“Doctors Do Too Little Technology”: A Longitudinal Field Study of an Electronic Healthcare System Implementation

With the strong ongoing push toward investment in and deployment of electronic healthcare (e-healthcare) systems, understanding the factors that drive the use of such systems and the consequences of using such systems is of scientific and practical significance. Elaborate training in new e-healthcare systems is not a luxury that is typically available to healthcare professionals—i.e., doctors, paraprofessionals (e.g., nurses) and administrative personnel—because of the 24 × 7 nature and criticality of operations of healthcare organizations, especially hospitals, thus making peer interactions and support a key driver of or barrier to such e-healthcare system use. Against this backdrop, using social networks as a theoretical lens, this paper presents a nomological network related to e-healthcare system use. A longitudinal study of an e-healthcare system implementation, with data gathered from doctors, paraprofessionals, administrative personnel, patients, and usage logs lent support to the hypotheses that: (1) ingroup and outgroup ties to doctors negatively affect use in all user groups; (2) ingroup and outgroup ties to paraprofessionals and administrative personnel positively affect use in both those groups, but have no effect on doctors' use; and (3) use contributes positively to patient satisfaction mediated by healthcare quality variables—i.e., technical quality, communication, interpersonal interactions, and time spent. This work contributes to the theory and practice related to the success of e-healthcare system use in particular, and information systems in general.