Adoption of Digital Healthcare with the Concept of the Patient as an Organisation
Authors: Gupta Atantra Das 
Published: June 2022

Abstract
Background: The concept of a patient as an organization in the discussion based on the adoption of digital healthcare delivered through technology is unique because, till date, attributes of the patient-doctor relationship, such as trust, advocacy, acuity, and engagements, have been considered concepts in the several works of literature. Furthermore, while studying different organizational metaphors, the study described organisms as organizations, an idea that fits parameters similar to those of patients. Existing research, "An Integrative Model of Patient-Centeredness," highlights the lack of patient-centeredness in the traditional event-based doctor-patient model. Hence, the argument is that by adopting technology and empowering the patient as an organization, can script a new chapter of primary healthcare all over the world? Where primary healthcare is still a neglected phenomenon by the larger population and the government. In large countries like India, only 6 to 7% of healthcare spending is on primary healthcare, while 56% done in secondary and tertiary healthcare. It has impaired the development of robust healthcare infrastructure to combat bioterrorism and deadly pandemic like Covid. Hence failed to avoid adverse economic effects due to prolonged lockdown. Further, failing to harness the demographic dividend in the absence of proper healthcare infrastructure for countries like India. therefore, improved primary healthcare through technology intervention and increased patient empowerment will usher a new era of quality healthcare for all. The prevalence of mobile phones and wearables are considered vital components of digital health acceptance. However, the factors like data privacy, security, reliability, and use-ability that influence the general population's acceptance of digital healthcare remain unclear.Objective: This study aimed to identify the factors affecting digital health acceptance using the TAM (Technology Acceptance Model ), HB(Health Belief model), and the UTAUT (Unified Theory of Acceptance and Use of Technology ). The argument is made that the adoption of the technology enables patients to create resources (i.e., data), transforming patients from consumers to producers because it is giving birth to the 'Virtual Self,' i.e., the digital manifestation of the human body.Methods: I proposed extended versions of the TAM and HB model and used them to conduct a cross-sectional survey of individuals across multiple age groups. In total, I collected 164 usable responses. Used variable loadings, Cronbach's alpha, and composite dependability (CR) to examine the validity of the measurements. Partial least squares (PLS) investigated digital health acceptance factors.Results: PLS analysis showed that health beliefs and perceived ease of use had positive effects on the perceived usefulness of digital healthcare, and system capabilities positively impacted perceived ease of use. Furthermore, perceived service, the customer's willingness to change and reference group influence significantly impacted adoption intention (b > 0.1, t > 1.96, p < 0.05). However, privacy protection and data security, online healthcare resources, and user guidance were not positively associated with perceived usefulness.Conclusions: Perceived usefulness, the customer's willingness to change, and the influence of the reference group are decisive variables affecting adoption intention among the general population, whereas privacy protection and data security are indecisive variables. Online resources and user guides do not support adoption intentions. This study adds to the knowledge on digital health adoption in primary and preventive healthcare.