Page - 68 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

2.1. Case Study 1: Perceived usefulness and perceived ease of use of electronic health records among nurses: Application of Technology Acceptance Model In this study of Ahmad Tubaishat from 2017 [12], 1.539 nurses from 15 Jordanian hospitals using a nursing electronic health records (EHR) were surveyed using a 28-item questionnaire based on TAM. Results show that the nurses demonstrated a positive perception of the usefulness and ease-of-use of EHRs, and their acceptance of the technology. Both Perceived Usefulness and Perceived Ease of Use had an influence on the intention to use EHRs: The effect of Perceived Usefulness explained 51% of the variance of intention to use EHRs, whereas Perceived Ease of Use predicted 42% of the variance. Perceived Usefulness was affected by gender, professional rank, EHR experience, and computer skills of the nurses, these variables explained 55% of the variance of Perceived Usefulness. The Perceived Ease of Use was affected by nursing experience, EHR experience, and computers skills, these variables explained 44% of the variance of Perceived Ease of Use. The authors concluded that training should include also basic computer skills, as this may positively influence Perceived Ease of Use and Perceived Usefulness and by this may increase EHR acceptance. The case study shows how the TAM based survey can help to identify factors for further optimization of health IT implementation. In particular, it shows which variables influence directly or indirectly Behavioral Intention to Use in this context, opening ways to intervene e.g. by training. 2.2. Case study 2: Analyzing older users' home telehealth services acceptance behavior, applying an extended UTAUT model In this study by Miha Cimperman from 2016 [13], 400 Slovenian participants aged 50 years or older were surveyed on their acceptance of a home telehealth service using UTAUT. Respondents were randomly selected equally across all regions. Respondents first got a short written explanation of the idea of home telehealth service and were then asked on their opinion on this. The survey comprised 47 standardized items based on UTAUT. Three context specific predictors were added to the original UTAUT model, namely Doctor’s Opinion, Computer Anxiety, and Perceived Security. As expected, Performance Expectancy, Effort Expectancy, Facilitating Conditions, and Perceived Security were found to have a direct impact on Behavioral Intention to Use the home telehealth service. In addition, Computer Anxiety was found to be an antecedent of Effort Expectancy with a strong negative influence, and Doctor’s Opinion influence showed a strong positive impact on Performance Expectancy. Different to the UTAUT assumption, Social Influence was not a predictor of Behavioral Intention, which authors explained by the fact the elderly users may not be so much dependent on social pressure [13]. The model of the six predictors explained 77% of the total variance of Behavioral Intention to Use, indicating a strong predictive power of the revised model [13]. The authors concluded that health professionals should be involved as social agents to frame home telehealth services as useful and beneficial, as this will raise acceptance among the users. Also, home telehealth services should be promoted as secure, to build trust. Different types of technical equipment should be made available to reduce computer anxiety. Due to low social influence, they see it as unlikely that early adopters E.Ammenwerth /TechnologyAcceptanceModels inHealth Informatics: TAMandUTAUT68