Hospital Information System adoption: Expert perspectives on an adoption framework for Malaysian public hospitals

•An adoption framework for Malaysian public hospitals was developed.•The model was developed based on TOE, institutional theory, and HOT fit.•A nationwide survey was conducted on small, medium, and large public hospitals.•Both HIS adopters and non-adopters in Malaysia participated in this research survey.•An effective prediction of the HIS adoption was achieved by the framework.

Hospital Information System (HIS) is important in the healthcare industry as it supports a wide range of highly specialized health-care tasks and services. In Malaysia, HIS diffusion is still in its early stage and there is slow rate of adoption among large, medium, and small public hospitals. To investigate the factors influencing the adoption of HIS in the hospitals' work processes, this study proposed the initial theoretical framework based on the combined Technology Organization Environment (TOE), institutional theory, and Human Organization Technology (HOT) fit model. A nationwide survey was conducted on small, medium, and large public hospitals involving both HIS adopters and non-adopters in Malaysia to verify the validity of the initial integrated framework. We find that relative advantage, compatibility, security concern, hospital size, mimetic pressure-competitors, vendor support, perceived technical competence of IS staff, and employees' IS knowledge as the influential factors on HIS adoption. In addition to the only moderator of this study (occupational level), any significant moderating effects on the Technology-Organization-Environment-Human dimensional factors and the adoption of HIS by Malaysian public hospitals was not found. Hence, these results indicated that the developed integrated framework provides an effective prediction of the HIS adoption by Malaysian public hospitals.