Predicting Patients' Use of Provider-Delivered E-Health: The Role of Facilitating Conditions

Predicting Patients' Use of Provider-Delivered E-Health: The Role of Facilitating Conditions

E. Vance Wilson (Arizona State University, USA) and Nancy K. Lankton (Michigan State University, USA)
Copyright: © 2009 |Pages: 13
DOI: 10.4018/978-1-60566-016-5.ch016
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This chapter presents a new rational-objective (R-O) model of e-health use that accounts for effects of facilitating conditions as well as patients’ behavioral intention. An online questionnaire measured patients’ behavioral intention to use a new e-health application as well as proxy measures of facilitating conditions that assess prior use of and structural need for health services. A second questionnaire administered three months later collected patients’ self-reported use of e-health during the intervening period. The new model increased predictions of patients’ e-health use (measured in R2) by more than 300% over predictions based upon behavioral intention alone, and all measured factors contributed significantly to prediction of use during the three-month assessment period.
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Wilson and Lankton (2004) studied factors that contribute to initial acceptance of e-health among new registrants to a prototype e-health application. That study found patients’ behavioral intention (BI) toward e-health use is predicted well by three prominent models of IT acceptance: the technology acceptance model (TAM) (Davis, Bagozzi, & Warshaw, 1989), the motivational model (Davis, Bagozzi, & Warshaw, 1992), and the integrated model (Venkatesh, Speier, & Morris, 2002). All are examples of rational models (Ajzen, 2002; Kim & Malhotra, 2005), so named because predictions are based upon individuals’ beliefs regarding such factors as ease of use and usefulness of the IT. Within these models, effects of beliefs upon IT use behaviors are theorized to be fully mediated by BI that individuals form through rational processes. Wilson and Lankton (2004) also report that belief factors in the models are significantly predicted by three patient characteristics that are developed prior to use of e-health: satisfaction with the provider, information-seeking preference, and Internet dependence. This finding is important, as it implies that patients’ BI toward e-health use can be predicted early in design stages of application development.

Rational models of behavior have performed well in predicting individual behaviors across a wide range of research domains. In the preponderance of published studies, a positive association is reported between BI and behavior (see reviews by Ouellette & Wood, 1998; Sheppard, Hartwick, & Warshaw, 1988). Based on this substantial literature most IT acceptance studies do not assess actual use, under the assumption that IT use is normatively predicted by BI (Lee, Kozar, & Larsen, 2003). Indeed, a recent review of 277 published IT acceptance studies conducted by one of the authors finds just 13 that evaluate effects of BI on self-reported IT use. Results from these 13 studies are summarized in Table 1.

Table 1.
Review of associations between BI and self-reported IT use
ReferenceIT TypeVariance in IT Use Explained by BI
Davis et al. (1989) Word processor12-40%
Dishaw & Strong (1999) Software maintenance tool36%, including direct effect of perceived usefulness
Hartwick & Barki (1994) Business IS application35-74%
Horton, Buck, Waterson, & Clegg (2001) Intranet11%
Lai (2004) Short message services15%
Limayem & Hirt (2003) Communication application47%, including direct effects of habit and facilitating conditions
Moon & Kim (2001) World wide Web38%
Morris & Dillon (1997) Netscape Web browser19%
Shih & Fang (2004) Internet banking24%
Stoel & Lee (2003) Web-based courseware4%
Suh & Han (2002, 2003)Internet banking3%
Szajna (1996) E-mail6-32%

Complete Chapter List

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List of Reviewers
Table of Contents
Joseph Tan
E. Vance Wilson
Chapter 1
Juanita Dawson, Bengisu Tulu, Thomas A. Horan
This chapter provides a conceptual foundation by exploring the existing literature on traditional healthcare, patient-centered healthcare, and the... Sample PDF
Towards Patient-Centered Care: The Role of E-Health in Enabling Patient Access to Health Information
Chapter 2
Alejandro Mauro
This chapter introduces a series of techniques and tools useful for developing patient-centered e-health. As information technology (IT) is... Sample PDF
Patient-Centered E-Health Design
Chapter 3
Jan-Are K. Johnsen
In this chapter, we look at some fundamental aspects of communicating about ourselves and our health through technology. In particular, we examine... Sample PDF
Connecting with Ourselves and Others Online: Psychological Aspects of Online Health Communication
Chapter 4
Ebrahim Randeree
An increasing focus on e-health and a governmental push to improve healthcare quality while giving patients more control of their health data have... Sample PDF
Personal Health Records: Patients in Control
Chapter 5
Elaine A. Blechman
Newly disabled workers are often unemployed, uninsured, and indigent. They are in desperate need of Social Security OASDI monthly benefits, and the... Sample PDF
Disability Determinations and Personal Health Records
Chapter 6
E-Health Marketing  (pages 70-80)
Muhammad F. Walji, John A. Valenza, Jiajie Zhang
In this chapter, we review key concepts, using the marketing mix framework, to identify the needs of healthcare consumers, and the tools and... Sample PDF
E-Health Marketing
Chapter 7
Olli P. Järvinen
This chapter introduces the privacy management framework as a means of studying patient-centered e-health. The chapter raises some important issues... Sample PDF
Privacy Management of Patient-Centered E-Health
Chapter 8
Richard Klein
Patient-centered e-health (PCEH) offerings see the emergence of divergent, new third parties, through initiatives, including (a) medical content... Sample PDF
Trust in Patient-Centered E-Health
Chapter 9
John Powell, Natalie Armstrong
This chapter deals with the principles and practice of patient and public involvement in e-health research, and discusses some of the issues raised.... Sample PDF
Involving Patients and the Public in E-Health Research
Chapter 10
Stefano Forti, Barbara Purin, Claudio Eccher
This chapter presents a case study of using interaction design methods for exploring and testing usability and user experience of a Personal Health... Sample PDF
Using Interaction Design to Improve Usability of a PHR User Interface Based on Visual Elements
Chapter 11
Jiao Ma
This chapter explores the use of Web sites to provide patients with understandable information about the quality and price of healthcare (healthcare... Sample PDF
Healthcare Quality and Cost Transparency Using Web-Based Tools
Chapter 12
Ann L. Fruhling
This chapter is drawn from a comprehensive study that examined the effect Human-Computer Interaction usability factors had on rural residents’... Sample PDF
Perceptions of E-Health in Rural Communities
Chapter 13
Elizabeth Cummings, Stephen Chau, Paul Turner
This chapter explores how in developing patient-centred e-health systems it is possible to accommodate heterogeneous characteristics of end-users... Sample PDF
Assessing a Patient-Centered E-Health Approach to Chronic Disease Self-Management
Chapter 14
Michel J. Sassene
This chapter investigates asthmatics’ reasons for not adopting an e-health system for asthma selfmanagement. An understanding of these reasons is... Sample PDF
Incompatible Images: Asthmatics' Non-Use of an E-Health System for Asthma Self-Management
Chapter 15
Linda M. Gallant, Cynthia Irizarry, Gloria M. Boone
An extended version of the technology acceptance model (TAM) is applied to study hospital Web sites, one specific area of e-health. In a review of... Sample PDF
Exploring the Technology Adoption Needs of Patients Using E-Health
Chapter 16
E. Vance Wilson, Nancy K. Lankton
This chapter presents a new rational-objective (R-O) model of e-health use that accounts for effects of facilitating conditions as well as patients’... Sample PDF
Predicting Patients' Use of Provider-Delivered E-Health: The Role of Facilitating Conditions
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