How does online doctor–patient interaction affect online consultation and offline medical treatment?
| Published date | 02 December 2019 |
| Date | 02 December 2019 |
| Pages | 196-214 |
| DOI | https://doi.org/10.1108/IMDS-05-2019-0261 |
| Author | Wen Xing,Ping Yu Hsu,Yu-Wei Chang,Wen-Lung Shiau |
| Subject Matter | Information & knowledge management,Information systems,Data management systems,Knowledge management,Knowledge sharing,Management science & operations,Supply chain management,Supply chain information systems,Logistics,Quality management/systems |
How does online doctor–patient
interaction affect
online consultation and offline
medical treatment?
Wen Xing
Hong Kong Baptist University, Kowloon, Hong Kong
Ping Yu Hsu
Department of Business Administration,
National Central University, Taoyuan, Taiwan
Yu-Wei Chang
National Taichung University of Science and Technology, Taichung, Taiwan, and
Wen-Lung Shiau
Department of Business Administration,
Zhejiang University of Technology, Hangzhou, China
Abstract
Purpose –The purpose of this paper is to investigate factors that influence the patients’intentions to
visit doctors face-to-face for consultations from the perspective of online doctor–patient interaction.
Justice theory, SERVQUAL and the halo effect are integrated to develop a research model based on the
performance-evaluation-outcome framework. The authors hypothesize that perceived justice and service
quality are the significant factors in reflecting the performance of online doctor–patient interaction, which
influences patient satisfaction evaluation and online and offline behavioral intentions.
Design/methodology/approach –The study conducted an online survey to collect data. Patients on a
healthcare consulting website were invited to participate in the survey. The research model and hypotheses
were tested with 254 collected data from patients and analyzed using the partial least squares method.
Findings –The results show that perceived justice and service quality have a positive effect on patient
satisfaction, and satisfaction and the intention of online consultation have a positive effect on the intention of
face-to-face consultation.
Practical implications –This study offers suggestions on how doctors interact with patients and build
their brand image. The findings also offer effective insights into improving doctors’online services to retain
patients and even encourage patients to go to clinics.
Originality/value –Onlinehealth consultationis one of the mostpopular online healthservices andis growing
quickly.After patients consult onlinedoctors, they are able to visittheir doctors in person for furtherdiagnosis
and treatment if they have the need. This study investigates how patients’online interactive experience
influencestheir offline behavioralintentions, which are different from mostof the past literature on eHealth.
Keywords Service quality, Justice theory, Halo effect, eHealth, Doctor–patient interaction, Online consultation
Paper type Research paper
1. Introduction
eHealth has become an emerging industry. eHealth refers to electronic health information
and services obtained through the internet, such as internet technology and mobile media
(Eysenbachand Diepgen, 2001). These services allow patients to use the internet, for
example, through blogs, forums, online communities, patient–physician communication
systems and other advanced systems, to acquire health support. More than 5,000 health
care-related applications or software are available worldwide (AppleChina, 2017). For
example, Chunyu Yisheng (Spring Rain Doctor) is a widely used health care service platform
in China with more than 300,000 doctors and 86m patients (Chunyu Yisheng, 2017). In 2016,
Industrial Management & Data
Systems
Vol. 120 No. 1, 2020
pp. 196-214
© Emerald PublishingLimited
0263-5577
DOI 10.1108/IMDS-05-2019-0261
Received 1 May 2019
Revised 23 September 2019
Accepted 28 October 2019
The current issue and full text archive of this journal is available on Emerald Insight at:
www.emeraldinsight.com/0263-5577.htm
196
IMDS
120,1
the market revenue of online healthcare services increased and reached RMB 22.3bn
(iResearch, 2016).
Online health consultation is one of the most popular online health services and is
growing quickly. The number of online consultation users is growing constantly. China has
more than 250,000 health consultations per month (iResearch, 2016), and one-third of
Europeans have experienced online consultations (Lynne and Judy, 2009). On online
consultation platforms, patients can interact with doctors and obtain professional guidance.
Doctors are able to increase their income and strengthen their relationships with their
patients (Ball and Lillis, 2001). After patients consult online doctors, they are able to visit
their doctors in person for further diagnosis and treatment if they have the need. Service
quality and processes are the key factors influencing patients’intentions to continue to
consult online doctors and visit doctors offline. Thus, online consultation may persuade
patients to a face-to-face consultation offline. In short, online consultation performance can
influence patient satisfaction and subsequent behavioral intentions (McGeady et al., 2008;
Cao et al., 2017; Chang et al., 2019).
Although several scholars have studied eHealth (McGeady et al., 2008; Huppertzand
Carlson, 2010), most of the research in this field has only surveyed online services, such as
the effect of online medical consultation on online behavioral intentions. McGeady et al.
(2008) reviewed the benefits and costs of patient–physician web messaging and claimed that
online communication tools can improve the quality of care because of the increased amount
of patient–physician communication. From the patient’s point of view, Cao et al. (2017) found
that service quality and eWOM are important factors influencing the patients’intentions to
consult doctors. To the best of our knowledge, no work has investigated how patients’
online interactive experience influences their offline behavioral intentions.
In fact, patients who pay for eHealth information are sensitive to their health and may
visit doctors more frequently (Xiang and Stanley, 2017; Lee, 2008). Thus, this study assumes
that patients’online consulting experience might affect their offline behavioral intentions.
If patients feel relaxed and satisfied with online consultations, they are more willing to use
face-to-face consultations. To fill the research gap, this study focuses on the following issue
from the perspective of the doctors providing online health services:
RQ1. What factors regarding online consultation can motivate patients to visit doctors
face-to-face for consultations?
By answering the above research question, this study contributes to the eHealth literature.
First, we propose a three-stage model with a performance-evaluation-outcome framework
that shows the entire process from online consultation to face-to-face consultation.
Furthermore, online consultation performance is measured in detail based on justice theory
and SERVQUAL. Patient satisfaction is the main measure of the evaluation stage, while the
relationship between the intention of online consultation and the intention of face-to-face
consultation is regarded as the outcome. Second, the study simultaneously measures
perceived justice and service quality in a research model. Perceived justice is a second-order
formative construct, and service quality is a second-order reflective construct. Third,
this study not only explores patient online behavior, but also considers the effects of
online experience on patients’offline behavioral intentions. The findings of this study offer
effective insights into improving doctors’online services to retain patients and even
encourage patients to go to clinics.
2. Literature review
2.1 Performance-evaluation-outcome framework
The performance-evaluation-outcome framework was proposed by Roy et al. (2017). The
framework was developed based on the theory of reasoned action (TRA). The TRA suggests
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Online
doctor–patient
interaction
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