abstract
A systematic review of the literature was carried out to identify variables that favor the acceptance of consumer health information technology (CHIT) by patients. The electronic bibliographic databases Web of Science, Elite Business Source, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles and PsycInfo were explored. A search of references cited for articles that met the inclusion criteria to reduce deficiencies was also performed. Fifty-two items met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. The majority of the people evaluated (71%) were patient-related factors, including sociodemographic characteristics, health and treatment variables, and previous experience or exposure to computer / health technologies. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. A total of 62 (66%) predicted acceptance in at least one study. The existing literature focuses mainly on factors related to the patient. No study has examined the impact of social and task-related factors on acceptance, and few have tested the effects of organizational or environmental factors on acceptance. Future research guided by theories of technology acceptance should fill these gaps to improve our understanding of patient acceptance through the CHIT system, which could improve the design and implementation of CHIT systems.
introduction
In the United States, the need to improve the health care system has led to the launch of a national initiative focused on the use of health information technologies to improve the quality of care and support. health security and provide profitable health services to consumers. that is, patients or people receiving medical attention1,2. While much of the discussion has been devoted to the need for health care organizations, such as hospitals, to adopt health information technologies for patient safety, there is a growing recognition that consumers can use these technologies directly to acquire new forms of medical care, such as telehomecare. When patients use them, these technologies are called Consumer Health Information Technologies (CHIT). Several definitions describing CHIT can be found in the literature. In this review article, CHITs are defined as computer systems designed to facilitate access and exchange of information, improve decision-making, provide social and emotional support and help behavioral changes that promote health and well-being 3.
There is considerable research on the feasibility, acceptability and effectiveness of several CHITs for the provision of primary health care services in general, or the self-care of patients, particularly 6-15. For self-care, CHITs facilitate the care process by providing patients with quick access to their medical records, information on medications and diseases, electronic communications and location-based decision support services. 3,13,16-18 These readily available resources can have a positive impact on the results for patient health, quality of life, hospital readmission rates and mortality rates15,19-22. In addition, CHITs are increasingly frequent and there are reasons to believe that patients will increasingly face CHITs by treatment and self-management. frequently. The first reason why patients can see a greater opportunity to use CHIT is that CHITs allow patients to participate in information exchange and decision making, allowing them to have more control and to contribute to quality of health care 23, 25. High cost of conventional health care, patients quickly leave hospitals once their acute conditions stabilize. The average length of hospital stay for hospitalized patients decreased from 7.3 days in 1980 to 4.8 days in 2004.26,27. It is for this reason that the patient care environment is transferred from the hospital to another less expensive environment, such as home 28. Patients can widely use CHITs for personal care.
Although the possibility of using CHIT to improve medical care has been recognized, patients still do not accept these technologies for a variety of reasons, including low device use, insufficient training in the use of technology, lack of computer skills and low autonomy -efficacy. 8,29-34 This is an important concern for patients and health care organizations. Patients who reject CHITs will not benefit, and rejection means a loss of return on investment for health organizations. This concern has been realized. Evidence shows that a significant number of potential users do not accept CHIT 35, which has resulted in the failure of technology implementation in several projects30-33. Therefore, studies are needed to examine the predictors of patient acceptance of CHIT. Identifying the factors that predict acceptance can (1) help create acceptance of technology, (2) help develop and evaluate the ability of CHIT applications to meet the needs and expectations of patients, and (3) increase the possibilities of a successful implementation of technology36. The interest of patients and their willingness to use (also known as acceptance) CHITs to control their diseases have been a field of scientific research that has undergone a thorough review. However, to date, no attempt has been made to synthesize and interpret the evidence of quantitative predictors of patient acceptance of CHIT. To this end, this synthesis study (1) analyzes and synthesizes the predictors of CHIT acceptance of patients, (2) examines the main shortcomings of the current literature on CHIT acceptance and (3) guides future research. .
