title: Critical factors influencing physicians' intention to use computerized clinical practice guidelines: an integrative model of activity theory and the technology acceptance model.
abstract: BACKGROUND
  With the widespread use of information communication technologies, computerized clinical practice guidelines are developed and considered as effective decision supporting tools in assisting the processes of clinical activities. However, the development of computerized clinical practice guidelines in Taiwan is still at the early stage and acceptance level among major users (physicians) of computerized clinical practice guidelines is not satisfactory. This study aims to investigate critical factors influencing physicians' intention to computerized clinical practice guideline use through an integrative model of activity theory and the technology acceptance model.
  
  
  METHODS
  The survey methodology was employed to collect data from physicians of the investigated hospitals that have implemented computerized clinical practice guidelines. A total of 505 questionnaires were sent out, with 238 completed copies returned, indicating a valid response rate of 47.1 %. The collected data was then analyzed by structural equation modeling technique.
  
  
  RESULTS
  The results showed that attitudes toward using computerized clinical practice guidelines (γ = 0.451, p < 0.001), organizational support (γ = 0.285, p < 0.001), perceived usefulness of computerized clinical practice guidelines (γ = 0.219, p < 0.05), and social influence (γ = 0.213, p < 0.05) were critical factors influencing physicians' intention to use computerized clinical practice guidelines, and these factors can explain 68.6 % of the variance in intention to use computerized clinical practice guidelines.
  
  
  CONCLUSIONS
  This study confirmed that some subject (human) factors, environment (organization) factors, tool (technology) factors mentioned in the activity theory should be carefully considered when introducing computerized clinical practice guidelines. Managers should pay much attention on those identified factors and provide adequate resources and incentives to help the promotion and use of computerized clinical practice guidelines. Through the appropriate use of computerized clinical practice guidelines, the clinical benefits, particularly in improving quality of care and facilitating the clinical processes, will be realized.
authors.affiliation: Department of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science, Tainan City, Taiwan R.O.C.. mayo5012@gmail.com.
authors.forename: Ju-Ling
authors.initials: JL
authors.lastname: Hsiao
authors.affiliation: Department of Information Management, Chia-Nan University of Pharmacy and Science, No.60, Sec. 1, Erren Rd., Rende Dist., Tainan City, 71710, Taiwan R.O.C.. rafuchen@gmail.com.
authors.forename: Rai-Fu
authors.initials: RF
authors.lastname: Chen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D005260:Female; D006302:Health Services Research; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010820:Physicians / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D013624:Taiwan