Multifaceted understanding of user behaviour and implementation success of electronic medication management system

Abstract

This study aims to comprehensively understand user behaviour and the implementation success of an electronic medication management system (eMMS) with multiple perspectives, such as user resistance, assimilation, changes in user perceptions, etc. Two cross-sectional surveys were conducted in an Australian hospital, one at the time of implementation and another one at one year after the implementation. The data collected were quantitatively analysed with SEM. FsQCA (fuzzy set Qualitative Comparative Analysis) was also employed to complement SEM-based analysis. User resistance study indicated that performance expectancy, switching costs, and facilitating conditions are direct predictors of clinician resistance, whereas effort expectancy and social influence showed indirect effects on clinician resistance through performance expectancy or switching costs. The study of changes in user perceptions indicated that most expectations had been positively confirmed in the assimilation stage. More importantly, while performance expectancy and social influence remain important one year after the implementation, effort expectancy and facilitating conditions are moving toward a decrease in importance to the success of eMMS. IT assimilation study showed that nurses with more absorptive capacity are more deeply and widely assimilated. For doctors, their direct supervisors and intrinsic motivation influence their depth of assimilation. Interestingly, nurses with a more favourable perception of performance expectancy have assimilated more deeply, whereas more deeply assimilated doctors are those with a less favourable perception of performance expectancy. FsQCA analysis showed that doctors should have a high general ability and high selfmotivation, and they should be rewarded in their performance evaluation for both high assimilation width and depth. In contrast, nurses should have a high general ability for high assimilation width and high self-motivation for high assimilation depth.