Save Face or Save Life: Physicians' Dilemma in Using Clinical Decision Support Systems

• 成果类型: Article
• 署名作者: Liang, Huigang; Xue, Yajiong
• 署名单位: University of Memphis; University of North Carolina; East Carolina University
• 刊物名称: INFORMATION SYSTEMS RESEARCH
• ISSN/ISSBN: 1047-7047
• DOI: 10.1287/isre.2021.1082
• 发表日期: 2022
• 页码: 737-758
• 关键词: electronic health records; social cognitive neuroscience; information-technology; self-esteem; user acceptance; MODERATING ROLE; medical-record; Time pressure; primary-care; status-quo

摘要

Clinical decision support systems (CDSS) provide advice to physicians that could save patients' lives, but they could also make physicians feel losing face. Considering the pivotal role of face in social interactions in China, this research attempts to understand Chinese physicians' dilemma of choosing between saving face or saving patients and how this dilemma makes them reluctant to follow CDSS recommendations. Drawing from the dual process theory, we postulate that physicians' resistance to CDSS recommendations is reduced by their rational perception of the system's usefulness and increased by their experiential belief of face loss and that these effects are contingent on two contextual factors, professional autonomy, and time pressure. Based on a longitudinal field survey with 182 physicians and follow-up interviews in a large Chinese hospital, we find support for the opposing effects of face loss and perceived usefulness. Furthermore, we show that face loss has a stronger effect on CDSS resistance at a high level of professional autonomy. In addition, when time pressure is high, perceived usefulness more strongly reduces while face loss more strongly increases CDSS resistance, thus amplifying the dilemma. This research makes a significant contribution by integrating the concept of face loss into information technology resistance research and revealing the dark side of professional autonomy and the paradoxical moderating effect of time pressure in the healthcare context.