Understanding the impact of indirect system use in the hospital: A control perspective

In the hospital, designated system users (i.e., principal physicians) are usually found to delegate system-related tasks to other people (i.e., agent physicians). This behavior is termed as indirect use. Despite the prevalence of indirect use, the understanding of its clinical impacts is limited. In this research, we first propose different effects of indirect use on clinical care quality and physician-patient interaction care quality. We then draw on the agency theory and organization control literature to identify the moderating effects of three control mechanisms: input control, process control, and outcome control. A total of 242 physicians from a general public hospital were surveyed to verify the proposed hypotheses. The results show that three control mechanisms moderate the impacts of indirect use in different manners. Implications and plan for future research are then discussed.