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RFID Continuance Usage Intention in Health Care Industry

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 Quality Improvement Initiatives

RFID Continuance Usage Intention in

Health Care Industry
Mohammad Iranmanesh, PhD; Suhaiza Zailani, PhD, RN, NEA-BC, FAAN; Davoud Nikbin, PhD

Radio-frequency identification (RFID) has been proved to be an effective tool both for improving operational efficiency
and for gaining competitive advantage in the health care industry despite its relatively low-usage rate in hospitals.
The sustained use of RFID by health care professionals will promote its development in the long term. This study
evaluates the acceptance continuance of RFID among health care professionals through technology continuance
theory (TCT). Data were collected from 178 medical professionals in Malaysia and were then analyzed using the
partial least squares technique. The analysis showed that the TCT model provided not only a thorough understanding
of the continuance behavior of health care professionals toward RFID but also the attitudes, satisfaction, and perceived
usefulness of professionals toward it. The results of this study are expected to assist policy makers and managers
in the health care industry in implementing the RFID technology in hospitals by understanding the determinants of
continuance of RFID usage intention.
Key words: continuance usage, Malaysia, RFID, technology continuance theory

E ach year, several deaths in Malaysia are caused

by medication-related errors.1 These errors can
be caused by various reasons such as confusion in
the packaging and labels of medication, lack of man-
power, and negligence of health care personnel.2-4 In
light of such errors, hospitals use different technologies
to monitor activities related to medication. For exam-
ple, radio-frequency identification (RFID) technology is
applied by hospitals to reduce medication errors and
ensure patient safety.5,6 RFID also improves the orga-
nizational performance and competitiveness of health
care businesses.7-9 Apart from improving operations,
RFID can guarantee patient safety as well.10,11 Despite
the immense potential of the technology in hospitals,
the use of RFID remains low and meets constant re-
sistance from caregivers, particularly from physicians.1
Although the initial adoption of an innovation is im-
portant for realizing its success, the long-term viability
and the ultimate success of a technology depend on its
continued use.12 The initial acceptance of a technology
does not guarantee the continuance thereof because
users may reevaluate their earlier acceptance decision
or experience psychological motivational changes af-
ter their initial acceptance.12,13 Continued adoption of
a new technology or system is a constant concern in
the management of health care organizations because
the success of such technology depends on the will-
ingness of caregivers toward its continued utilization.
Author Affiliation: Faculty of Business and Accountancy, University of
Malaya, Kuala Lumpur, Malaysia (Drs Iranmanesh and Zailani); and Faculty
of Business, Sohar University, Sohar, Sultanate of Oman (Mr Nikbin).
Correspondence: Mohammad Iranmanesh, PhD, Faculty of Business,
Multimedia University, 75450 MMU, Melaka (iranmanesh.mohammad@
gmail.com).
The authors declare no conflicts of interest.
Q Manage Health Care
Vol. 26, No. 2, pp. 116–123
Copyright 
C 2017 Wolters Kluwer Health, Inc. All rights reserved.
DOI: 10.1097/QMH.0000000000000134
116 April–June 2017 r Volume 26 r Number 2
Furthermore, adopting and implementing a new tech-
nology such as RFID are not only a simple action to pro-
vide all the necessary hardware and software but also
a social and technological interaction process among
the users, organizations, and their environment.14 Al-
though many studies have investigated the determi-
nants of RFID adoption,1,15,16 few studies have explored
the RFID continuance usage behavior of health care
professionals. To maximize the use of RFID and hospi-
tals, both hospital managers and policy makers should
have a thorough understanding of the adoption behav-
ior of RFID users. Therefore, the present study probes
into the RFID continuance usage behavior of health
care professionals.
RFID TECHNOLOGY IN HEALTH CARE
The RFID technology uses radio waves to collect and
transfer data. This rapidly developing technology also
has the capacity for efficient and automatic (ie, with-
out need for human intervention) data capture.17 Health
care professionals traditionally used bar codes for pa-
tient identification and to ensure the proper distribution
of drugs. However, the bar code system has several
limitations. First, a line of sight between the bar code
scanner and the wristband is required in this system.
However, it may present difficulty in patient identifica-
tion when the patient is asleep and the bar code is not
visible. Second, bar code scanners read the bar code
using optical sensors; thus, the code cannot be read or
may be read incorrectly if the wristband is unclean. An
incorrect reading of the bar code will then cause a mis-
take in the medication provided to the patient. These
2 limitations are addressed by RFID, which is a wire-
less technology and therefore does not require a line
of sight.18 Despite its high cost, RFID has many advan-
tages over the bar code technology.19 First, printed bar
codes fade after a particular period of time. Second, as
a line of sight between the RFID tag and reader is not
www.qmhcjournal.com

Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
April–June 2017 r Volume 26 r Number 2
necessary, RFID removes the reading difficulty when
the tag is dirty. Third, RFID has the capacity to read
hundreds of RFID tags simultaneously.
Hawrylak et al18 provided 3 primary applications of
RFID in the health care industry: inventory tracking and
management; locating of assets, patients, and person-
nel; and improvement of patient care quality. The first
function assists hospitals in reducing overload invento-
ries and in exhausting their supplies before expiration.20
The second function enables hospitals to monitor their
personnel and locate patients, thus increasing their ca-
pacity to contain diseases and effectively facilitate quar-
antine and isolation.21 Finally, RFID assists patients in
following their treatment schedule, thus improving the
quality of patient care.22
RFID was adopted in the health care industry more
recently than in other industries such as manufactur-
ing, retail, logistics and supply chain, and library and
information management.10 In general, the application
of RFID in health care is deemed as the “next disruptive
innovation in health care.”23 Several researchers have
provided many benefits of RFID for the health care
system. For example, Wang et al21 and Tzeng et al24
revealed the ability of the RFID technology to reduce
cost and improve patient safety, medical services, and
business processes. However, despite these numer-
ous benefits, the use of RFID in the health care in-
dustry has not gained as much attention as expected.
Therefore, this study investigated the continuance us-
age behavior of health care professionals with regard
to RFID.
RFID TECHNOLOGY IN THE MALAYSIAN HEALTH
CARE INDUSTRY
The Malaysian health care industry is among the
fastest-growing service industries in the country.25 In
light of such growth, the Malaysian government has
focused on medical and health tourism, promoting
the high-quality and affordable medical services in
Malaysia to attract patients from all over the world.
Aside from competing with other local health care
providers, Malaysian hospitals and clinics also compete
with those in other countries such as Singapore and
Thailand.25 Apart from offering high-quality medical ser-
vices, the Malaysian health care industry can also com-
pete by increasing the efficiency of its operations.26
Despite the potential of RFID to assist in such im-
provement, many hospitals in Malaysia remain reluc-
tant to use the technology.10 A number of hospitals
in Malaysia, Singapore, and Indonesia conducted pilot
studies on the application of RFID in their operations.10
However, after such pilot studies were completed, only
Singapore continued using RFID for its health care
industry.
MODEL CONCEPTUALIZATION AND HYPOTHESIS
DEVELOPMENT
Previous studies mostly used 3 models to explain
continuance intention, namely, technology acceptance
model (TAM), expectation confirmation model (ECM),
Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
www.qmhcjournal.com 117
and cognitive model (COGM). Davis et al27 developed
TAM based on theory of reason action (TRA)28 and iden-
tified perceived usefulness (PU) and perceived ease of
use (PEU) as external motivators of the attitude and
behavioral intention of individuals to use technology.
TAM claims that user attitude toward technology use
motivates behavioral intention to use such technology,
which then directly determines technology use.29 This
model is commonly applied in the examination of con-
tinuance and postadoption behavior.30,31 However, TAM
is incapable of taking into account the effects of ex-
ternal variables and barriers on technology adoption.32
Therefore, previous research deemed TAM as too par-
simonious despite its explanatory power when com-
bined with external factors.33,34
The recently proposed ECM12 describes the behav-
ior of users toward the continued use of a technology.
This model assesses the intention of an individual to
continue using a technology, and it indicates that user
satisfaction is the most critical factor in determining the
continuance intention of users. ECM claims that such
continuance intention is determined by the satisfaction
of users with the technology and the PU of continued
technology use. Consequently, the satisfaction of users
is motivated by the confirmation of their expectations
from PU and prior technology use. Unlike TAM, ECM
emphasizes the factors that affect retention and con-
stancy, as the long-term success of a technology is
driven by continued use rather than first-time use.12,29
Oliver35 proposed COGM, which suggests that individ-
ual behavioral intention is a function of attitude and
satisfaction.
Addressing the limitations of these 3 models to ac-
commodate the entire adoption cycle, technology con-
tinuance theory (TCT) was proposed as an enhanced
model for technology continuance.29 Five constructs of
TAM, ECM, and COGM were combined to produce a
reduced model. These constructs are confirmation, sat-
isfaction, PU, PEU, and attitude. One primary advantage
of TCT is that it integrates the attitude and satisfaction,
which are the 2 central constructs, into one continu-
ance model and adopts the other constructs of PU and
PEU as first-level antecedents.29
The present study used TCT to evaluate the contin-
uance usage of electronic medical record (EMR) in the
health care industry (Figure 1). Among the models that
