Assessing the Physicians' Acceptance of E-Prescribing in a Developing Country: An Extension of the UTAUT Model With Moderating Effect of Perceived Organizational Support

Assessing the Physicians' Acceptance of E-Prescribing in a Developing Country: An Extension of the UTAUT Model With Moderating Effect of Perceived Organizational Support

Ikram Ullah Khan (School of Management, University of Science and Technology of China, Hefei, China), Yugang Yu (School of Management, University of Science and Technology of China, Hefei, China), Zahid Hameed (Department of Management Sciences, Khwaja Fareed University of Engineering and Information Technology, Rahim Yar Khan, Pakistan), Safeer Ullah Khan (Donlinks School of Economics and Management, University of Science and Technology Beijing, Beijing, China) and Abdul Waheed (Donlinks School of Economics and Management, University of Science and Technology Beijing, Beijing, China)
Copyright: © 2018 |Pages: 22
DOI: 10.4018/JGIM.2018070109
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This article describes how physicians in developing countries spend much time and effort in handling manual prescriptions, which can be easily reduced with the help of online technology. Although different theoretical models for technology acceptance have been thoroughly explored, there is as yet sparse literature regarding its use in the context of healthcare in developing countries, especially with innovative models. To this end, this article uses an integrative model of Unified Theory of Acceptance and Use of Technology (UTAUT) extended by perceived credibility to better understand the acceptance of e-prescribing among physicians in a developing Asian country. In addition, the article uses perceived organizational support as a moderator between behavioral intentions and usage of technology. Using a survey method, the article collects data from 295 physicians in the capital city of Pakistan and analyzes the data through structural equation modeling (SEM) to evaluate relationships among the identified constructs. The authors' results supply empirical evidence that performance expectancy, effort expectancy, facilitating conditions, social influence, and perceived credibility all have a positive and significant impact on physicians' behavioral intentions to adopt e-prescribing. The article also concludes that the higher the perceived organizational support, the higher the use of e-prescribing. The study enriches theory and practice by giving implications for both academicians and practitioners.
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1. Introduction

Information and communications technology (ICT) has been rightly embedded deep in every sphere of life and has made the social life more standardized today, especially in providing IT-facilitated healthcare (Jang, Kim, & Lee, 2016). The proliferation of ICT has been a revolutionary force and has ensured the provision of quality health services in patient care, safety, and delivery cases (Blumenthal & Glaser, 2007; Tao, Shao, Liu, Wang, & Qu, 2016; Yarbrough & Smith, 2007). In the health management perspective, it is extremely important to provide health services that are quality, inexpensive and quick to the general masses, because people are conscious of their time, effort, and costs while using hospitals and consulting their physicians. Holden and Karsh (2010) considered the electronic developments in hospitals as a healthcare innovation which results in ubiquitous healthcare to the common people. The revolution in health technology needs adequate understanding to assimilate it deeply into society for better and smarter health future (Aarts & Gorman, 2007) and for transparent administration and supply of medicine through decision support systems.

Prescribing medicine is a general phenomenon in healthcare, where physicians select appropriate medicine for patients and send them to pharmacies to ensure dispensing the medicine[s] in the right quantity and quality (Mohan, Sharma, & Panwar, 2014). In the traditional prescription method, physicians write a prescription manually for their patients who visit the doctor’s office. Each patient then takes the hand-written prescription to the pharmacy to get the medicine[s] (Smith, 2006). In electronic prescribing (e-prescribing), the physician sends the patient prescription electronically to a pharmacist or another department in an accurate, understandable, and error-free way (Kooienga & Singh, 2016). E-prescribing is a long overdue alternative to the hand-written prescriptions for almost billions of drug treatments annually (Salmon & Jiang, 2012). E-prescribing facilitates both physicians and pharmacies by creating and passing the prescription electronically (Lapane, Waring, Schneider, Dubé, & Quilliam, 2008). E-prescribing reduces errors and increases efficiency while enabling direct communications between physicians and pharmacy offices (Lawrence, 2010).

Warholak and Rupp (2009) discussed the costs of e-prescribing, considering that it can endanger patients’ lives if wrong information is given while entering dosing directions or drugs medication. In common parlance, technology has dark aspects that can harm human lives if it is fed wrong information or not properly conducted as per standard operating procedures. The previous literature on e-prescribing indicates that physicians hesitate to adopt e-prescribing due to unintended medication errors that can jeopardize the patients’ health (Zadeh & Tremblay, 2016). In this regard, further study would benefit by bringing physicians’ behavior into line with the expected future online health services. This might help improve the quality of healthcare, reduce medical errors, and advance the use of appropriate and complete information to manage each patient’s prescription in a speedy, uninterruptable, and reliable way. Investigating the relationship of second-generation e-prescribing and outcomes of community pharmacists through a quantitative survey method, Peikari, Shah, Zakaria, Yasin, and Elhissi (2015) concluded that the outcomes can be improved with the help of improving features of the e-prescribing system. E-prescribing has not only strengthened the authentication process of writing, transmitting, and checking the prescriptions but also has facilitated the presentation of prescription information for onward transmission (Kivekäs, Enlund, Borycki, & Saranto, 2016). E-prescribing is regarded as very useful for patient care efficiency (Hsu et al., 2015); it has large economic benefits for the hospitals (Ahmed, Barber, Jani, Garfield, & Franklin, 2016); it ensures a transparent supply of medicine which provides an auditable platform for the entire medication process (Cornford, Dean, Savage, Barber, & Jani, 2009); and it improves cross-border health cooperation and patient registration (Kierkegaard, 2013).

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