Aceptación de tecnologías de información en el sector hospitalario

Abstract

Hospitals, as organizations, concerned with fulfilling the health requirements of the population, must be able to offer patients a cohesive health system and thus require sophisticated clinical and management integration. The integration of services, products and techniques in a hospital has direct impact on patients, nursing personnel and doctors, service and financial personnel and even on the relationships with external agents to the organization, such as financial institutions, suppliers and sanitation authorities. Van Merode, et al. (2004) defends the potential of Enterprise Resource Planning (ERP) as the ideal information system to support sanitation organizations. In general, ERP systems have been used to facilitate the integration between all areas within a company (Muscatello et al. 2003, Klaus et al. 2000, Alshawi et al. 2004, Kansal 2006). However, in hospitals, ERP systems offer only a partial solution to the problem. Despite the technical advantages that a certain technological tool might offer, such is the case with ERP systems, its impact on the organization depends, in all cases, on the degree to which the individuals of the organization make use of said tool. The utilization of the information system by the users does not seem to be a question that depends solely on the technological experience of the introducers. It deals with the dynamic interaction between the ERP system and different groups within the organization, such as sales personnel, consultants and stakeholders, among others (Newman y Westrup 2005). Consequently, it seems appropriate to study which factors cause an ERP system to be employed more or less by its users, which will then allow us to explain and predict not only an initial failure but also final success in the implementation of an ERP system (Akkermans y Helden 2002). This way, the general objective of this investigative study is to analyze aspects related to the attitudes towards the utilization of ERP systems in public hospitals. The study�s elaboration and structure are outlined in the following. Chapter 1 presents an analysis of the attitudes that health personnel have towards the use of ERP systems in a Spanish public hospital, along with identification of the factors that influence use of this kind of system in a hospital environment. The research is based on a regression analysis of latent variables, and employs Partial Least Squares optimization approach, while it also applies the TAM model of technology acceptance. Chapter 2 analyzes the impact of cultural factors on users� attitudes towards ERP utilization in a public hospital, identifying the critical aspects that encourage the use of the ERP system. The theoretical framework of this research is based on the TAM model of technological acceptance. The results, obtained through the optimization of Partial Least Squares method, shows that resistance to change can be a crucial factor in the implementation of ERP systems in hospitals. Chapter 3 tackles the systematic evaluation, by means of a longitudinal study, of one experience of information integration in a sanitary organization, comprising all the implications that this entails. This research extends the use of the TAM model to personal characteristics and the organizational structure of the sanitation entities, within the context of the attitudes towards usage of ERP systems in Spanish public hospitals. On one hand, the results of this research allow us to identify the critical factors that are involved in forming attitudes towards ERP systems, such as previous experience and the age of the users; on the other hand, they permit us to corroborate the direct influence on users� attitudes of the following factors: resistance to change, resistance to being controlled and perceived risk. Presenting the particular case study of this hospital represents an example of the integration on an economic level and in real time, of the diverse agents of the activity implicit in a hospital, as well as the automation of the processes associated with this integration.