Perceptions on the Adoption of Electronic Health Systems by Private Medical Practitioners in Harare Central Business District and Avenues Area

Abstract

In the study, the researcher set out to analyse perceptions of medical practitioners in Harare CBD and the Avenues Area towards electronic health systems relating to systems adoption factors and outcome benefits. The purpose of the study was 1. To establish the perceptions of medical practitioners in Harare CBD and Avenues area on the following e-health adoption factors? • Regulations • Information Technology Infrastructure • Skills • Security

2. To establish the perceptions of medical practitioners in Harare CBD and Avenues area on the following adoption outcome benefits? • Financial Benefits • Quality of Service • Customer Satisfaction • Access to Information

The Technology Acceptance Model on acceptance of new technology posits that the acceptance of a new technology depends on user perceptions on adoption factors and adoption benefits hence it is important to get the perceptions of medical practitioners to understand why the adoption level is at the current levels.

The research was designed to gather quantitative data and was descriptive in nature. A sample of 70 medical practitioners drawn from a population of 146 participated in the study. The sample was selected through stratified random sampling. From the sample of 70 only 34 responses were received. The variables of the study were rated on a scale of 1-5, with 5 being the highest score. A mean was used as a measure of central tendency and a standard deviation computed to find deviation from the mean.

Statement of the Problem The private healthcare sector plays a key role in complementing the public health sector which is facing a myriad of economic challenges. The services sector which the healthcare industry is part of plays an important role in the economy contributing significantly to the Gross Domestic Product. System inefficiencies lead to wastages that result in higher costs of services. The use of ICT in other service industries has enhanced the quality of service and e-health is expected to bring the same benefits. E-health has been shown to have many benefits that can strengthen the Zimbabwean health system but the use of ICT has not been widespread among the medical practitioners in Zimbabwe. This study explored perceptions of medical practitioners towards e-health. Perceptions on new technology can lead to acceptance or rejection of that technology.

Research Methodology The researcher used quantitative data to get insight on the perceptions of medical practitioners on e-health in Harare CBD and Avenues area. A self-administered questionnaire was sent over email to gather primary research data which was analysed and interpreted by the researcher. A pilot study was carried out to validate the research instrument. A sample of 70 medical practitioners was selected from the population and 146, 34 medical practitioners responded.

Findings of the Study 1. The study found that medical practitioners found adopting e-health systems to be difficult in the Harare CBD and Avenues area. • Information Technology Infrastructure- The research findings show that most medical practitioners are not sure if there is adequate information technology infrastructure to support the adoption of e-health. Information Technology infrastructure scored a mean of 3.4412 and standard deviation of .78591. • Regulations – The medical practitioners’ perceptions were that the existing regulations on e-health make the adoption of e-health difficult. Perceptions on the existence of clear and supporting e-health regulations scored a mean of 2.3529 and standard deviation of .94972. • Skills – Medical practitioners in the Harare CBD and Avenues area were of the perception that there are adequate skills to support the use of e-health systems with a mean score of 3.5682 and standard deviation of 0.62896. • Security- Perceptions of medical practitioners of e-health showed a lack of confidence in e-health security systems with a mean score of 3.0294 and standard deviation of 0.67354. Poor security systems would not support the adoption of e-health systems. The WHO definition of e-health emphasises that it is the secure use of information communication technologies in health and health related fields (Al-Shorbaji & Giessbuhler, 2012).

2. The following findings were made on the medical practitioners perceptions towards e-health in Harare CBD and Avenues Area • Financial- Financial benefits scored a mean of 3.9706 and standard deviation of .77793 which shows that practitioners perceive e-health systems to have financial benefits. • Quality of Service- Harare CBD and Avenues medical practitioners’ perceptions were that e-health systems adoption would result in improvements in quality of service with a mean score of 3.6970 and standard deviation of 0.73090 • Customer Satisfaction- Perceptions on Customer satisfaction benefit of e-health scored a mean of 3.6288 and standard deviation of 0.68214 which shows that the medical practitioners think that if e-health systems are adopted customer satisfaction would increase. • Increased Access to Information- The highest mean was on access to information with a mean of 4.0808 and a standard deviation of .63481. This is explained by the fact that e-health is an information based system.

Conclusion It has been discovered through this study that most medical practitioners think that adoption of E-health systems will have significant benefits. However perceptions on the adoption factors show that generally medical practitioners have negative perceptions on the availability of adoption factors which support the use of e-health. The issue of the lack of a clear regulatory framework and trust in e-health systems data security results in the perceived ease of use being negative. Perceived benefits and perceived ease of adoption affect acceptance of a new technology according to the Technology Acceptance Model. The low level of adoption of e-Health systems in the particular area under study may be as a result of an environment that presents poor adoption factors. It is possible that these findings can be extended to the rest of Zimbabwe as the area under study is expected to have the best environment for the adoption of e-health.

Recommendations In the course of the research, the researcher examined the perceptions of medical practitioners in the Harare CBD and Avenues area on the perceived benefits and perceived ease of use of E-health systems. Based on the findings of the study the researcher makes the following recommendations 1. The Government and other regulatory authorities must address the issue of a lack of a clear regulatory framework on e-Health. There is a strong perception that there are no clear regulatory policies on e-Health. From the literature review The Ministry of Health and Child Care only had a Draft Strategy on e-Health. If there are some regulatory policies that are already in place the authorities must publicise them. 2. The issue of Data Security is fundamental in the health industry. From the study it has been discovered that medical practitioners do not have trust in the existing data security systems. The software developers must do more to assure the users of e-Health systems of data security. Laws that deal with privacy of health information must be put in place. 3. While significant developments have been made in the area of information technology infrastructure development the study revealed practitioners are not very confident that the existing infrastructure will be able to support e-health. Providing reliable electricity will contribute to the increased adoption of e-health systems. There is an opportunity for other forms of sustainable energy like solar energy solutions to come in to support e-health systems 4. On analysing the perceptions on benefits of e-Health Systems it was discovered through this study that medical practitioners in the Harare CBD and Avenues area perceive e-Health systems as beneficial. This presents an opportunity to government and other stakeholders like developers and vendors to market this new technology which will have demand if other adoption factors are addressed.

Recommendations for Further Study Given the findings and the background of this study, the following is proposed for future research on this subject. 1. This study was not exhaustive in its analysis of the benefits and adoption factors of e-health. There is need for other studies to be done on the benefits and adoption factors not covered in this study. 2. A similar study can be conducted on a population from an environment which is different from the one considered in this study. 3. This study only considered the perceptions of medical practitioners. The perceptions of healthcare customers are important hence other studies to consider these perceptions are recommended.