Skip to main content

Advertisement

SpringerLink
Log in

Assessing the Relationship between Technology Readiness and Continuance Intention in an E-Appointment System: Relationship Quality as a Mediator

  • Systems-Level Quality Improvement
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

Abstract

Numerous types of self-service technologies have prevailed due to innovations in network and information technology. To hospitals, patient intentions to continue to use the e-appointment system are crucial. Previous investigations discussed only the relationships between the technology readiness of users and their continuance intentions, and ignored the most important mediator, relationship quality. This study explored the relationships among technology readiness, relationship quality, and continuance intention. The research results demonstrated that both optimism and innovativeness significantly and positively influenced continuance intention through the mediating effect of relationship quality. However, discomfort and insecurity hid not significantly influence relationship quality or continuance intention. Finally, theoretical contributions, managerial implications and future research directions were discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gefen, D., Karahanna, E., and Straub, D. W., Trust and TAM in online shopping: An integrated model. MIS quarterly 27(1):51–90, 2003.

    Google Scholar 

  2. Bhattacherjee, A., and Premkumar, G., Understanding changes in belief and attitude toward information technology usage: A theoretical model and longitudinal test. MIS Quarterly 28(2):229–254, 2004.

    Google Scholar 

  3. Lin, C. S., Wu, S., and Tsai, R. J., Integrating perceived playfulness into expectation-confirmation model for web portal context. Information and Management 42(5):683–693, 2005.

    Article  Google Scholar 

  4. Thong, J. Y. L., Hong, S., and Tam, K. Y., The effects of post-adoption beliefs on the expectation-confirmation model for information technology continuance. International Journal of Human-Computer Studies 64(9):799–810, 2006.

    Article  Google Scholar 

  5. Liao, C., Chen, J. L., and Yen, D. C., Theory of planning behavior (TPB) and customer satisfaction in the continued use of e-service: An integrated model. Computers in Human Behavior 23(6):2804–2822, 2007.

    Article  Google Scholar 

  6. Bhattacherjee, A., Perols, J., and Sanford, C., Information technology continuance: A theoretic extension and empirical test. Journal of Computer Information Systems 49(1):17–26, 2008.

    Google Scholar 

  7. Chen, S. C., Chen, H. H., and Chen, M. F., Determinants of satisfaction and Continuance Intention towards Self-service Technologies. Industrial Management and Data Systems 109(9):1248–1263, 2009.

    Article  Google Scholar 

  8. Recker, J., Explaining usage of process modeling grammars: Comparing three theoretical models in the study of two grammars. Information & Management 47(5–6):316–324, 2010.

    Article  Google Scholar 

  9. Chen, S. C., Liu, M. L., and Lin, C. P., Integrating technology readiness into the expectation–confirmation model: an empirical study of mobile services. Cyberpsychology, Behavior, and Social Networking 16(8):604–612, 2013.

    Article  Google Scholar 

  10. Chou, H. K., Lin, I. C., Woung, L. C., and Tsai, M. T., Engagement in e-learning opportunities: An empirical study on patient education using expectation confirmation theory. Journal of Medical Systems 36(3):1697–1706, 2012.

    Article  Google Scholar 

  11. Chen, M. L., Su, Z. Y., Wu, T. Y., Shieh, T. Y., and Chiang, C. H., Influence of dentistry students’ e-learning satisfaction: a questionnaire survey. Journal of Medical Systems 35(6):1595–1603, 2011.

    Article  Google Scholar 

  12. Top, M., and Gider, Ö., Nurses’ Views on Electronic Medical Records (EMR) in Turkey: An analysis according to use, quality and user satisfaction. Journal of Medical Systems 36(3):1979–1988, 2012.

    Article  Google Scholar 

  13. Yui, B. H., Jim, W. T., Chen, M., Hsu, J. M., Liu, C. Y., and Lee, T. T., Evaluation of Computerized Physician Order Entry System—A Satisfaction Survey in Taiwan. Journal of Medical Systems 36(6):3817–3824, 2012.

