title: Determinants of physicians' technology acceptance for e-health in ambulatory care.
abstract: BACKGROUND
  Germany is introducing a nation-wide telemedicine infrastructure that enables electronic health services. The project is facing massive resistance from German physicians, which has led to a delay of more than five years. Little is known about the actual burdens and drivers for adoption of e-health innovations by physicians.
  
  
  OBJECTIVE
  Based on a quantitative study of German physicians who participated in the national testbed for telemedicine, this article extends existing technology acceptance models (TAM) for electronic health (e-health) in ambulatory care settings and elaborates on determinants of importance to physicians in their decision to use e-health applications.
  
  
  METHODS
  This study explores the opinions, attitudes, and knowledge of physicians in ambulatory care to find drivers for technology acceptance in terms of information technology (IT) utilization, process and security orientation, standardization, communication, documentation and general working patterns. We identified variables within the TAM constructs used in e-health research that have the strongest evidence to determine the intention to use e-health applications.
  
  
  RESULTS
  The partial least squares (PLS) regression model from data of 117 physicians showed that the perceived importance of standardization and the perceived importance of the current IT utilization (p<0.01) were the most significant drivers for accepting electronic health services (EHS) in their practice. Significant influence (p<0.05) was shown for the perceived importance of information security and process orientation as well as the documentation intensity and the e-health-related knowledge.
  
  
  CONCLUSIONS
  This study extends work gleaned from technology acceptance studies in healthcare by investigating factors which influence perceived usefulness and perceived ease of use of e-health services. Based on these empirical findings, we derive implications for the design and introduction of e-health services including suggestions for introducing the topic to physicians in ambulatory care and incentive structures for using e-health.
authors.affiliation: Department of Informatics, Technical University of Munich, Bolzmannstrasse 3, 85748 Garching bei München, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Dünnebeil
authors.forename: Ali
authors.initials: A
authors.lastname: Sunyaev
authors.forename: Ivo
authors.initials: I
authors.lastname: Blohm
authors.forename: Jan Marco
authors.initials: JM
authors.lastname: Leimeister
authors.forename: Helmut
authors.initials: H
authors.lastname: Krcmar
mesh_terms: D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D004059:Diffusion of Innovation; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010820:Physicians / Q000523:psychology*