Examining the post-adoptive infusion of mobile technology in a healthcare domain: determinants and outcomes

The healthcare industry is beginning to appreciate the benefits which can be obtained from using Mobile Health Systems (MHS) at the point-of-care. As a result, healthcare organisations are investing heavily in mobile health initiatives with the expectation that users will employ the system to enhance performance. Despite widespread endorsement and support for the implementation of MHS, empirical evidence surrounding the benefits of MHS remains to be fully established. For MHS to be truly valuable, it is argued that the technological tool be infused within healthcare practitioners work practices and used to its full potential in post-adoptive scenarios. Yet, there is a paucity of research focusing on the infusion of MHS by healthcare practitioners. In order to address this gap in the literature, the objective of this study is to explore the determinants and outcomes of MHS infusion by healthcare practitioners. This research study adopts a post-positivist theory building approach to MHS infusion. Existing literature is utilised to develop a conceptual model by which the research objective is explored. Employing a mixed-method approach, this conceptual model is first advanced through a case study in the UK whereby propositions established from the literature are refined into testable hypotheses. The final phase of this research study involves the collection of empirical data from a Canadian hospital which supports the refined model and its associated hypotheses. The results from both phases of data collection are employed to develop a model of MHS infusion. The study contributes to IS theory and practice by: (1) developing a model with six determinants (Availability, MHS Self-Efficacy, Time-Criticality, Habit, Technology Trust, and Task Behaviour) and individual performance-related outcomes of MHS infusion (Effectiveness, Efficiency, and Learning), (2) examining undocumented determinants and relationships, (3) identifying prerequisite conditions that both healthcare practitioners and organisations can employ to assist with MHS infusion, (4) developing a taxonomy that provides conceptual refinement of IT infusion, and (5) informing healthcare organisations and vendors as to the performance of MHS in post-adoptive scenarios. xii ACKNOWLEDGEMENTS The researcher wishes to thank all of the people who assisted her in conducting this research. In particular, I wish to acknowledge the contribution of the following people: Firstly, I would like to thank Dr Philip O’ Reilly and Dr John O’ Donoghue, my research supervisors, for their continuous support and guidance throughout this process. They made sure I worked to the best of my ability, and for that, I thank them sincerely. I would also like to thank Professor Ciaran Murphy, Patricia Lynch, and Dr Joseph Feller for their support and encouragement throughout the years in completing this study. I would also like to thank Professor Andreev and Professor Adam for their time in reviewing my dissertation and providing me with invaluable feedback. Secondly, I would like to thank Dr Gaye Kiely who helped me throughout the study and answered all my questions, for which there were many! Special thanks go to all the lecturers who shared their knowledge and experience during and after the taught component of the PhD programme, even when they were not obliged to do so. I would like to thank Dr Brian O’Flaherty for his support throughout the process and his frequent “comments” on the Kerry football team which made my Monday mornings all that more exciting! Liz Ahern and Pat Scriven for assisting me when required and keeping me sane when the printers acted up! To all the staff, both administrative and academic, I would like to thank you for your support and assistance throughout the PhD process. Thirdly, I would like to thank all the interviewees in the University Hospitals Birmingham, NHS Foundation Trust in the UK, survey respondents in the Ottawa Hospital, Canada and all who took part in various phases of this study. Without your assistance and participation this thesis would be non-existent, so thank you.