EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPTANCE OF TELEMONITORING FOR CHRONIC PATIENTS Estibalitz Orruño1, Marie-Pierre Gagnon2-3, José Asua4, Eva Reviriego1 1 Basque Office for Health Technology Assessment (Osteba), Department of Health and Consumer Affairs, Basque Government, Vitoria-Gasteiz, Spain. 2 Faculty of Nursing Sciences, Université Laval, Québec, Canada. 3 Research Centre of the Centre Hospitalier Universitaire de Québec, Québec, Canada. 4 Direction of Knowledge Management and Evaluation, Department of Health and Consumer Affairs, Basque Government, Vitoria-Gasteiz, Spain.

1. EVALUATION OF PSYCHOSOCIAL
FACTORS INFLUENCING
HEALTHCARE PROFESSIONAL
ACCEPTANCE OF
TELEMONITORING FOR CHRONIC
PATIENTS
Estibalitz Orruño1, Marie-Pierre Gagnon2-3, José Asua4, Eva Reviriego1
1 Basque Office for Health Technology Assessment (Osteba), Department of Health and Consumer Affairs,
Basque Government, Vitoria-Gasteiz, Spain.
2 Faculty of Nursing Sciences, Université Laval, Québec, Canada.
3 Research Centre of the Centre Hospitalier Universitaire de Québec, Québec, Canada.
4 Direction of Knowledge Management and Evaluation, Department of Health and Consumer Affairs, Basque
Government, Vitoria-Gasteiz, Spain.

2. Outline of the presentation
 Introduction
 Objectives
 Methodology
 Results
 Conclusions and Implications

3. Introduction
 IT use in the health sector has an enormous
potential to help to improve the quality of the
services offered.
 A key factor is that the health professionals are
ready to accept those new technologies.
 The acceptance of telemedicine applications by
the health professionals constitutes an important
requirement for the fruitful diffusion of this
technology on a large scale.

4. Introduction
 In the Basque Country, pilot telemedicine projects have
been developed to support the delivery of care, inside the
“Tackling the Challenge of Chronicity”.
 For instance, home telemonitoring for patients with chronic
diseases is viewed as a promising solution to lessen the
burden on health care organisations and professionals.
 However, we know little about the factors that could
facilitate or impede health professionals’ willingness to
engage in telehomecare.

5. Objetives
 Based on the Technology Acceptance
Model (TAM), this study examines the main
factors that could affect healthcare
professionals' intention to use telemonitoring
technology.

6. Methods
 A validated questionnaire, based on an extension of
the TAM, was distributed to a total of 605 nurses,
general practitioners and paediatricians.
 Cronbach alpha were calculated to measure the
reliability of the model.
 Construct validity was evaluated using inter-item
correlation analysis.
 Logistic regression analysis was performed to test the
theoretical model.
 Adjusted odds ratios (OR) and their 95% confidence
intervals (CI) were computed.

7. Adapted Technology Acceptance
Model

8. Results
 A global response-rate of 44.3% was
achieved (n = 268):
 131 Nurses
 122 Physicians
 15 Paediatricians
 The internal consistency of theoretical
constructs was high (Cronbach α between
0.80 and 0.96).
 All theoretical variables were well correlated
(r > 0.6) with Intention to use, except Habit.

9. Results
Charateristics frequency percent
Gender
Women 209 78.0
Men 59 22.0
Age
<30 11 4.1
30-39 43 16.0
40-49 93 34.7
50-59 117 43.7
>60 4 1.5
Years in clinical practice mean = 21.3 (SD=9.1)

10. Results
 The original TAM model was good at
predicting intention to use the telemonitoring
system (χ2 was significant; Nagelkerke R2 =
0.63).
 However, the extended model, which
included other theoretical variables, was still
significant and more powerful (Nagelkerke R 2
= 0.72).
 Perceived Usefulness, Compatibility and
Facilitators were the significant predictors of
intention.

11. Results
Independent Multivariate 95% CI p
variables regression OR
Original
TAM
Perceived
5.28 3.14-10.01 0.000
usefulness
Perceived
1.93 1.11-2.37 0.020
ease of use
Nagelkerke R2 = 0.63

12. Results
Independent Multivariate 95% CI p
variables regression
OR
Extended TAM
Perceived
2.65 1.15-6.12 0.022
usefulness
Perceived ease of
0.66 0.31-1.39 0.276
use
Compatibility 3.06 1.30-7.18 0.010
Subjective Norm 1.06 0.56-2.03 0.851
Facilitators 4.90 2.38-10.09 0.000
Habit 2.56 0.56-11.70 0.226
Nagelkerke R2 = 0.72

13. Results
 A detailed analysis showed that intention to
use telemonitoring was best predicted by:
 Healthcare professionals’ belief that they would
obtain adequate training and technical support;
 Belief that telemonitoring would require important
changes in their practice.

14. Discussion
 Our findings show that the extended TAM is a
good predictive model of healthcare
professionals’ intention to use a telemonitoring
system for chronic care patients in primary care.
 The perception of facilitators in the organisational
context is the most important variable to consider
for increasing healthcare professionals’ intention
to use the new technology.

15. Implications for the health
system/professionals/patients/society
 This study confirms the value of this
framework for examining telemonitoring
acceptance among primary care
professionals
 The Modified TAM questionnaire provides a
validated instrument for the investigation of
key factors for successful telemedicine
implementation.

16. For more detailed information:
e-orruno@ej-gv.es
marie-pierre.gagnon@fsi.ulaval.ca
jasua@ej-gv.es