Explaining Physicians' Acceptance and Resistance to the NHI Pharmacloud: A Theoretical Model and Empirical Test

The PharmaCloud allows physicians to streamline many of their healthcare processes and ensure patient safety in a more efficient and cost-effective manner. Despite its great potential, however, there are gaps in our understanding of how physicians evaluate change in relation to the PharmaCloud and why they decide to resist it. Thus, this study develops an integrated model to explain physicians’ intention to use the PharmaCloud and their intention to resist it. A field survey was conducted in Taiwan to collect data from physicians. Structural equation modeling (SEM) using the partial least squares (PLS) method was employed to test the research model. The results show that physicians’ resistance to the use of the PharmaCloud is the result of regret avoidance, inertia, perceived value, transition costs, and perceived threat. Information quality, system quality, and service quality are shown to have positive and direct effects on physicians’ intention to use the PharmaCloud. Our study illustrates the importance of incorporating user resistance in technology acceptance studies in general and health technology usage studies in particular, providing grounds for a model of resistance that can serve as the starting point for future research in this relatively unexplored yet potentially fertile area of research.