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Dynamics of Technology Acceptance to the Sustainability of eHealth Systems in Resource Constrained Environments

Thesis (PhD)--University of Pretoria, 2019.

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Other Authors: Pretorius, Leon
Format: Thesis
Language:English
Published: University of Pretoria 2019
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access_status_str Open Access
author2 Pretorius, Leon
author_browse Pretorius, Leon
author_facet Pretorius, Leon
collection Thesis
dc_rights_str_mv © 2019 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.
description Thesis (PhD)--University of Pretoria, 2019.
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institution University of Pretoria (South Africa)
language English
last_indexed 2026-06-10T12:36:58.812Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository
publishDate 2019
publishDateRange 2019
publishDateSort 2019
publisher University of Pretoria
publisherStr University of Pretoria
record_format dspace
source_str UPSpace — University of Pretoria Institutional Repository
spelling oai:repository.up.ac.za:2263/72032 Dynamics of Technology Acceptance to the Sustainability of eHealth Systems in Resource Constrained Environments Pretorius, Leon getnet.fanta@up.ac.za Erasmus, Louwrence Fanta, Getnet Bogale UCTD Sustainability eHealth System dynamics Technology acceptance Socio-technical Techno-organizational Techno-economic Thesis (PhD)--University of Pretoria, 2019. Healthcare in developing countries is confronted with a shortage of skilled healthcare workforce, medical errors, inequity and inefficient healthcare service delivery. Innovative ways of solving healthcare problems through Information and communication technology (ICT) can improve the efficiency, effectiveness, access and quality of the healthcare system. Despite highly anticipated benefits of eHealth system to improve the efficiency of healthcare delivery, the healthcare had barely begun to take advantage of ICT mainly in a resource-constrained environment. The implementation of eHealth systems in developing countries could not proceed beyond the pilot phase to demonstrate sustainability in a large-scale rollout. The general research problem in this thesis focuses on how factors of eHealth implementation interplay to influence technology and information use to ensure the long-term sustainability of eHealth in resource-constrained settings. Systems thinking and system dynamics modelling method were used to handle complexity in the implementation of eHealth. Moreover, sustainability theory, technology acceptance model (TAM) and IS success models were used to develop a system dynamics model of sustainable eHealth implementation. The socio-technical, techno-organizational and techno-economic factors of sustainable eHealth systems are discussed to address the research objectives. The system dynamics simulation model of sustainable eHealth implementation is developed, verified, validated and tested. This applied research study focused on addressing the problems of sustainable eHealth systems implementation in resource-constrained environments. The model-based theory-building research study followed in this thesis aimed at enhancing the understanding of sustainable eHealth implementation in a resource-constrained environment to maximize the acceptance of eHealth by the end-users. Both the ontological and epistemological assumptions of this research study supported the position of the constructivist research paradigm. Methodologically, this study mainly applies qualitative research methodology which is common in the interpretive approach. Structured and semi-structured questionnaires were used to elicit information from purposefully sampled eHMIS and SmartCare health facilities in Ethiopia. Field notes, document review, interview and focus group discussion data were analysed using ATLAS.ti software. Vensim DSS Version 6.3D was used to model and simulate the system dynamics model. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) approach was followed in the systematic literature review of techno-economic factors. The simulation results confirmed that the ‘effectiveness of training’ was a dominant factor to improve the ‘acceptance rate’ of eHMIS and SmartCare in the socio-technical dimension of sustainable eHealth implementation. The adequacy of ICT and healthcare workforce within eHealth implementing facility and end-users’ familiarity with digital technology showed a stronger influence on the ‘acceptance rate’ of both eHMIS and SmartCare systems in the techno-organizational dimension. An economic incentive, funding duration, funding amount, funding source and economic benefit are identified as techno-economic factors that influence the long-term sustainability of eHealth projects. Graduate School of Technology Management (GSTM) PhD Unrestricted 2019-10-29T10:52:18Z 2019-10-29T10:52:18Z 2020-04 2019 Thesis Fanta, GB 2019, Dynamics of Technology Acceptance to the Sustainability of eHealth Systems in Resource Constrained Environments, PhD Thesis, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/72032> A2020 http://hdl.handle.net/2263/72032 en © 2019 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria
spellingShingle UCTD
Sustainability
eHealth
System dynamics
Technology acceptance
Socio-technical
Techno-organizational
Techno-economic
Dynamics of Technology Acceptance to the Sustainability of eHealth Systems in Resource Constrained Environments
title Dynamics of Technology Acceptance to the Sustainability of eHealth Systems in Resource Constrained Environments
title_full Dynamics of Technology Acceptance to the Sustainability of eHealth Systems in Resource Constrained Environments
title_fullStr Dynamics of Technology Acceptance to the Sustainability of eHealth Systems in Resource Constrained Environments
title_full_unstemmed Dynamics of Technology Acceptance to the Sustainability of eHealth Systems in Resource Constrained Environments
title_short Dynamics of Technology Acceptance to the Sustainability of eHealth Systems in Resource Constrained Environments
title_sort dynamics of technology acceptance to the sustainability of ehealth systems in resource constrained environments
topic UCTD
Sustainability
eHealth
System dynamics
Technology acceptance
Socio-technical
Techno-organizational
Techno-economic
url http://hdl.handle.net/2263/72032