scholar 

  26. Kirkley, D., and Stein, M., Nurses and clinical technology: sources of resistance and strategies for acceptance. Nurs. Econ. 22(4):216–223, 2004.

    Google Scholar 

  27. Kuziemsky, C. E., Laul, F., and Leung, R. C., A review on diffusion of personal digital assistants in healthcare. J. Med. Syst. 29(4):335–342, 2005 doi:10.1007/s10916-005-5893-y.

    Article  Google Scholar 

  28. Lee, T. T., Lee, T. Y., Lin, K. C., and Chang, P. C., Factors affecting the use of nursing information systems in Taiwan. J. Adv. Nurs. 50(2):170–178, 2005 doi:10.1111/j.1365–2648.2005.03376.x.

    Article  Google Scholar 

  29. Lee, T. T., Patients’ Perceptions of Nurses’ Bedside Use of PDAs. CIN: Computers, Informatics. Nursing. 25(2):106–111, 2007.

    Google Scholar 

  30. Lee, T. T., Lin, K. C., and Lin, J. S., Development and testing of an evaluation scale of personal digital assistants. CIN: Computers, Informatics. Nursing. 25(3):171–179, 2007.

    MathSciNet  Google Scholar 

  31. Lynn, M. R., and Redman, R. W., Faces of the nursing shortage: influences on staff nurses’ intentions to leave their positions or nursing. J. Nurs. Adm. 35(5):264–270, 2005 doi:10.1097/00005110-200505000-00010.

    Google Scholar 

  32. Nelson, L., Step-by-step guide to selecting mobile wireless devices. Nurs. Manage. 30(11):12–13, 1999 doi:10.1097/00006247–199911000–00004.

    Google Scholar 

  33. Nunnally, J. C., Psychometric theory, 2nd edition. McGraw-Hill, New York, 1978.

    Google Scholar 

  34. Porter, M., and Millar, V. E., How information gives you competitive advantage. Harv. Bus. Rev. 63(4):149–160, 1985.

    Google Scholar 

  35. Reich, B. H., and Benbasat, I., An empirical investigation of factors influencing the success of customer-oriented strategic systems. Inf. Syst. Res. 1(3):325–347, 1990.

    Article  Google Scholar 

  36. Rogers, E. M., Diffusion of innovations. The Free Press, New York, 1995.

    Google Scholar 

  37. Simpson, R. L., A few points about point-of-care technology. Nurs. Manage. 29(11):19–21, 1998 doi:10.1097/00006247-199811000-00007.

    Google Scholar 

  38. Spil, T. A. M., and Schuring, R. W., E-health system diffusion and use. IDea Group, Hershey, 2006.

    Google Scholar 

  39. Teo, T. S. H., and Tan, M., An empirical study of adopters and non-adopters of the Internet in Singapore. Inf. Manage. 34(6):339–346, 1998 doi:10.1016/S0378-7206(98)00068-8.

    Article  Google Scholar 

  40. Thong, J. Y. L., An integrated model of information systems adoption in small business. J. Manage. Inf. Syst. 15(4):187–214, 1999.

    Google Scholar 

  41. Tornatzky, L. G., and Klein, K. J., Innovation characteristics and innovation adoption-implementation: a meta-analysis of findings. National Science Foundation, Division of Industrial Science and Technological Innovation, Washington, DC, 1981.

    Google Scholar 

  42. Watson, C. A., Integration of technology and facility design: implications for nursing administration. J. Nurs. Adm. 35(5):217–219, 2005 doi:10.1097/00005110-200505000-00001.

    Google Scholar 

  43. Varshney, U., A framework for supporting emergency messages in wireless patient monitoring. Decision Support Systems, In Press, Available online at http://www.science-direct.com, Accessed on 4/8/2008.

  44. Wilson, E. V., and Lankton, N. K., Interdisciplinary research and publication opportunities in information system and healthcare. Commun. Assoc. Inf. Syst. 14(17):332–343, 2004.