    Article  Google Scholar 

  14. Wu, I. L., and Chen, J. L., An extension of trust and TAM model with TPB in the initial adoption of on-line tax: an empirical study. International Journal of Human-Computer Studies 62(6):784–808, 2005.

    Article  Google Scholar 

  15. Tung, F. C., Chang, S. C., and Chou, C. M., An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry. International Journal of Medical Informatics 77(5):324–335, 2008.

    Article  Google Scholar 

  16. Parasuraman, A., Technology readiness index (TRI): a multiple-item scale to measure readiness to embrace new technologies. Journal of Service Research 2(4):307–320, 2000.

    Article  Google Scholar 

  17. Yen, H. R., An attribute-based model of quality satisfaction for internet self-service technology. The Service Industries Journal 25(5):641–659, 2005.

    Article  Google Scholar 

  18. Lin, J. C., and Hsieh, P. L., The role of technology readiness in customers, perception and adoption of self-service technologies. International Journal of Service Industry Management 17(5):497–517, 2006.

    Article  Google Scholar 

  19. Crosby, L. A., Evans, K. R., and Cowles, D., Relationship quality in services selling: an interpersonal influence perspective. Journal of Marketing 54:68–81, 1990.

    Article  Google Scholar 

  20. Parasuraman, A., and Colby, C. L., Techno-ready marketing: how and why customers adopt technology. The Free Press, New York, 2001.

    Google Scholar 

  21. Chen, S. C., and Chen, H. H., The empirical study of customer satisfaction and continued behavioral intention towards self-service banking: technology readiness as antecedents. International Journal of Electronic Finance 3(1):64–76, 2009.

    Article  Google Scholar 

  22. Bhattacherjee, A., Understanding information systems continuance: an expectation-confirmation model. MIS Quarterly 25(3):351–370, 2001.

    Article  Google Scholar 

  23. Smith, J. B., Buyer-seller relationship: Bonds, relationship management and quality. Psychology and Marketing 13(2):3–21, 1998.

    Article  Google Scholar 

  24. Chiu, C. K., Understanding relationship quality and online purchase intention in e-tourism: a qualitative application. Quality and Quantity 43(3):669–675, 2009.

    Article  Google Scholar 

  25. Lin, C. P., and Ding, C. G., Opening the black box: assessing the mediating mechanism of relationship quality and the moderating effects of prior experience in ISP service. International Journal of Service Industry Management 16(1):55–80, 2005.

    Article  Google Scholar 

  26. Westbrook, R. A., Sources of consumer satisfaction with retail outlets. Journal of Retailing 57(3):68–85, 1981.

    MathSciNet  Google Scholar 

  27. Wulf, K. D., Odekerken-Schroder, G., and Lacobucci, D., Investments in consumer relationships: a cross-country and cross-industry exploration. Journal of Marketing 65(4):33–50, 2001.

    Article  Google Scholar 

  28. Kim, W. G., and Cha, Y., Antecedents and consequences of relationship quality in hotel industry. International Journal of Hospitality Management 21(4):321–338, 2002.

    Article  Google Scholar 

  29. Lang, B., and Colgate, M., Relationship quality, on-line banking and the information technology gap. International Journal of Bank Marketing 21(1):29–37, 2003.

    Article  Google Scholar 

  30. Lin, C. P., and Ding, C. G., Comparing the main effects and moderating effects of education among three models in it service: a quantitative approach. Quality and Quantity 43(4):617–633, 2009.

    Article  MathSciNet  Google Scholar 

  31. Ibáñez, V. A., Hartmann, P., and Calvo, P. Z., Antecedents of customer loyalty in residential energy markets: Service quality, satisfaction, trust and switching costs. The Service Industries Journal 26(6):633–650, 2006.

    Article  Google Scholar 

  32. Macintosh, G., Customer orientation, relationship quality, and relational benefits to the firm. Journal of Services Marketing 21(3):150–159, 2007.

