EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING

HEALTHCARE PROFESSIONAL ACCEPTANCE OF

TELEMONITORING FOR CHRONIC PATIENTS

Estibalitz Orruño1, Marie-Pierre Gagnon2-3, José Asua4, Eva Reviriego1

1 Basque Office for Health Technology Assessment (Osteba), Department of Health and Consumer Affairs, Basque Government, Vitoria-Gasteiz, Spain.

2 Faculty of Nursing Sciences, Université Laval, Québec, Canada.3 Research Centre of the Centre Hospitalier Universitaire de Québec, Québec, Canada.

4 Direction of Knowledge Management and Evaluation, Department of Health and Consumer Affairs, Basque Government, Vitoria-Gasteiz, Spain.

Outline of the presentation

Introduction Objectives Methodology Results Conclusions and Implications

Introduction

IT use in the health sector has an enormous potential to help to improve the quality of the services offered.

A key factor is that the health professionals are ready to accept those new technologies.

The acceptance of telemedicine applications by the health professionals constitutes an important requirement for the fruitful diffusion of this technology on a large scale.

Introduction

In the Basque Country, pilot telemedicine projects have been developed to support the delivery of care, inside the “Tackling the Challenge of Chronicity”.

For instance, home telemonitoring for patients with chronic diseases is viewed as a promising solution to lessen the burden on health care organisations and professionals.

However, we know little about the factors that could facilitate or impede health professionals’ willingness to engage in telehomecare.

Objetives

Based on the Technology Acceptance Model (TAM), this study examines the main factors that could affect healthcare professionals' intention to use telemonitoring technology.

Methods

A validated questionnaire, based on an extension of the TAM, was distributed to a total of 605 nurses, general practitioners and paediatricians.

Cronbach alpha were calculated to measure the reliability of the model.

Construct validity was evaluated using inter-item correlation analysis.

Logistic regression analysis was performed to test the theoretical model.

Adjusted odds ratios (OR) and their 95% confidence intervals (CI) were computed.

Adapted Technology Acceptance Model

Results A global response-rate of 44.3% was

achieved (n = 268): 131 Nurses 122 Physicians 15 Paediatricians

The internal consistency of theoretical constructs was high (Cronbach α between 0.80 and 0.96).

All theoretical variables were well correlated (r > 0.6) with Intention to use, except Habit.

Results

Charateristics frequency percent

Gender     Women 209 78.0 Men 59 22.0Age     <30 11 4.1 30-39 43 16.0 40-49 93 34.7 50-59 117 43.7 >60 4 1.5Years in clinical practice  mean = 21.3 (SD=9.1)

Results The original TAM model was good at

predicting intention to use the telemonitoring system (χ2 was significant; Nagelkerke R2 = 0.63).

However, the extended model, which included other theoretical variables, was still significant and more powerful (Nagelkerke R2 = 0.72).

Perceived Usefulness, Compatibility and Facilitators were the significant predictors of intention.

Results

Independent variables

Multivariate regression

OR

95% CI p

Original TAM

     

Perceived usefulness

5.283.14-10.01

0.000

Perceived ease of use

1.93 1.11-2.37 0.020Nagelkerke R2 = 0.63

Results

Nagelkerke R2 = 0.72

Independent variables

Multivariate regression

OR

95% CI p

Extended TAM      Perceived usefulness

2.65 1.15-6.12 0.022

Perceived ease of use

0.66 0.31-1.39 0.276

Compatibility 3.06 1.30-7.18 0.010Subjective Norm 1.06 0.56-2.03 0.851Facilitators 4.90 2.38-10.09 0.000Habit 2.56 0.56-11.70 0.226

Results

A detailed analysis showed that intention to use telemonitoring was best predicted by:

Healthcare professionals’ belief that they would obtain adequate training and technical support;

Belief that telemonitoring would require important changes in their practice.

Discussion

Our findings show that the extended TAM is a good predictive model of healthcare professionals’ intention to use a telemonitoring system for chronic care patients in primary care.

The perception of facilitators in the organisational context is the most important variable to consider for increasing healthcare professionals’ intention to use the new technology.

Implications for the health system/professionals/patients/society

This study confirms the value of this framework for examining telemonitoring acceptance among primary care professionals

The Modified TAM questionnaire provides a validated instrument for the investigation of key factors for successful telemedicine implementation.

For more detailed information:e-orruno@ej-gv.esmarie-pierre.gagnon@fsi.ulaval.cajasua@ej-gv.es