Adoption and Use of Public Hospital Information Systems in Croatia Based on PLS-SEM Analysis

Adoption and Use of Public Hospital Information Systems in Croatia Based on PLS-SEM Analysis

Josipa Osvaldic Galic (Poliklinika Medikol, Croatia), Mirjana Pejic-Bach (Faculty of Economis and Business, University of Zagreb, Croatia), Sarwar Khawaja (SK-Research-Oxford Business College, Oxford, UK), Fayyaz Hussain Qureshi (SK-Research-Oxford Business College, Oxford, UK), and Pradeep Dwivedi (Sage University, Indore, India)
Copyright: © 2025 |Pages: 23
DOI: 10.4018/IJESMA.365287
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Abstract

The Hospital Information System (HIS) is a key digital platform facilitating communication and information sharing. Despite its potential, full utilization of HIS remains limited. This study explores factors influencing HIS adoption in Croatia, focusing on expected performance, expected effort, social influence, and system support. Data from a survey conducted at General Hospital Bjelova was analyzed through Partial Least Squares Structural Equation Modelling (PLS-SEM). Results show that expected performance and effort significantly enhance the intention to use HIS. Social influence from colleagues positively impacts intention, while administrative processes negatively affect it, fostering resistance among users. Intention to use HIS positively correlates with its intensity in daily operations but negatively affects occasional usage. These findings provide insights into optimizing HIS implementation and enhancing user engagement, offering practical recommendations for healthcare administrators and policymakers.
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Introduction

Digital transformation is reshaping industries by integrating innovative technologies into business processes, enabling agility, efficiency, and new value creation. Ramljak, Tajalić, and Brkljačić (2024) highlight the role of agile methodologies in navigating digital transformation, emphasising their impact on fostering adaptability and responsiveness in dynamic environments. Tomičić-Pupek et al. (2023) explore the intersection of disruptive business model innovation and digital transformation, noting how leveraging digital tools drives competitive advantage and reinvents traditional business practices. In the European Union, digital transformation has shown varied progress across regions, with Huňady et al. (2024) noting an accelerated adoption during the COVID-19 pandemic but persistent disparities between countries. Similarly, Hunady et al. (2022) observe a north-south divide in digital maturity within the EU, with northern countries leading in technological adoption and southern regions facing structural challenges. Together, these studies emphasise digital transformation as a complex yet essential journey, requiring organisational agility, strategic innovation, and regional cooperation to bridge gaps and drive sustainable growth. Digital transformation is reshaping hospitals by fostering the development of platform ecosystems that enhance operational efficiency and patient engagement. As Hermes et al. (2020) highlight, these ecosystems empower patients with greater access to healthcare data and services while streamlining processes for providers, ultimately transforming the traditional roles within the healthcare industry and paving the way for more personalised and efficient care delivery.

The hospital information system (HIS) is a platform designed to facilitate the exchange of information, communication, and transactions among all participants in the hospital system (Stoumpos et al., 2023). While these systems are available to all stakeholders except patients, their utilisation remains incomplete among certain user groups. Public hospital information systems, often referred to as hospital planning systems, originated in the 1960s and had a primary focus on administrative management (Dezelic et al., 2014). HIS typically consists of a central system complemented by peripheral subsystems, which are often disconnected from one another. These peripheral subsystems cater to different levels of healthcare, including primary care, secondary and tertiary care, and health organisations (White, 2015). Despite the growing adoption of HIS, understanding the factors influencing user behaviour remains limited, particularly in the context of health app adoption. These factors often vary with each HIS implementation project (Esmaeilzadeh et al., 2011). Increasing interest has been directed toward understanding what drives users to adopt systems developed by others. However, research on technology adoption in healthcare, especially in low-resource settings, remains scarce (Weck & Afanassieva, 2023). According to Hu (1998) and Zakaria and Yusof (2001), technology acceptance is influenced by three key factors: personal attributes, technological characteristics, and organisational context. Additionally, low levels of acceptance among specific user groups can increase the risk of implementation failure (Lakbala & Dindarloo, 2014).

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