Factors influencing adoption of hospital information system framework in Malaysian public hospitals

Hospital Information System (HIS) is an integrated Information System (IS) designed to enhance clinical, financial and administrative functions of a hospital. HIS is vital to the healthcare sector especially in public hospitals as they need to serve the public with high-quality healthcare services. Therefore, it is important to investigate the adoption of HIS in public hospitals. However, the investigation of HIS adoption in Malaysian public hospitals has been rarely explored in previous studies. Hence, the aim of this study is to identify significant factors that importantly driving the proposed HIS adoption framework from adopters‘ and non-adopters‘ perspective within the context of Malaysian public hospitals. This study examines the role of hospital size to determine whether it has moderating effect on the relationships among the potential factors and HIS adoption. Accordingly, this study integrates the Technology Organization Environment (TOE) Framework, Institutional Theory and Human Organization Technology (HOT) Fit Model to predict the factors influencing adoption of HIS framework in Malaysian public hospitals. Fourteen hypotheses were developed to test the proposed framework. This research applied the quantitative approach and conducted survey which involved eighty-eight small, eighteen medium and thirty-one large Malaysian public hospitals. A survey method using web-based questionnaire was conducted to examine the effects of the potential factors on HIS adoption by Malaysian public hospitals. Partial Least Square (PLS) method was performed to evaluate internal consistency, indicator reliability, convergent and discriminant validity of the survey instrument. The logistic regression method was applied to test the research hypotheses. The results from hypotheses testing indicated that relative advantage, compatibility, security concern, hospital size, mimetic pressure-competitors, vendor support, perceived technical competence of IS staff and employees‘ IS knowledge were the most significant factors for adopting HIS in the Malaysian public hospitals with p-value 0.05 on the relationships in the framework. The research findings conclude that the significant factors have the same effect on HIS adoption within the different sizes of hospitals. This study provides a useful understanding of factors in the hospital context influencing the adoption of HIS framework in both adopter and non-adopter hospitals