    Article  Google Scholar 

  33. Rauyruen, P., and Miller, K. E., Relationship quality as a predictor of B2B customer loyalty. Journal of Business Research 60(1):21–31, 2007.

    Article  Google Scholar 

  34. Sanchez-Franco, M. J., Ramos, A. F. V., and Velicia, F. A. M., The moderating effect of gender on relationship quality and loyalty toward Internet service providers. Information & Management 46(3):196–202, 2009.

    Article  Google Scholar 

  35. Kim, T. T., Kim, W. G., and Kim, H. B., The effects of perceived justice on recovery satisfaction, trust, word-of-mouth, and revisit intention in upscale hotels. Tourism Management 30(1):51–62, 2009.

    Article  Google Scholar 

  36. Athanasopoulou, P., Relationship quality: A critical literature review and research agenda. European Journal of Marketing 43(5/6):583–610, 2009.

    Article  Google Scholar 

  37. Lin, C. P., and Ding, C. G., Comparing the main effects and moderating effects of education among three models in it service: a quantitative approach. Quality and Quantity 43(4):617–633, 2009.

    Article  MathSciNet  Google Scholar 

  38. Moliner, M.A. (2009), Loyalty, perceived value and relationship quality in healthcare services, Journal of Service Management, 20 No. 1, pp.76-97.

  39. Vesel, P., and Zabkar, V., Comprehension of relationship quality in the retail environment. Managing Service Quality 20(3):213–235, 2010.

  40. Pierre, C., Dagger, T. S., and Don, O., Service quality, trust, commitment and service differentiation in business relationships. Journal of Services Marketing 24(5):336–346, 2010.

  41. Hyun, S. S., Predictors of relationship quality and loyalty in the chain restaurant industry. Cornell Hospitality Quarterly 51(2):251–267, 2010.

    Article  MathSciNet  Google Scholar 

  42. Chen, S. C., Chiu, K. K. S., Chen, H. H., and Liao, Y. C., A pilot study for understanding the relationships of information system quality, relationship quality and loyalty. Australian Journal of Business and Management Research 1(5):17–23, 2011.

    Google Scholar 

  43. Zhang, Y., Fang, Y., Wei, K. K., Ramsey, E., McCole, P., and Chen, H., Repurchase intention in B2C e-commerce- A relationship quality perspective. Information & Management 48:192–200, 2011.

  44. Liu, C. T., Guo, Y. M., and Lee, C. H., The effects of relationship quality and switching barriers on customer loyalty. International Journal of Information Management 31(1):71–79, 2011.

  45. Chen, S. C., To use or not to use: Understanding the factors affecting continuance intention of mobile banking. International Journal of Mobile Communications 10(5):490–507, 2012.

    Article  Google Scholar 

  46. Chen, S. C., Liu, S. C., Li, S. H., and Yen, D. C., Understanding the mediating effects of relationship quality on technology acceptance: an empirical study of e-appointment system. Journal of Medical Systems 37(6):1–13, 2013.

    Google Scholar 

  47. Oliver, R. L., A cognitive model for the antecedents and consequences of satisfaction. Journal of Marketing Research 17(4):460–469, 1980.

    Article  Google Scholar 

  48. Lin, C. H., Shih, H. Y., and Sher, P. J., Integrating technology readiness into technology acceptance: the TRAM model. Psychology and Marketing 24(7):641–57, 2007.

    Article  Google Scholar 

  49. Leuthesser, L., Supplier relational behavior: An empirical assessment’. Industrial Marketing Management 26:245–254, 1997.

    Article  Google Scholar 

  50. Garbarino, E., and Johnson, M. S., The different roles of satisfaction, trust and commitment in customer relationships. Journal of Marketing 63(2):70–87, 1999.

    Article  Google Scholar 

  51. Tam, J. L. M., and Wong, Y. H., Interactive selling: a dynamic framework for services. Journal of Service Marketing 15(5):379–396, 2001.

