Impact of IT identity on consumer negatively-valenced engagement in mobile medical consultation: from consumer experience perspective
| DOI | https://doi.org/10.1108/IMDS-04-2022-0209 |
| Published date | 16 August 2022 |
| Date | 16 August 2022 |
| Pages | 2508-2539 |
| 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 |
| Author | Wenjing Zhang,Dong Li |
Impact of IT identity on consumer
negatively-valenced engagement in
mobile medical consultation: from
consumer experience perspective
Wenjing Zhang and Dong Li
School of Management, Harbin Institute of Technology, Harbin, China
Abstract
Purpose –The mobile medical consultation (MMC) service is growing rapidly, but not all consumers are
always willing to actively engage with it. To address this issue, based on IT identity theory, this study explores
the underlying mechanism of how two types of platform-related consumer experience influence MMC platform
identity, in turn, result in consumer negatively-valenced engagement in MMC.
Design/methodology/approach –The data was collected from 400 consumers with the experience of MMC
and analyzed by the partial least square (PLS) method.
Findings –The findings unfold that these two distinct consumer experience, servicescape experience (i.e.
perceived telepresence and perceived platform surveillance) and service search experience (i.e. perceived
diagnosticity and perceived serendipity), are associated with MMC platform identity and consumer negatively
valenced engagement with MMC.
Originality/value –Research on consumer negatively-valenced engagement in the field of MMC is still in a
nascent stage. The study identifies consumer experience in accordance with the unique context of the MMC
platform and fills the research gap on the role of IT identity in consumer negatively valenced engagement.
Keywords Mobile medical consultation (MMC), Servicescape experience, Service search experience, IT
identity, Consumer negatively-valenced engagement
Paper type Research paper
1. Introduction
The mobile medical consultation (MMC) service allows patients to purchase text- and video-
based consultation services provided by qualified healthcare professionals through digital
mobile medical consultation (MMC) platforms anytime and anywhere (Yang et al., 2021;Zhao
et al., 2022;Yoo et al., 2021). It benefits patients by enabling them to save time and travel costs
during MMC service encounters (Jiang et al., 2021b). Particularly, during the COVID-19
pandemic, MMC use has increased dramatically due to help reduce the risk of cross-infection
for patients with mild illnesses (Goyal et al., 2021). Despite its popularity and potential
advantages, consumers are not always willing to actively engage with MMC services (Wu
et al., 2022a;Cao et al., 2022) and the adoption rate of MMC is relatively low in China (Zheng
et al., 2022), limiting the promotion of MMC services and jeopardizing the effectiveness and
sustainability of the MMC platforms (Yang et al., 2019). Thus, going beyond the initial usage
perspective to further unravel why consumers express negatively-valenced engagement in
using MMC services during the post-consumption stage is needed.
Extant research on MMC is emerging, yet, most previous studies on MMC mainly
examined the determinants of consumer positively-valenced engagement with MMC such as
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Authorship: All authors have made substantial contributions to this paper. Wenjing Zhang has collected,
analyzed the data and drafted the manuscript. Dong Li has contributed to the conception, method and
revision of this paper.
Conflict of interest declaration: The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence the work reported in this paper.
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/0263-5577.htm
Received 8 April 2022
Revised 26 July 2022
Accepted 27 July 2022
Industrial Management & Data
Systems
Vol. 122 No. 11, 2022
pp. 2508-2539
© Emerald Publishing Limited
0263-5577
DOI 10.1108/IMDS-04-2022-0209
patient satisfaction, the adoption or continuous usage of MMC and the choice or purchase of
MMC (Chiu et al., 2021;Song et al., 2021;Zhang et al., 2022;Kamal et al., 2020;James et al.,
2022), focusing on the antecedents of MMC success but limiting research being conducted on
MMC failure. Given the negative impact of negatively-valenced engagement on the long-term
development of MMC (Jiang et al., 2021a), researchers, albeit few, started to pay attention to
this issue, but they addressed it by investigating the influencing factors for positively-
valenced engagement. For example, Wu et al. (2022a) and Yang et al. (2021) have pointed out
that some patients may be reluctant to engage in MMC due to privacy concerns and a lack of
trust. However, some scholars believe that negatively-valenced engagement can be a
dimension that is different from positively-valenced engagement because the reasons behind
positively-valenced engagement may be different from those behind negatively-valenced
engagement (Um and Lau, 2018). Thus, evidence from academics that aim at uncovering the
underlying reasons for negatively valenced engagement in the MMC context is still lacking.
