Health Information System Adoption among Healthcare Professionals in Pakistan: The Role of Trust, Security, Privacy, and Organizational Support
Abstract
Background
Health Information Systems (HIS) have become an essential element in enhancing the quality of healthcare, patient safety, clinical decisions, and efficiency of the organization. Despite significant gains made by Pakistan in the implementation of digital health, there is still an imbalanced adoption of HIS because of technological, organizational, and human factors. The knowledge of the factors affecting the adoption of HIS by the healthcare professionals will allow formulating effective strategies to increase the pace of computerization in healthcare.
Objective
This paper set out to test the determinants of Health Information System adoption among the healthcare professionals in Pakistan by assessing the impact of performance expectancy, effort expectancy, social influence, facilitating conditions, security, privacy, trust, and organizational factors.
Methods
A cross-sectional survey was performed nationwide on 278 healthcare professionals selected by convenient and snowball methods recruited in both the public and private healthcare organizations of Pakistan. The participants were physicians and nurses, allied health professionals, health information officers, and hospital administrators. A structured, self-administered questionnaires (including demographic data and measures of Health Information System adoption, which were validated) were used to gather data. Responses were measured on a five-point Likert scale. IBM SPSS Statistics version 29.0 was used in analyzing these data. There were the descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson correlation analysis, multiple linear regression, logistic regression and hierarchical regression to determine the factors related with the adoption of HIS. The statistical significance was set at p < 0.05.
Results
Out of the 278 medical workers, there were 55.4 percent males and 44.6 percent females with a majority working in the government health facilities. All told, the respondents indicated a favorable attitude to Health Information Systems and regularly use digital health technologies. Trust emerged as the strongest predictor of HIS adoption (β = 0.307, p < 0.001), followed by performance expectancy (β = 0.248, p < 0.001), security (β = 0.241, p < 0.001), and facilitating conditions (β = 0.216, p < 0.001). The HIS adoption variance was explained by the regression model (R 2 = 0.684; 68.4). All variables of the study had significant positive correlations, with trust with the strongest relationship with HIS adoption (r = 0.81, p = < 0.001). Substantial obstacles that were cited by participants ranged through heavy workload, lack of training, insufficient technical assistance, poor internet connection, and privacy issues over their data.
Conclusion
Trust, perceived usefulness, organizational support, security, and privacy have a powerful effect on the adoption of Health Information Systems by the Pakistani healthcare professionals. Despite favorable values portrayed by healthcare professionals regarding digital health technologies, some challenges associated with infrastructure, training of workforce, and cybersecurity still pose hurdles towards an optimal implementation. To increase HIS penetration and facilitate the current digitalization of the Pakistani healthcare system, it is necessary to improve digital infrastructure, provide more training to professionals, enhance technical support, and develop effective information security policies.
Keywords: Health Information Systems; Electronic Health Records; Healthcare Professionals; Digital Health; Technology Adoption; Trust; Information security; privacy; Health Informatics, Pakistan.
