Towards a better understanding of the intention to use eHealth services by medical professionals :the case of developing countries

Abstract

Healthcare services are a necessity for every country, and particularly in developing countries, where the shortage of medical professionals is greatest. To resolve this issue, it requires substantial resources that are not available. Therefore, the recent advancement in Information and Communication Technology (ICT) provides the platform for innovative eHealth services and the opportunity for improving access to medical services. Despite Governments, International Organisations, and companies‟ growing interest in eHealth Services for enabling access to medical treatment using ICT, research in developing countries related to user behavioural intention of these services remains relatively scarce. This is a research study to identify and measure the motivational factors that would expedite the introduction and widespread use of eHealth services in developing countries. More specifically, it endeavours to understand what factors would motivate medical professionals to successfully adopt eHealth Services. The study aims to identify and measure the determinants that would lead to successful adoption of eHealth services. This thesis is, thus, a services marketing study. To achieve this goal, a literature review was conducted in order to develop an original conceptual model of eHealth services in developing countries. Based on the literature review, an exploratory qualitative study was undertaken to assess awareness and gain insight into specific motivational factors which are incorporated into the original conceptual behavioural model. A reliable and valid model to measure behavioural intention to use eHealth services in developing countries was developed. This model incorporates several influencing factors determining usage intention and the analysis also tests a set of hypotheses covering moderating effects. The experimental fieldwork was conducted in cooperation with the International Telecommunications Union Study Group on eHealth and with local medical institutions in several developing countries having formalized cooperation agreements with the University where the researcher works. The study draws on responses from a sample of 549 medical professionals from ten developing countries. As the nature of this study is exploratory, factor and multiple regression analysis were used to test the hypotheses.This thesis answered the research questions, “What are the motivational factors influencing the “intention to use” of eHealth services by medical staff in developing countries”, and the managerial sub-questions, “What do the empirical results imply for the development of marketing strategies for eHealth services in developing countries? Can medical professionals be segmented on the basis of eHealth early adoption dimensions? What marketing strategies are necessary to gain the acceptance and adoption of eHealth services in developing countries? The main contributions of this thesis to theory and practice are as follows: Overall Research Question: - What are the motivational factors influencing the “intention to use” of eHealth services by medical staff in developing countries? Value-added #1: Created a new unique behavioural intention model for developing countries (did not exist before) Value-added #2: Validated and measured new influencing factors Value-added #3: Validated new scales for a new domain, eHealth and in a new context, developing countries The Managerial sub-questions are: - What do the empirical results imply for the development of marketing strategies for eHealth services in developing countries? - Can medical professionals be segmented on the basis of eHealth early adoption dimensions? - What marketing strategies are necessary to gain the acceptance and adoption of eHealth services in developing countries? Value-Added #4: Principles of marketing strategies developed based on measured influencing factors Value-added # 5: Identified the early adopters of eHealth services based on moderation effects Value-added #6: Developed a Segmentation and positioning framework This study contributes to academic theory through the creation of a behavioural intention model for eHealth services in developing countries, and by extending and modifying the UTAUT model to a new service (eHealth) and a new environment (developing countries). eHealth has not reached critical mass and this research study aims to move this new innovative service from pilot to full-scaled schemes. The study contributes to management practice by providing a new understanding of the factors that would encourage medical professionals and medical administration to use eHealth Services. These results can be used to develop principles for a marketing strategy framework aimed at providers of eHealth services in the private sector. Specifically, this thesis identifies the early adopters of these services and proposes a market segmentation and positioning strategy focused on the key stakeholders in this field. The results of this study can also inform international bodies tasked with promoting eHealth solutions in developing countries, such as the International Telecommunications Union Development Sector to help in the progression of eHealth services in developing countries. eHealth is an important international topic and is on the agenda of international and governmental organisations, such as: the International Telecommunications Union (ITU), the World Health Organisation (WHO), the European Union (EU), and others for more than ten years. However, the diffusion of eHealth services is rather slow and for this reason it is important to understand the main obstacles and user influencing factors for developing an applied marketing strategy.