Health IT acceptance factors in long-term care facilities: a cross-sectional survey

Abstract

Background and purpose: This study applied a modified version of the extended technology acceptance model (TAM2) to examine the factors determining the acceptance of health IT applications by caregivers in long-term care facilities. The antecedent variables, including social influence factors such as subjective norm and image were examined together with demographic variables including age, job level, long-term care work experience and computer skills in regard to their impact on caregivers' acceptance of health IT applications.

Methods: A self-administered questionnaire was developed based on the validated items from TAM2. The data was collected in a cross-sectional survey using convenience sample. Confirmatory factor analysis and structural equation modelling techniques were used to validate our causal model.

Results: Perceived usefulness, perceived ease of use and computer skills had significant positive impact, whereas image had significant negative impact on caregivers' intention to use health IT applications. Image, subjective norm and computer skills also indirectly impacted on intention through the mediating factor of ease of use. Ease of use, subjective norm and job level also determined perceived usefulness. The other demographic factors (including age and long-term care work experience) did not have any significant effect on caregivers' acceptance of a health IT application. Our model explains 34% of caregivers' intention to use an introduced IT application before any hands-on experience with the system established.

Conclusions: The planners and managers should ensure that a health IT application to be introduced into a long-term care facility is useful and easy to use. Effort should be focused on forming a positive social norm for the introduction of the new innovation and improving caregivers' computer skills. Securing the managers' and senior nurses' support for the innovation at the onset of the project is critical for success. Finally the caregivers appear to dislike the idea of increased IT ability will elevate their status.