explain continuance intention, TCT was used in this
study because of its ability to explain the entire life cy-
cle of adoption. Liao et al29 revealed that TCT is superior
over TAM, ECM, and COGM in explaining user behavior
both quantitatively and qualitatively. In particular, TCT
can provide a quantitative explanation not only of be-
havioral intention but also of attitude and satisfaction.
Furthermore, TCT combines the central constructs of
attitude and satisfaction, which improve the qualitative
explanatory power of the continuance model.
HYPOTHESIS DEVELOPMENT
Confirmation is a cognitive belief that reflects the ex-
tent to which user expectation of technology use,
which is derived from prior technology use, is satisfied
118 April–June 2017 r Volume 26 r Number 2
Figure 1. Proposed theoretical model.
during actual use.12 Although usefulness perception is
expected to be low in the initial stages of technology
use, such perception may be adjusted when users con-
firm that their initial perceptions are unrealistically low.
Therefore, confirmation elevates user PU whereas dis-
confirmation reduces such perceptions.14
ECM posits that user satisfaction is determined by
2 constructs: expectation of the technology and confir-
mation of expectation following actual use. User expec-
tation forms the baseline level, against which confirma-
tion is assessed to determine the evaluative response
or satisfaction of the users. Confirmation is positively
related to satisfaction with technology use because
it implies the realization of the expected benefits of
such use, whereas disconfirmation suggests failure to
achieve such expectation.12 The study of Hossain and
Quaddus36 on continuance usage of the RFID technol-
ogy revealed that user satisfaction is influenced by a
confirmation of expectations from prior experience of
using the RFID technology. Such confirmation shows
that health care professionals obtained their expected
benefits through their experiences of using the EMR
system, which produced a positive effect on their satis-
faction. Thus, the following hypotheses are developed
in the present study:
H1: Confirmation of the expectations of health care
professionals positively affects their PU of the RFID
technology.
H2: Confirmation of the expectations of health care
professionals positively affects their satisfaction with
the RFID technology.
PEU refers to the degree to which a person believes
that using a technology will be free of effort37 ; that is,
the technology is generally perceived as more useful
if it is easy to use. Previous studies provided strong
empirical support for a positive relationship between
PU and PEU.38,39 Moreover, health care professionals
need to feel that the RFID technology is easy to use.
TRA suggests that PEU affects the attitude of a user.
Therefore, we posit the following:
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www.qmhcjournal.com
H3: PEU among health care professionals positively
affects their PU of the RFID technology.
H4: PEU among health care professionals positively
affects their attitudes toward the RFID technology.
PU refers to the perceptions of individuals of a spe-
cific technology that will enable them to perform their
tasks better.37 Previous studies demonstrated that user
satisfaction with technology is strongly correlated with
PU.12,40 An individual who perceives a particular type of
technology as useful is more likely to be satisfied with
that technology than one who perceives otherwise.
In addition, health care professionals independently
decide whether to use the RFID technology, and this
decision reflects their individual attitude toward this
technology, which is influenced by “usefulness,” as
suggested by the original TAM.37
Considerable studies have identified that PU is pos-
itively related to the acceptance and utilization of a
new technology.1,37,41 When users believe that using
a specific technology can enhance their productivity,
they may want to continue to use that technology.12,13
Therefore, we develop the following hypotheses:
H5: PU among health care professionals positively
affects their satisfaction with the RFID technology.
H6: PU among health care professionals positively
affects their attitude toward the RFID technology.
H7: PU among health care professionals positively af-
fects their continued usage intention toward the RFID
technology.
User satisfaction refers to an overall evaluation of a
technology that reflects an emotion-based response to-
ward the target technology.42 Although several studies
regard attitude and satisfaction as synonymous with
each other,43 most researchers believe that the 2 fac-
tors are different from a conceptual standpoint. Sat-
isfaction is a transient and experience-specific affect,
whereas attitude is relatively more enduring and tran-
scends all previous experiences.31 Attitude is the per-
ceptual evaluation of a product or service, and satis-
faction is the postpurchase evaluation of a product or
April–June 2017 r Volume 26 r Number 2
service.44 Liao et al29 demonstrated that satisfaction
positively influences attitudes toward information sys-
tem usage.
Other researchers have investigated user satisfac-
tion both as an indicator of user perception of the effec-
tiveness of technology45 and as an important indicator
of success in the adoption of technology in a manda-
tory environment.46 ECM suggests that user continu-
