The National Renal Patient Record System and Technology Acceptance Ali Al-iady A dissertation ...

159 Pages·2011·2.27 MB·English

The National Renal Patient Record System and
Technology Acceptance

Ali Al-iady

A dissertation to the University of Dublin, in partial fulfilment
of the requirements for the degree of
Masters of Science in Health Informatics

2011
Declaration
I declare that the work described in this dissertation is, except where otherwise
stated, entirely my own work, and has not been submitted as an exercise for a
degree at this or any other university.

Signed: ____________
Ali Al-iady
Date: ______________

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Permission to lend and/or copy
I agree that the Trinity College Library may lend or copy this dissertation upon
request.

Signed: _______________
Ali Al-iady
Date: _________________

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Acknowledgement
The researcher would like to pay his regards to all the people that contributed in many ways
to make this dissertation possible. A special debt is owed to Dr. Gaye Stephen who guided
me throughout the research process and constructively criticised my work to make it better.
Many thanks to all the survey respondents for their volunteer participation in this research.
The researcher would also like to thanks the administration of two hospitals for allowing the
researcher to conduct research in their premises and to collect data from their staff members.
Special thanks to my family members and friends for their understanding, support and
encouragement. A Special thanks to my big sister Fatima ( RIP 29/07/2011) who gave me the

love and care, I will keep remember her in my prayers.

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Summary
The prevalence and incidence of renal diseases worldwide is on increase. This is also evident
in Ireland where it has become more difficult to manage the large number of patients
presenting with renal failure. Keeping in view the reported benefits of these Electronic
Patient Record Systems (EPRS) on the health-care system, two hospitals – Letterkenny
Hospital and Sligo Hospital - have recently introduced into their haemodialysis units an
EPRS, named eMEDRenal. Mindful of the critical need of a renal patient record system in
Ireland, the present study investigates and describes the degree to which the staff members of
these two units have accepted the new system and are ready to use it, with the help of a
technology acceptance model. The technology acceptance model has been designed after
reviewing a number of important technology acceptance models used in previous studies.
The acceptance of the eMEDRenal system was benchmarked using a number of factors that
can affect the user acceptance of technology. The study noted that staff members from both
hospitals considered the eMEDRenal system to be useful for their professional career and
claimed that it was easy to use. Staff members also regarded themselves as ready to use an
EPRS and had a positive attitude towards the eMEDRenal system. The study also found that
there is little difference in the acceptance of the eMEDRenal system among doctors and
nurses. The study also proposed a technology acceptance model for future testing.
Because the study has found the eMEDRenal system to be an acceptable EPRS for recording
and sharing renal patients‟ data in the two hospitals of Ireland, it is suggested that the
eMEDRenal system ought to be introduced into other haemodialysis units as well. However,
for improved perceived readiness and ease of use among users, it is important to provide
training on the use the eMEDRenal system to staff members prior its introduction into
haemodialysis units a cross Ireland.

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Table of Content

Table of Content ............................................................................................................................ iv
List of Tables and Figures.............................................................................................................. ix
Tables ............................................................................................................................................. ix
Figures............................................................................................................................................. x
Abbreviations ................................................................................................................................ xii
CHAPTER 1 ................................................................................................................................... 1
INTRODUCTION .......................................................................................................................... 1
1.1 Study Background ............................................................................................................ 1
1.2 Research Questions .......................................................................................................... 2
1.3. Study Rationale ............................................................................................................... 2
1.4. Hypotheses ...................................................................................................................... 3
1.5. Outline of Dissertation .................................................................................................... 4
CHAPTER 2 ................................................................................................................................... 6
LITERATURE REVIEW ............................................................................................................... 6
2.1 Introduction ...................................................................................................................... 6
2.2 Renal Diseases in Ireland ................................................................................................. 7
2.2.1 Incidence and Prevalence .......................................................................................... 9
2.2.2. Treatment Facilities: .............................................................................................. 10
2.2.3. Control and Prevention Services:........................................................................... 12
2.3 Electronic Patient Record System .................................................................................. 13
2.3.1 Electronic Patient Record System Acceptance ....................................................... 17
2.3.2 Electronic Patient Record System in Ireland .......................................................... 20
2.4. The eMEDRenal System............................................................................................... 21
2.4.1 The eMEDRenal Foundation .................................................................................. 23
2.4.2 The Current Use of eMEDRenal: ........................................................................... 26

