The moderating effect of hospital size on inter and intra-organizational factors of Hospital Information System adoption

Healthcare is a highly institutionalized industry, subject to multiple regulatory forces, high levels of professionalism, and growing network externalities which may affect the decisions to adopt. Hence, this research integrates the Resource Dependence Theory (RDT), institutional theory along with Human Organization Technology (HOT) fit model as the organization theories to explain the adoption of Hospital Information System (HIS). To examine the effects of inter and intra-organizational potential factors on HIS adoption, within the context of Malaysian public hospitals, a survey method using web-based questionnaire is employed. The role of hospital size in this study is investigated to determine its distinct moderating influence among the relationships of the HIS adoption and significant dimensional factors. The results indicated that system affiliation (p < 0.05), mimetic pressure-competitors (p < 0.1), normative pressure (p < 0.05), and employees' IS knowledge (p < 0.05) were the most significant drivers for adopting HIS in the public hospitals of Malaysia. The results also showed that hospital size as the only moderator of this study has no significant effect on the other relationships in our developed theoretical model. In other words, the effects of the significant factors on HIS adoption are the same in three small, medium, and large Malaysian public hospitals. This research presents a conceptual foundation for future researches and fills a gap in the literature regarding the inter-organizational factors influencing the adoption of HIS.