MMC service is an emerging service based on mobile health technology (i.e. MMC
platform) (Wan et al., 2020;Li et al., 2021). Using traditional adoption theories such as Theory
of Reasoned Action, Technology Acceptance Model and Unified Theory of Acceptance and
Use of Technology, a body of previous studies has addressed the adoption of technology
services from a human-technology interaction perspective (Li, 2020;Kamal et al., 2020;Wu,
2018). These studies are insightful but not adequate for explaining the adoption mechanism
of MMC services because they have paid little attention to IT-specific traits enabled by the
MMC platform in the process of patient-platform interaction (Wu et al., 2022b). Diverged from
the previous perspective, this study argues that IT identity is a suitable overarching concept
to fill this gap as it describes consumers’emotional ties with specific IT and is a product of
personal histories of interacting with IT (Esmaeilzadeh, 2020). Besides, research has revealed
that individuals’ability to identify themselves with specific technology influences their
enthusiasm to engage in technology services (Sun et al., 2020). Specific to the MMC context, in
the process of MMC service delivery, a patient may continuously interact with the MMC
platform to search for information or consult a physician. This repetitive interaction will
make the MMC platform be integrated into a patient’s sense of self and internalize into a type
of IT identity called MMC platform identity (Wu et al., 2022b). There is robust literature
available to prove that MMC platform identity is an important predictor of consumer
engagement with mHealth (Reychav et al., 2019;Esmaeilzadeh, 2020). Nonetheless, to the best
of our knowledge, the exploration of the underlying mechanism of IT identity in the post-
adoption context remains limited and hardly any studies have examined the relationship
between IT identity and consumer negatively-valenced engagement with MMC.
Although previousresearch has demonstratedthat IT experience, IT characteristics,social
interactions,belongingness andprivacy risk can act as catalystsfor IT identity (Esmaeilzadeh,
2020;Balapour et al.,2019;Ogbanufe and Gerhart, 2020), few noticed the role of consumer
experience with MMC platform in forming MMC platform identity, which is a vital but
underexploredpredictor. The premiseof the formation of IT identityis the repeated interaction
between consumerand technology (Wu et al., 2022b), but only the pleasant IT experience can
facilitaterepetitive interaction (Esmaeilzadeh, 2020).Therefore, it is reasonable to suggest that
consumer experience is an antecedent of IT identity. Several studies have indicated that IT
experience affected IT identity (Esmaeilzadeh, 2020), yet,the research investigated the role of
platform-related consumer experience on MMC platformidentity is scant.
Besides, consumer experience is a multidimensional variable and various aspects of
consumer experience perceptions during the service experience process play simultaneous
and parallel roles in consumers’overall evaluation of the service experiences (Taheri et al.,
2021). When interacting with a MMC platform, an individual will generate various senses
because of various platform-specific characteristics. However, to date, there is still little
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discussion about how different types of consumer experience influence MMC platform
identity.
To address the above gaps in the literature, viewing IT identity theory as a lens to build
the model and integrating consumer experience perspective as a complementary means to
identify antecedent variables, we explore the underlying mechanism of how different types of
platform-related consumer experience influence MMC platform identity, in turn, result in
consumer negatively-valenced engagement in MMC. Two specific research questions guide
this paper:
RQ1. How does consumer experience influence MMC platform identity?
RQ2. How does MMC platform identity affect consumer negatively-valenced
engagement in MMC?
This study makes some contributions. Theoretically, it makes multifarious contributions to
the online health consultation services literature and IT identity theory. Practically, the
findings help platform managers take measurements to decrease consumer negatively
valenced engagement in MMC by improving consumer experience and increasing
consumers’MMC platform identity.
2. Theoretical development
2.1 IT identity theory
IT identity can be conceptualized as a new material identity, referring to the extent to which
an individual views the use of IT as integral to his or her sense of self (Michelle Carter and
Grover, 2015). As the fruit of human-computer intertwinement, IT identity maps out an
emotional bond between users and specific IT and figuratively describes users’emotional
state after human-computer interaction (Michelle Carter et al., 2013). Since its inception,
existing studies have demonstrated that IT identity was a better way to explain consumers’
IT usage behavior in various technology contexts. So far, numerous studies have explored the
antecedents and the consequences of IT identity. Adopting the views of Ogbanufe and
Gerhart (2020) and Mosafer and Sarabadani (2021), we made efforts to summarize previous
literature (As seen in Table 1) and integrated an IT identity framework (in Figure 1). Based on
the IT identity framework, this study examines the mechanisms that influence negatively-
valenced engagement with MMC.
A body of contextualized IT identity concepts appears in diverse domains with foci, such
as smartwatch identity (Ogbanufe and Gerhart, 2020), mobile identity (Sun et al., 2020) and
mobile technology identity (Balapour et al., 2019). The extension of the concept of IT identity
is related to the specific technology. In this article, the mobile medical consultation (MMC)
platform (e.g. Weiyi apps; Chunyu Doctor apps) is a unit of technology with characteristics
attributed to both software and hardware and can be viewed as a specific IT. In line with
Reychav et al. (2019) and Michelle Carter and Grover (2015), we propose the term MMC
platform identity, describing the extent to which an individual views use of the MCC platform
as integral to his or her sense of self. In line with the related literature (Li et al., 2020b,Michelle
Carter and Grover, 2015), we further suggest that MMC platform identity is a high-order
construct with three reflective dimensions. Dependence is defined as an individual’s sense of
reliance upon an IT, emotional energy refers to the level at which the individual expresses
continuous feelings of enthusiasm and excitement when using IT technology as a result of
positive interactions in the past and relatedness can be defined as the level on which the
individual expresses feelings of connection or a close and significant relationship when
thinking of his/herself concerning his/her mobile device.
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