    Google Scholar 

  45. Zmud, R. W., An examination of push-pull theory applied to process innovation in knowledge work. Manage. Sci. 30(6):727–738, 1984.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Dept. of Information Management, National Chung Cheng University, No. 168, University Rd., Min-Hsiung, Chia-Yi, Taiwan

    Shih-Jung Hsiao

  2. Dept. of Health Services Administration, Chun Shan Medical University, No. 110, Sec. 1., Jianguo N. Rd., Taichung, Taiwan

    Yi-Chang Li

  3. Dept. of Information Management, Nan-Kai University of Technology, No. 568, Chung-Cheng Rd., Tsao-Tun, Nantou, Taiwan

    Ying-Ling Chen

  4. Dept. of Mechatronics Engineering, National Chang-hua University of Education, No. 2, Shi-Da Rd, Chang-Hua, Taiwan

    Hsi-Ching Ko

Authors
  1. Shih-Jung Hsiao
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  2. Yi-Chang Li
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  3. Ying-Ling Chen
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  4. Hsi-Ching Ko
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Corresponding author

Correspondence to Yi-Chang Li.

Appendix: Questionnaire Items

Appendix: Questionnaire Items

Environmental Factors

Business competition

  1. 1.

    Pressure from industry regarding the usage of MNIS as a standard nursing practice.

  2. 2.

    Pressure of the loss of competitive edge due to the lack of MNIS development.

  3. 3.

    Number of competitors in my area who have adopted MNIS.

  4. 4.

    The need for the development of MNIS for patients.

Government Policy Support

  1. 1.

    The extent of the clarity of the government policy for supporting MNIS.

  2. 2.

    The extent of the physical support (i.e., funding, expertise) provided by the government units to our hospital.

External Supplier’s Support

  1. 1.

    The sufficiency of technical support in MNIS development

  2. 2.

    The sufficiency of technical support in MNIS maintenance

  3. 3.

    The sufficiency of user training and support provided by vendors

Organizational Factor

Project Team’s Capability

  1. 1.

    The capabilities of the information-system’s development of the project team.

  2. 2.

    The capabilities of the information-system’s planning of the project team.

  3. 3.

    The project team’s understanding of the nursing needs

Top Management Support

  1. 1.

    The ability of the top management to take the risk involved in the adoption of MNIS.

  2. 2.

    The commitment of the top management to provide adequate financial and other resources for the development and operation of MNIS.

  3. 3.

    The vision of the top management to project the firm as a leader in the usage of new IT.

  4. 4.

    The level of top management support for MNIS usage in nursing care.

User Involvement and Cooperation in MNIS projects

  1. 1.

    The degree of user participation in the requirement analysis of the projects.

  2. 2.

    The degree of user participation in the vendor’s proposal review of the projects.

  3. 3.

    The degree of user participation in the system testing of the projects.

  4. 4.

    The degree of user participation in the meetings about MNIS projects.

  5. 5.

    The mutual understanding and support between the IT and the nursing departments.

Championship

  1. 1.

    The degree of the champions’ understanding of the mobile needs of nursing departments.

  2. 2.

    The capability of champions in acquiring an organization’s resources to support MNIS projects.

  3. 3.

    The capability of champions to coordinate the top management and the nursing department.

Internal Needs

  1. 1.

    The need for speeding up the response time of nursing care

  2. 2.

    The need for reducing the costs of nursing care

  3. 3.

    The need to enhance the productivity of nursing care

  4. 4.

    The need to access high quality information at the point of care

  5. 5.

    The need for improving the quality of nursing care

Technological Factors

Mobile Devices’ Suitability

  1. 1.

    Reliability of mobile devices

  2. 2.

    Battery or power supply duration

  3. 3.

    User interface friendliness

  4. 4.

    Ease of use

  5. 5.

    Portability of mobile devices

  6. 6.

    Theft prevention

  7. 7.

    Electro-magnetic interference from mobile devices with electronic medical equipment (negative item)

Wireless Communication Suitability

  1. 1.

    The compatibility with the existing network infrastructure

  2. 2.

    Data transmission speed

  3. 3.

    Availability of wireless networks

  4. 4.

    Reliability of wireless networks

  5. 5.

    Patient confidentiality protection

  6. 6.

    Radio interference from mobile communication with electronic medical equipment (reverse scoring)

The integration of MNIS with the existing hospital information systems

  1. 1.

    Database integration

  2. 2.

    Interface compatibility

  3. 3.

    The abilities of integration

Cost Benefit

  1. 1.

    Benefits of adopting MNIS.

  2. 2.

    Expected ROI increase

  3. 3.

    Resource allocation feasibility

  4. 4.

    Implementation cost (reverse scoring)

  5. 5.

    Training cost (reverse scoring)

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Hsiao, SJ., Li, YC., Chen, YL. et al. Critical Factors for the Adoption of Mobile Nursing Information Systems in Taiwan: the Nursing Department Administrators’ Perspective. J Med Syst 33, 369 (2009). https://doi.org/10.1007/s10916-008-9199-8

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