A Deterrence Approach to Regulate Nurses' Compliance with Electronic Medical Records Privacy Policy.

Hospitals have become increasingly aware that electronic medical records (EMR) may bring about tangible/intangible benefits to managing institutions, including reduced medical errors, improved quality-of-care, curtailed costs, and allowed access to patient information by healthcare professionals regardless of limitations. However, increased dependence on EMR has led to a corresponding increase in the influence of EMR breaches. Such incursions, which have been significantly facilitated by the introduction of mobile devices for accessing EMR, may induce tangible/intangible damage to both hospitals and concerned individuals. The purpose of this study was to explore factors which may tend to inhibit nurses' intentions to violate privacy policy concerning EMR based upon the deterrence theory perspective. Utilizing survey methodology, 262 responses were analyzed via structural equation modeling. Results revealed that punishment certainty, detection certainty, and subjective norm would most certainly and significantly reduce nurses' intentions to violate established EMR privacy policy. With these findings, recommendations for health administrators in planning and designing effective strategies which may potentially inhibit nurses from violating EMR privacy policy are discussed.

An empirical study of adopting mobile healthcare service: the family's perspective on the healthcare needs of their elderly members.

In an aging society, the issue of increased medical costs troubles both government agencies and families with aging parents. Many elderly people require long-term care, and the medical and financial problems associated with long-term care worry their entire family. Mobile healthcare service (MHS) has been widely applied by medical practitioners and researchers for years. Unfortunately, the elderly often fear both the technology and the cost its use incurs; hence, they seldom actively adopt MHS without the prompting and support of other family members. This study highlights this issue of long-term healthcare for the elderly and extracts the factors affecting their family's intentions in adopting MHS. Based on the integration of the Theory of Planned Behavior and the Technology Acceptance Model, the factors associated with the family's intention of the aging people toward MHS are explored. Data were collected from 200 students in the "Job Master" track in a local "Executive Master of Business Administration" program. Half of them had at least one immediate family member who was older than 65 years of age. A partial least squares (PLS) analysis shows that "attitude" significantly affected the behavioral intention of adopting MHS, and "perceived usefulness" and "perceived ease-of-use" had an indirect effect via "attitude." The PLS model explains the variance in intention (64.1%), attitude (58.1%), and perceived usefulness (33.8%). Overall, this study shows that attitude was an important determinant of MHS adoption. Gender also significantly affected the relationship between attitude and behavioral intention to adopt MHS.

Mobile information and communication in the hospital outpatient service.

OBJECTIVES: Most healthcare providers provide mobile service for their medical staff; however, few healthcare providers provide mobile service as part of their outpatient service. The mobile outpatient service system (MOSS) focuses on illness treatment, illness prevention and patient relation management for outpatient service users. Initiated in a local hospital in Taiwan, the MOSS pilot project was developed to improve outpatient service quality and pursue higher patient safety. METHOD: This study focuses on the development of the MOSS. The workflow, architecture and target users of the MOSS are delineated. In addition, there were two surveys conducted as part of this study. After a focus group of medical staff identified areas in which outpatient services might be improved by the MOSS, the first survey was administered to outpatients to confirm the focus group's intuitions. The second administration of the survey explored outpatient satisfaction after they used the MOSS service. RESULTS: With regard to outpatient attitudes, about 93% of participants agreed that the mobile outpatient service improved outpatient service quality. In the area of outpatient satisfaction, about 89% of participants indicated they were satisfied with the mobile outpatient service. DISCUSSION/CONCLUSION: Supported by our study finding, we propose that more diverse mobile outpatient services can be provided in the future.

Factors affecting the adoption of electronic signature: Executives' perspective of hospital information department.

The healthcare industry is experiencing a major transformation towards e-healthcare, which delivers and enhances related information through the Internet among healthcare stakeholders and makes the electronic signature (e-signature) more and more important. This paper uses a mature framework, Technology-Organization-Environment (TEO), in information system discipline to identify factors that affect hospitals in adopting e-signature. A survey was conducted on regional hospitals and medical centers in Taiwan to verify the validity of the research framework. The results show that TEO framework is useful in distinguishing hospitals as adopters and non-adopters of e-signature. Based on the research findings, implications and limitations are discussed.

The adoption of mobile health management services: an empirical study.

As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people. In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption of personal health management services is one way to maintain current levels of personal health and to efficiently manage the distribution of healthcare resources. This study introduces Mobile Health Management Services (MHMS) and employs the Technology Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile health management technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed that "perceived usefulness" and "attitude" significantly affected the behavioral intention of adopting MHMS. Both "perceived ease of use" and "perceived usefulness," significantly affected "attitude," and "perceived ease of use" significantly affected "perceived usefulness" as well. The results also show that the determinants of intention toward MHMS differed with age; young adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably promote the management of personal health among this population. Successful promotion of personal health management will contribute to increases in both the level of general health and the efficient management of healthcare resources.

An assessment of patient safety in acupuncture process under EMR support.

With the facilitating roles of IT, this study is to investigate the safety issues of the acupuncture process in the current practices under EMR support. A self-administered questionnaire survey was conducted in 80 Chinese medicine practice hospitals and clinics in Taiwan. Concerns over patient safety during the acupuncture process were raised, such as an inconsistency between the practice and prescription and a lack of monitoring patient's condition during the treatment. Confirming the physicians' prescription and documenting patients' reaction for patient record management are needed to add to the EMR system for patient safety while performing acupuncture. The results of this study can be used by the government or medical institutes to assess the work flow and set up standards of EMRs design for their acupuncture treatment to ensure patient safety and to enhance healthcare quality.

Assessing the quality of a web-based learning system for nurses.

Continuing professional education is essential for nurses to update their clinical skills and knowledge to meet the complex demands of current patient care. Compared to traditional in-class continuing education, a web-based learning system is efficient for nurses with a three shift-working schedule and is timely to deliver knowledge about newly emerging epidemics such as Severe Acute Respiratory Syndrome. Many studies reveal the advantages of various web-based learning systems but seldom evaluate them from the perspective of quality. This study develops an instrument to assess the quality of a web-based learning system for nurses' continuing education based on the quality dimensions of a mature information systems success model. The research results show that all indicators of the instrument provide a fit to the quality measurement of a web-based learning system and have high reliability and validity. Based on the research findings, implications and limitations are discussed.