ance intention is determined by user satisfaction with
technology use. Many studies have observed that sat-
isfaction can enhance long-term user intention to use
a system.30,47 Therefore, we develop the following
hypotheses:
H8: Satisfaction of health care professionals positively
affects their attitude toward the RFID technology.
H9: Satisfaction of health care professionals posi-
tively affects their continued RFID technology usage
intention.
Attitude refers to “the degree of a person’s pos-
itive or negative feelings about performing a target
behavior.”27 TAM suggests that user attitude can de-
termine user behavior toward technology use. Previous
studies showed that attitude significantly affects inten-
tion to continue technology usage.48,49 When health
care professionals form positive attitudes toward the
RFID technology, they will have a stronger intention
toward using it. Therefore, the following hypothesis is
proposed:
H10: Attitude of health care professionals positively af-
fects their continued RFID technology usage intention.
RESEARCH METHODOLOGY
Measure of constructs
This study used a survey instrument that consists of
2 sections: the first section identifies the demographic
attributes of the respondent, and the second section
measures the theoretical constructs of TCT. To en-
sure content validity, the survey items were derived
from those used in previous studies. Both PU and PEU
scales were adopted from Venkatesh and Davis.50,51
Three, 4, and 3 items in confirmation, satisfaction, and
RFID continuance intention, respectively, were derived
from Bhattacherjee.12 A 4-item scale was adopted from
Taylor and Todd31 to measure attitude. Each item in this
scale was measured using a 5-point Likert scale. Table
1 presents these items.
Data collection and the sample
The units of analysis used in this study were RFID
end users, including physicians, nurses, and medical
technicians who had used the RFID technology in
selected hospitals in Malaysia. The willingness of end
users to continue using the RFID technology is crucial
for the successful implementation of this technology
in hospitals. Therefore, end-user input is highly sought.
The list of hospitals with RFID technology experience
was obtained through the Malaysia Ministry of Health
and the Malaysia Medical Council to determine which
hospitals to include in this study. To ensure the
reliability of respondents, potential respondents were
Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
www.qmhcjournal.com 119
chosen only from hospitals with experience in using
the RFID technology. Moreover, a filtering question
at the beginning of the survey questionnaire ensured
that the respondents had adequate experience in
RFID. The survey was conducted using questionnaires
that were distributed through hospital administrators
or human resources departments using the drop and
pickup method. Of 250 questionnaires sent out to the
hospitals, 194 were collected, thus yielding a return
rate of 77.6%. Sixteen returned questionnaires were
only partially completed and were thus not usable. The
usable response rate was about 71.2%.
Analysis
To test the research model, this study used the par-
tial least squares (PLS) technique of structural equa-
tion modeling using SmartPLS (version 3.0). This tech-
nique was selected because of its capacity to analyze a
complicated model.52 As recommended by Hair et al,53
this study applied the 2-step approach for data analysis.
The first step analyzed the measurement model, and
the second step assessed the structural relationships
among the latent construct. This approach was used to
determine the reliability and validity of the measures
before testing the structural relationship of the model.
RESULTS
Profile of respondents
Male respondents comprised 46.6% of the sample,
and female respondents comprised 53.7%. A total of
66 respondents (37.1%) were between 26 and 35 years
old, followed by 61 respondents (34.3%) between 36
and 45 years old, 30 respondents (16.8%) between 46
and 55 years old, 12 (6.7%) respondents older than
55 years, and 9 respondents (5.1%) younger than
25 years. With regard to their professions, 28.7% of
the respondents were physicians, 43.8% were nurses,
and 27.5% were medical technicians. The job tenure
of 47.8% of the respondents was less than 10 years,
and 52.2% had tenure of more than 10 years.
Measurement model analysis
To test the reliability and validity of the reflective con-
structs, composite reliability (CR) was measured in re-
lation to internal reliability. Table 1 shows that all con-
structs had CR values above 0.7, which satisfies the
suggestion of Hair et al53 to accept items with loadings
of at least 0.7. Individual item reliability was deemed
acceptable because all the loadings associated with
each of the scales were greater than 0.7. Convergent
validity was then assessed using the average variance
(AVE), which was above 0.5, thus indicating satisfactory
convergent validity.
Two approaches were used to assess the discrimi-
nant validity of the constructs. First, the cross loadings
of the indicators were examined. Findings of this as-
sessment revealed that no indicator loads were higher
in an opposing construct.54 Second, on the basis of
the Fornell and Larcker55 criterion, the square root of
AVE for each construct exceeded the intercorrelations
120 April–June 2017 r Volume 26 r Number 2 www.qmhcjournal.com

