Measuring Patients’ Perceptions and Social Influence on Home Telecare Management System Acceptance

1. Introduction

Home Telecare Management System (HTMS) (Lovell et al., 2002; Celler et al., 2003; Rahimpour, 2006), a kind of new innovative technology, is designed to record clinical indicators of a patient’s health status and provides feedback to patients including medication reminders and measurement scheduling (Celler et al., 2003). Generally, HTMS incorporates an extensive suite of clinical instruments including a wireless weight scale, single lead electrocardiogram, hemadynamometer, spirometer, thermometer, (pulse) oximeter, uricometer, and Internet enabled tools to facilitate patient management long-distance by the healthcare team (Rahimpour, 2006). Although prior studies showed that home telecare could improve outcomes from patients with congestive heart failure and reduce the cost of their care (Jerant et al., 2001); and could facilitate greater “continuity of care” due to improving access and supporting the process of disease management by practitioners (Balas et al., 1997). The implementation of a Home Telecare Management System may encounter user resistance, particularly when technical innovation is applied to manage chronic healthcare in elderly patients who are unfamiliar with modern technology (Rahimpour, 2006). Therefore, in order to gain benefit from this technology and successfully implement HTMS program, it is important to understand patients’ perceptions of HTMS from the psychological issues such as what are their concerns, how about their involvement in home telecare services, whether they believe that they can use the system independently, what factors are important in their acceptance, what is the influence of home telecare service on patients’ quality of life and health status. The reason is that patients’ perceptions of home telecare influence its acceptability and diffusion (Demeris, 2000).

According to the research of Rahimpour (2006) and Ramhimpour et al. (2008), Technology Acceptance Model (TAM) (Davis, 1986) can be as an analytical lens to explore patients’ perceptions and acceptance of HTMS. In the TAM, user acceptance is evaluated by assessing users’ beliefs, attitudes, intentions, and actual usage behavior. However, as several IS researchers (Davis, 1986; Davis, 1989; Davis et al., 1989; Hufnagel & Conca, 1994; Melone, 1990) have pointed out, TAM is incomplete in one important respect: it doesn't account for social influence (SI) in the adoption and utilization of new information systems. Davis (1986) and Davis et al. (1989) noted that it is important to account for subjective norm (SN), the construct denoting social influence. Legris, Ingham, and Collerette (2003) also stated that TAM is a useful model, but must be integrated into a broader model which would include variables related to both human and social change processes. Therefore, Malhotra and Galletta (1999) extend the technology acceptance model to account for social influence. Their study contributes to understanding the role of social influences related to individual acceptance and usage behavior in the implementation of new information technologies.

Since the HTMS is a kind of innovative technology that is used to assist patients in health management, we infer that social influence may also have an importance influence on patients’ perception and acceptance of HTMS. Therefore, we will adopt Kelman’s (1958) processes of social influence (compliance, identification, and internalization) to explore their effects on patients’ attitudes and behavioral intentions toward using HTMS. In light of past and current research on the TAM, Rahimpour’s (2006) conceptual framework of patients’ perceived HTMS, and Kelman’s (1958) social influence processes, the object of this study is intended to develop a completed theoretical model to investigate patients’ perceptions and acceptance of HTMS.