What is the point of the point-of-care? A case study of user resistance to an e-health system

Abstract

The purpose of this article is to explore the response of nurses to a point-of-care e-health system that was implemented in a large private hospital in South Africa, to determine why the nursing staff rejected the implementation of the system. The study examines user responses with reference to a model designed to account for the use and adoption of mobile handheld devices, having adapted the model for an e-health context. In addition to the input features of technological characteristics and individual differences identified in the model, the added features of nursing culture and group differences were found to be influential factors in fuelling the nurses' resistance to the point-of-care system. Nurses perceived a lack of cultural fit between the system and their work. Their commitment to their nursing culture meant that they were not prepared to adapt their processes to integrate the system into their work. The study shows that the model is useful for understanding adoption in an organizational context and also that the additional elements of nursing culture and group differences are important in an e-health context.