Relationships between Task Complexity, Digital Literacy, and Hospital Information Systems Quality A Study of Hospital Managers in New Zealand and Indonesia

Abstract

Hospitals are one of the most complex and unique organisations. A hospital is a secondary healthcare organisation that employs clinicians and other health professionals and utilises advanced technology to support the process of providing care to patients with diverse types of diseases and needs. Subsequently, hospital information systems (HIS) are made available for the staff and the managers to collect, process, and store data. Hospital managers use the data to obtain information to support their decision-making processes and manage their organisation. Hospital managers most likely deal with complex situations that require more helpful information for making decisions. As a result, they should have a sufficient level of digital skills to better use their HIS. With valuable information in hand, they will know what is required to provide equitable health and medical services for patients, whānau, and communities. Studies suggest that more data is delivered from HIS, yet not all managers are able to utilise it for obtaining information. In addition, the literature has recognised task as a factor in information-seeking behaviour. This leads to doing research to find the relationships between hospital managers’ tasks, digital skills, and the use of HIS. Fewer studies related to hospital managers’ task complexity and digital skills were discussed. Relevant theories were reviewed, and task-technology fit (TTF) theory was found to be helpful. My research model proposed four variables: task complexity, HIS, digital literacy, and tasktechnology- digital literacy fit (TTDLF). Task complexity involved managerial and informational aspects. Digital literacy includes computer skill, online information searching skill, hyperlink navigation skill, content evaluation skill, information collection skills, and online media skill. Whereas HIS attributes concern technology quality, service quality (i.e., to support task), and information quality. Survey research was selected to collect data from participants. A questionnaire development guideline consisting of seven stages was followed. A systematic literature review helped to identify task complexity and digital literacy dimensions. Four hospital managers helped to select relevant dimensions through focus group meetings. The development of questionnaire items and responses involved consultations with academia. Another group of managers pre-evaluated the questionnaire and provided some constructive feedback. A pilot test of the questionnaire involved four hospital managers prior to the finalisation stage. Ethics approvals and local permissions were obtained prior to deploying a research invitation. Survey data were collected from hospital managers in New Zealand (in English) and Indonesia (in Bahasa). The survey data were screened for any missing values. Descriptive analysis was conducted to obtain the proportion of survey respondents based on their characteristics, including organisational (i.e., hospital location and bed capacity), functional (i.e., seniority level, number of subordinates, years of experience, time spent with HIS), and individual (i.e., gender groups, age groups, background as a clinician, and digital training history). Crosstabulation analysis was done to show the levels of task complexity, digital literacy, HIS quality, and TTDLF. Principal component analysis (PCA) was employed to inform which components of measured variables need to be dropped or retained. The scores of each measured variable were calculated based on the retained components. Correlation analyses was conducted to test my research hypotheses concerning task complexity, digital literacy, HIS quality, and TTDLF. In the NZ context, the results indicated that HIS quality and digital literacy are significantly correlated to TTDLF. In the Indonesian context, the results indicated significant correlations between all measured variables. Subsequently, SEM analyses was performed to determine the relationships between measured variables. The results indicated that task complexity has a weak effect on TTDLF for both NZ and Indonesian contexts. Conversely, higher HIS quality and digital literacy levels linked to higher TTDLF level. The SEM model indicated that only HIS quality and digital literacy are correlated and indicated two ways relationships. The goodness of fit values for SEM models for NZ and Indonesian contexts were checked and the results showed that the models are good, fit, and close.