CLINICIANS¿ SATISFACTION WITH CLINICAL INFORMATION SYSTEMS: A DISCONFIRMATION PARADIGM PERSPECTIVE

Abstract

Clinical information systems (CIS) have been widely regarded as efficient means of achieving healthcare quality, patient safety, and reduced healthcare costs. However, the realization of these potential benefits of CIS depends on clinicians¿ satisfaction with and continuous use of CIS. Prior IS satisfaction research in general and CIS satisfaction studies in specific lack a strong theoretical background, and overemphasize on technical aspects of IS and CIS. In other words, they offer limited understanding of the psychological processes that convert the IS performance on various system characteristics into user reaction to the system. In this study, a conceptual framework is developed to identify the cognitive determinants of clinicians¿ satisfaction formation based on two models from the disconfirmation paradigm namely the expectations congruency and needs congruency models. The extant IS literature on user satisfaction is integrated into the research model of the study. As such, various IS attributes including system quality, information quality and service quality from the Delone and McLean¿s (2003) IS success model are utilized as the aspects of a system which clinicians may have expectations about. McClelland¿s learned needs theory (McClelland, 1976) is also employed to identify clinicians¿ needs in their work settings regarding CIS. In addition, the impact of perceived CIS performance (measured at functionality level) is investigated as another determinant of clinicians¿ satisfaction. Survey methodology is adopted in this study to empirically validate the proposed research model. The survey is conducted at a public hospital with more than 500 beds in Singapore. 200 surveys were distributed among doctors of different clinical departments in the sample hospital by their clinical secretaries. Nurse officers of the 19 wards in the sample hospital handed out 207 surveys to the nurses in their wards. The response rate from doctors and nurses were 57% and 100% respectively. The partial least squares (PLS) method is used to analyze 112 valid responses from doctors and 203 valid responses from nurses. The results of the study show that perceived CIS performance is the most influential factor on clinician satisfaction. Contrary to the most previous studies findings, nurses¿ expectations and expectations congruency did not show a significant effect on their satisfaction. However, doctors¿ expectations congruency was the next significant determinant of their satisfaction. For nurses, the needs congruency found to be significantly affecting their satisfaction.