    Article  Google Scholar 

  52. Wästlund, E., Reinikka, H., Norlander, T., and Archer, T., Effects of VDT and paper presentation on consumption and production of information: Psychological and physiological factors. Computers in Human Behavior 21(2):377–394, 2005.

    Article  Google Scholar 

  53. Massey, A. P., Khatri, V., and Montoya-Weiss, M. M., Usability of online services: The role of technology readiness and context. Decision Sciences 38(2):277–308, 2007.

    Article  Google Scholar 

  54. Chiu, Y. T. H., Fang, S. C., and Tseng, C. C., Early versus potential adopters: exploring the antecedents of use intention in the context of retail service innovations. International Journal of Retail & Distribution Management 38(6):443–459, 2010.

    Article  Google Scholar 

  55. Caison, A. L., Bulman, D., Pai, S., and Neville, D., Exploring the technology readiness of nursing and medical students at a Canadian University. Journal of Interprofessional Care 22(3):283–294, 2008.

    Article  Google Scholar 

  56. Caceres, R. C., and Paparoidamis, N. G., Service quality, relationship satisfaction, trust, commitment and business-to-bussiness loyalty. Journal of European Marketing 41(7):836–867, 2005.

    Google Scholar 

  57. Jin, C. H., The perspective of a revised TRAM on social capital building: The case of Facebook usage. Information & Management 50(4):162–168, 2013.

    Article  Google Scholar 

  58. Ribbink, D., Riel, A., Veronica, L., and Sandra, S., Comfort your online customer: Quality, trust and loyalty on the internet. Managing Service Quality 14(6):446–456, 2004.

    Article  Google Scholar 

  59. Hair, Jr., J. F., Black, W. C., Babin, B. J., and Anderson, R. E. (2010), Multivariate Data Analysis: A Global Perspective (7th ed.). Pearson Education International.

  60. Fornell, C. D., and Larcker, F., Evaluating structural equation models with unobservable variables and measurement errors. Journal of Marketing Research 18:39–50, 1981.

    Article  Google Scholar 

  61. Jackson, D. L., Gillaspy, J. A., and Purc-Stephenson, R., Reporting practices in confirmatory factor analysis research: An overview and some recommendations. Psychological Methods 14:6–23, 2009.

  62. Sobel, M. E., Asymptotic Intervals for Indirect Effects in Structural Equations Models. Sociological Methodology 290–312, 1982.

  63. Aroian, L. A., The probability function of the product of two normally distributed variables. Annals of Mathematical Statistics 18(2):265–271, 1947.

    Article  MATH  MathSciNet  Google Scholar 

  64. Goodman, L. A., On the Exact Variance of Products. Journal of the American Statistical Association 55(292):708–713, 1960.

    Article  MATH  MathSciNet  Google Scholar 

Download references

Acknowledgements

The authors thank Chien-Yi Li for his contribution to the assistance of data collection. This research is partially supported by Ministry of Science and Technology, Taiwan (103-2410-H-218 -007).

Author information

Authors and Affiliations

  1. Department of Accounting Information, Southern Taiwan University of Science and Technology, No. 1, Nan-Tai Street, Yungkang Dist., Tainan City, 710, Taiwan

    Shih-Chih Chen

  2. Chung Hwa University of Medical Technology, Tainan County, Taiwan, Republic Of China

    Din Jong

  3. Southern Taiwan University of Science and Technology, No. 1, Nan-Tai Street, Yungkang Dist., Tainan City, 710, Taiwan

    Min-Tsai Lai

Authors
  1. Shih-Chih Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Din Jong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Min-Tsai Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Din Jong.

Additional information

This article is part of the Topical Collection on Systems-Level Quality Improvement

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, SC., Jong, D. & Lai, MT. Assessing the Relationship between Technology Readiness and Continuance Intention in an E-Appointment System: Relationship Quality as a Mediator. J Med Syst 38, 76 (2014). https://doi.org/10.1007/s10916-014-0076-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10916-014-0076-3

Keywords

Search

Navigation