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      Adoption and Use of Digital Technologies among General Dental Practitioners in the Netherlands

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          Abstract

          Objectives

          To investigate (1) the degree of digital technology adoption among general dental practitioners, and to assess (2) which personal and practice factors are associated with technology use.

          Methods

          A questionnaire was distributed among a stratified sample of 1000 general dental practitioners in the Netherlands, to measure the use of fifteen administrative, communicative, clinical and diagnostic technologies, as well as personal factors and dental practice characteristics.

          Results

          The response rate was 31.3%; 65.1% replied to the questionnaire on paper and 34.9% online. Each specific digital technology was used by between 93.2% and 6.8% of the dentists. Administrative technologies were generally used by more dentists than clinical technologies. Dentists had adopted an average number of 6.3±2.3 technologies. 22.5% were low technology users (0 to 4 technologies), 46.2% were intermediate technology users (5 to 7 technologies) and 31.3% were high technology users (8 to12 technologies). High technology users more frequently had a specialization (p<0.001), were younger on average (p=0.024), and worked more hours per week (p=0.003) than low technology users, and invested more hours per year in professional activities (p=0.026) than intermediate technology users. High technology use was also more common for dentists working in practices with a higher average number of patients per year (p<0.001), with more dentists working in the practice (p<0.001) and with more staff (p<0.001).

          Conclusion

          With few exceptions, all dentists use some or a substantial number of digital technologies. Technology use is associated with various patterns of person-specific factors, and is higher when working in larger dental practices. The findings provide insight into the current state of digital technology adoption in dental practices. Further exploration why some dentists are more reluctant to adopt technologies than others is valuable for the dental profession’s agility in adjusting to technological developments.

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          Most cited references16

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          Systematic review of factors influencing the adoption of information and communication technologies by healthcare professionals.

          This systematic review of mixed methods studies focuses on factors that can facilitate or limit the implementation of information and communication technologies (ICTs) in clinical settings. Systematic searches of relevant bibliographic databases identified studies about interventions promoting ICT adoption by healthcare professionals. Content analysis was performed by two reviewers using a specific grid. One hundred and one (101) studies were included in the review. Perception of the benefits of the innovation (system usefulness) was the most common facilitating factor, followed by ease of use. Issues regarding design, technical concerns, familiarity with ICT, and time were the most frequent limiting factors identified. Our results suggest strategies that could effectively promote the successful adoption of ICT in healthcare professional practices.
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            The work to make telemedicine work: a social and articulative view.

            This article contends that the take up of telemedicine results inevitably in the reconfiguration of the existing work practices and socio-material relationships. This new way of working triggers a variety of shifts in coordination mechanisms, work processes and power relationships in the health care sector. The paper, which is based on the findings of a research project conducted in Northern Italy, addresses three critical issues of telemedicine: the conflict between the scripts embodied in telemedicine technologies and the daily work practices of heath care professionals; the tendency of telemedicine to produce a delegation of medical tasks to non-medical personnel (and to artifacts); and the tendency of telemedicine to modify the existing geography within the health care environment. The paper contends that telemedicine presupposes and entails some significant changes in work processes which affect both the material conditions of the expertise which is supposed to be distributed, and the relationships between health care professionals and their practices.
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              Physicians' beliefs about using EMR and CPOE: in pursuit of a contextualized understanding of health IT use behavior.

              To identify and describe physicians' beliefs about use of electronic medical records (EMR) and computerized provider order entry (CPOE) for inpatient and outpatient care, to build an understanding of what factors shape information technology (IT) use behavior in the unique context of health care delivery. Semi-structured qualitative research interviews were carried out, following the beliefs elicitation approach. Twenty physicians from two large Midwest US hospitals participated. Physicians were asked questions to elicit beliefs and experiences pertaining to their use of EMR and CPOE. Questions were based on a broad set of behavior-shaping beliefs and the methods commonly used to elicit those beliefs. Qualitative analysis revealed numerous themes related to the perceived emotional and instrumental outcomes of EMR and CPOE use; perceived external and personal normative pressure to use those systems; perceived volitional control over use behavior; perceived facilitators and barriers to system use; and perceptions about the systems and how they were implemented. EMR and CPOE were commonly believed to both improve and worsen the ease and quality of personal performance, productivity and efficiency, and patient outcomes. Physicians felt encouraged by employers and others to use the systems but also had personal role-related and moral concerns about doing so. Perceived facilitators and barriers were numerous and had their sources in all aspects of the work system. Given the breadth and detail of elicited beliefs, numerous design and policy implications can be identified. Additionally, the findings are a first step toward developing a theory of health IT acceptance and use contextualized to the unique setting of health care. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                26 March 2015
                2015
                : 10
                : 3
                : e0120725
                Affiliations
                [1 ]Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, the Netherlands
                [2 ]Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, the Netherlands
                UNC School of Dentistry, University of North Carolina-Chapel Hill, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: MZ RG IA DW. Performed the experiments: MZ. Analyzed the data: MZ IA. Wrote the paper: MZ RG IA DW.

                Article
                PONE-D-14-19462
                10.1371/journal.pone.0120725
                4374680
                25811594
                bc9893b9-6f73-4d1e-848d-d658ddee9986
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 16 May 2014
                : 6 February 2015
                Page count
                Figures: 0, Tables: 3, Pages: 13
                Funding
                The project this study is part of was funded by International Team for Implantology (ITI) https://www.iti.org/; ITI Grant 777_2011. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Custom metadata
                Ethical restrictions, and third party ownership, prevent public sharing of data. The data on age, year of birth, sex, and year of graduation are owned by the KNMT, and requests may be sent to Prof. Dr. J.J. Bruers ( j.bruers@ 123456knmt.nl ). All other data are owned by the authors, and requests may be sent to Dr. T.J.M. van Steenbergen, Research coördinator ACTA ( t.v.steenbergen@ 123456acta.nl ).

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