Doctor of Education (Ed.D.), Bowling Green State University, 2006, Leadership Studies

This study addresses post-implementation usage behavior of Computerized Physician Order Entry (CPOE) system among physicians in an organization by applying the Technology Acceptance Model (TAM). Implementation of CPOE is considered a major organizational activity by chief information officers (Kini & Savage, 2004), and physician acceptance of CPOE ultimately decides the success of CPOE implementation (Davis, 1989). Hence, this study assumes much importance. A CPOE-TAM instrument was developed for this study and assessed with principal component analysis. Six hypotheses were developed and tested using hierarchical multiple regressions. Study results suggest that the ‘total causal effects' of perceived usefulness of CPOE (PU) and perceived ease of use of CPOE (PEOU) on behavioral intention to use CPOE (BI) and CPOE adoption are striking, and PU is more important than PEOU in their relative influence on BI and CPOE adoption. Implications of the findings suggest that training sessions need to emphasize ‘usefulness' of CPOE and any increase in ease of use features of CPOE would directly influence usefulness of CPOE, which in turn influence BI and CPOE adoption. Studying the adoption of CPOE within an organizational context among physicians by applying TAM contributes richly to research literature in these major domains. This CPOE-TAM study was well-validated, and a parsimonious CPOE-TAM instrument is now available to information system and human-computer interaction researchers and practitioners. This CPOE-TAM instrument could be split further into two instruments: one for prediction of future acceptance of CPOE, and the other for explanation of CPOE adoption.

Committee: Patrick Pauken (Advisor) Subjects:

DNP, Kent State University, 2022, College of Nursing

Biosimilars are pharmaceutical agents approved by the Food and Drug Administration (FDA) as an option to treat multiple medical conditions. In rheumatology, they are used as an option to treat inflammatory diseases such as rheumatoid arthritis (RA) and spondyloarthritis (SpA). The term spondyloarthritis is used to describe a group of disorders, including ankylosing spondylitis (AS), nonradiographic axial spondyloarthritis (nr-axSpA), forms of arthritis associated with psoriasis (PsO), psoriatic arthritis (PsA), and with inflammatory bowel diseases (IBD), among others. The structure and therapeutic effects of biosimilars are similar to previously developed and approved patented biologic pharmaceutical agents. However, they cannot be considered identical, as they are not a product of controlled chemical synthesis but are produced by living cells. The main reason for possible differences is related to patent expiration dates, which typically occur for an active ingredient several years prior to the expiration of patent protection for a manufacturing process. Consequently, competitors may produce the active ingredient, but utilizing a different process, which can often result in variations in impurities and efficacy. With biologic production further complicated by the use of live organisms as production “reactors”, FDA's decision to classify off-patent biologic pharmaceutical agents as “biosimilar” rather than “generic”, as is done for small molecule synthetic pharmaceuticals, underscores the similar rather than identical efficacy of a reference biologic vs. its biosimilar. However, as with small molecule generic pharmaceuticals, biosimilars can be made available at a lower cost making them an economically preferred alternative. Available research data suggests that biosimilars and their reference products have comparable pharmacokinetics, safety, and efficacy. In January of 2019 majority of patients diagnosed with rheumatic diseases managed by the department of rheuma (open full item for complete abstract)

Committee: Lynn Gaddis (Committee Chair); Dana Hensen (Committee Member); Lisa Onesko (Committee Member) Subjects: Nursing