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2.4.3 The Compliance of eMEDRenal with EHR and Renal Registry Standards ........... 26
2.5 Development of Conceptual Model ............................................................................... 27
2.5.1 Technology Acceptance Model .............................................................................. 27
2.5.2. Technology Acceptance Model in Healthcare ....................................................... 33
2.5.3. Other Models of Technology Acceptance in Healthcare ....................................... 36
2.5.4. Conceptual Model for eMEDRenal Acceptance.................................................... 38
2.6 Hypotheses Development .............................................................................................. 40
CHAPTER 3 ................................................................................................................................. 41
RESEARCH METHODOLOGY.................................................................................................. 41
3.1. Introduction ................................................................................................................... 41
3.2. Research Philosophy ..................................................................................................... 42
3.3. Research Approach ....................................................................................................... 43
3.4. Research Method .......................................................................................................... 44
3.5. Research Design............................................................................................................ 45
3.5.1. Literature Review................................................................................................... 47
3.5.2. Development of Technology Acceptance Model .................................................. 48
3.5.3. Development of Hypotheses .................................................................................. 48
3.5.4. Designing of Survey Questionnaire ....................................................................... 48
3.5.5. Selection of Initial Sample ..................................................................................... 50
3.5.6. Taking Consent from Final Sample and Formal Permission from Hospitals ........ 50
3.5.7. Data Collection ...................................................................................................... 51
3.5.8. Data Analysis ......................................................................................................... 52
3.5.9. Hypotheses Testing ................................................................................................ 52
3.5.10. Deriving Conclusion ............................................................................................ 53
3.6. Ethical and Legal Considerations ................................................................................. 53
3.7. Limitations. ................................................................................................................... 54
CHAPTER 4 ................................................................................................................................. 56

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RESULTS AND DISCUSSION ................................................................................................... 56
4.1. Introduction ................................................................................................................... 56
4.2. Reliability Analysis ....................................................................................................... 56
4.3. Socio-Demographics ..................................................................................................... 56
4.3.1. Age ......................................................................................................................... 57
4.3.4. Profession ............................................................................................................... 59
4.4. Descriptive Statistics ..................................................................................................... 60
4.5. T-test: ............................................................................................................................ 63
4.6. Bivariate Correlation Analysis ...................................................................................... 67
4.7. Discussion on Study Findings:...................................................................................... 76
CHAPTER 5 ................................................................................................................................. 82
CONCLUSIONS AND RECOMMENATIONS .......................................................................... 82
5.1. Introduction ................................................................................................................... 82
5.2. Conclusions ................................................................................................................... 82
5.2.1. Acceptance of the eMEDRenal system among Hospital Staff ............................. 82
5.2.2. Acceptance of the eMEDRenal system among Doctors and Nurses ..................... 83
5.2.3. Revised Technology Acceptance Model ............................................................... 83
5.3. Recommendations ......................................................................................................... 85
5.3.1. Recommendations for Future Research ................................................................. 85
5.3.2. Recommendations for Practice .............................................................................. 86
5.4. Limitations .................................................................................................................... 87
REFERENCES ............................................................................................................................. 88
APPENDICES ............................................................................................................................ 100
Appendix A: Survey Questionnaire ................................................................................... 100
Questionnaire ................................................................................................................. 100
Appendix B: Information Letter and Consent Form. ......................................................... 106
Information Letter .......................................................................................................... 106

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Consent Form for Study Participants ............................................................................. 108
Appendix C: Tables of Bivariate Correlation Analysis ..................................................... 109
Letterkenny Sample ....................................................................................................... 109
Sligo Sample .................................................................................................................. 111
Both Letterkenny and Sligo Sample .............................................................................. 114
Appendix D: Tables of Independent Sample t-test ............................................................ 115
Appendix E: Ethics Committee Application Forms. ......................................................... 118
School of Computer Science and Statistics Research Ethical Application Form .......... 118
Request Ethical Approval from SCSS.TCD .................................................................. 126
Request Ethical Approval from Letterkenny General Hospital ..................................... 127
Request Ethical Approval from Sligo General Hospital ................................................ 128
Request Permission To Conduct A Study(Sligo) .......................................................... 147
Appendix F: Ethics Approval Letter .................................................................................. 149
Ethics Approval Letter From SCSS.TCD ...................................................................... 149
Permission To Conduct A Study (Sligo Hospital) ......................................................... 150
Permission To Conduct A Study (Letterkenny Hospital) .............................................. 151

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List of Tables and Figures
Tables
Table 2.1: Renal units in Ireland 11
Table 4.1: Age distribution of study sample 57
Table 4.2: Gender distribution of study sample 58
Table 4.3: Sample‟s level of education 58
Table 4.4: Sample‟s profession 59
Table 4.5: Descriptive Statistics 61
Table 4.6: Comparison of Doctors‟ and Nurses‟ Scores 64
Table 4.7: Levene‟s Test for Equality of Variance 66
Table 4.8: Correlation Analysis for Hypothesis 1 – Letterkenny Sample 67
Table 4.9: Correlation Analysis for Hypothesis 1 – Sligo Sample 68
Table 4.10: Correlation Analysis for Hypothesis 2 – Letterkenny Sample 69
Table 4.11: Correlation Analysis for Hypothesis 2 – Sligo Sample 69
Table 4.12: Correlation Analysis for Hypothesis 3 – Letterkenny Sample 70
Table 4.13: Correlation Analysis for Hypothesis 3 – Sligo Sample 71
Table 4.14: Correlation Analysis for Hypothesis 1 73
Table 4.15: Correlation Analysis for Hypothesis 2 74
Table 4.16: Correlation Analysis for Hypothesis 3 75

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