Table 1. Measurement Model Evaluation

Constructs Items Factor Loadings CR AVE
Confirmation My experience with using RFID was better than what I expected. 0.851 0.870 0.690
The service level provide by RFID was better than what I expected. 0.832
Overall, most of my expectations from using RFID were confirmed. 0.808
Perceived usefulness Using RFID improves my performance in my work place. 0.878 0.904 0.654
Using RFID improves my productivity in my work place. 0.811
Using RFID enhance my effectiveness in my work place. 0.754
Using RFID system would improve the quality of the tasks I perform. 0.827
I find RFID to be useful in my work place. 0.766
Perceived ease of use My interaction with RFID is clear and understandable. 0.854 0.939 0.754
Interaction with RFID does not require a lot of mental effort. 0.811
I find it easy to get RFID to do what I want it to do. 0.852
I find RFID to be easy to use in the hospital. 0.911
Learning RFID system would be easy for me. 0.909
Satisfaction My overall experience of RFID use was: very satisfied. 0.833 0.909 0.714
My overall experience of RFID use was: very pleased. 0.874
My overall experience of RFID use was: very contented. 0.903
My overall experience of RFID use was: absolutely delighted. 0.764
Attitude Using RFID in hospital would be a good idea. 0.908 0.949 0.822
Using RFID in hospital would be a wise idea. 0.912
I like the idea of using RFID. 0.885
Using RFID would be a pleasant experience. 0.922
RFID continuance intention I intend to continue using RFID rather than discontinue its use. 0.856 0.868 0.687
My intentions are to continue using RFID than use any alternative means. 0.841
If I could, I would like to continue using RFID as much as possible. 0.788
Abbreviations: AVE, average variance extracted; CR, composite reliability; RFID, radio-frequency identification.

of the construct with the other constructs in the model evaluated in terms of the portion of variance explained.
(Table 2). Both analyses confirmed the discriminant va- The results of such evaluation suggest that the model
lidity of all constructs. is capable of explaining 64.2% of the variance in
After obtaining satisfactory results for the measure- PU, 62.3% of that in satisfaction, 51.1% of that
ment model, the structural model was subsequently in attitude, and 41.7% of that in RFID continuance
evaluated. The predictive accuracy of the model was intention. Apart from estimating the magnitude of R2 ,
recent research has examined predictive relevance,
which was developed by Stone56 and Geisser57 as
Table 2. Discriminant Validity Coefficientsa an additional model fit assessment technique. This
CON PU PEU SAT ATT INT technique indicates the ability of the model to predict
the manifest indicators of each latent construct.
CON 0.831
Stone-Geisser Q2 (cross-validated redundancy) was
PU 0.711 0.809 computed in the present study to examine predictive
PEU 0.527 0.678 0.868 relevance using a blindfolding procedure in the PLS.
Following the guidelines provided by Chin,58 Q2 value
SAT 0.706 0.741 0.621 0.845
that is higher than zero implies that the model has pre-
ATT 0.654 0.655 0.683 0.667 0.907 dictive relevance. The present study obtained a value
INT 0.547 0.422 0.624 0.529 0.632 0.829 of 0.378 for average cross-validated redundancy (for all
endogenous variables). Therefore, the model exhibited
Abbreviations: ATT, attitude; CON, confirmation; INT, RFID continuance intention; PEU,
perceived ease of use; PU, perceived usefulness; RFID, radio-frequency identification;
acceptable fit and high predictive relevance. Further-
SAT, satisfaction. more, nonparametric bootstrapping was applied59 with
a
Assessment of the structural model. 2000 replications to test the structural model. Figure 2
Note: Diagonal terms (in bold) are square roots of the AVE. presents the structural model that resulted from the

Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
April–June 2017 r Volume 26 r Number 2
Figure 2. Path analysis. a p < 0.05, b p < 0.01, c p < 0.001.
PLS analysis. With the exception of one path (H7), all
the paths are significant. Therefore, H1-H6 and H8-H10
are supported, whereas H7 is not supported.
DISCUSSION
This study aimed to examine the continuance usage
intention of health care professionals toward the RFID
technology using TCT. One strength of TCT is that it
synthesizes attitude and satisfaction, the 2 central con-
structs, into one continuance model, and it preserves
PU and PEU as first-level antecedents at the same time.
With the exception of one hypothesis, all hypotheses
in the TCT model proposed in this study are supported.
This result reveals that the TCT model in this study has
explanatory power in the continuance usage of health
care professionals toward the RFID technology.
In accordance with the findings of Chen et al,38
Lee,39 and Lin et al,14 confirmation and PEU are the
antecedents to PU. The effect of confirmation on PU
is higher than that of PEU. This finding indicates that
confirmation plays a high role in the PU of RFID in the
postusage stage. As professionals gain more experi-
ence with the RFID technology, using such technology
becomes a routine for them. Therefore, the health care
professionals become familiar with the features of the
RFID technology so that the ease of use loses its impor-
tance in their perception of usefulness. From this per-
spective, health care providers should increase their
efforts to meet the expectations of health care pro-
fessionals in the RFID technology and make the RFID
technology easier to use.
The results also show the significant effects of
confirmation and PU on satisfaction, consistent with
those reported in the previous studies by Hossain and
Quaddus,36 Bhattacherjee,12 and Son et al.40 Therefore,
meeting the preusage expectations of health care pro-
fessionals and ensuring that the RFID technology is
useful are important considerations for both providers
and vendors after RFID technology implementation.
Considering such factors increases satisfaction among
Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
www.qmhcjournal.com 121
health care professionals. Therefore, health care orga-
nizations should foster close relationships with the ven-
dors to extend the usefulness of the RFID technology
and meet the expectations of health care professionals.
Attitude is determined collectively by PEU, PU, and
satisfaction. These results are consistent with those of
other previous studies such as Huang et al,60 Davis,37
and Hsu et al.61 This result implies that as users of the
RFID technology, health care professionals will have
a positive attitude toward this technology when they
perceive that using RFID will help them perform their
job better, that such usage will be free of additional
effort, and that they will be satisfied with their pos-
tusage experience of the RFID technology. Therefore,
managers must enhance the perception of ease of use
and usefulness of the RFID technology among health
care professionals to satisfy the users.
Although satisfaction and attitude have significant ef-
fects on the continuance intention of health care pro-
fessionals to use the RFID technology, PU has no such
direct effect. In the adopting stage, health care profes-
sionals are concerned about whether the RFID technol-
ogy can help them perform their job better. After con-
siderable use, the performance and usefulness of the
RFID technology are then approved by health care pro-
fessionals. At this time, usefulness is taken for granted
and is no longer an active determinant of usage. Con-
tinued usage is then determined by inner psychological
judgment such as satisfaction and attitude.
This study provides several academic implications.
First, based on the empirical results, the TCT model
can explain not only the continuance intention toward
the RFID technology but also the attitude, satisfaction,
and PU of users toward the technology. This finding
suggests that TCT offers a new theoretical basis for
explaining RFID. Second, the results show that con-
firmation has a stronger effect on PU than on PEU in
the postadoption stage. Therefore, future research may
explore the factors that influence confirmation.
In addition to its theoretical implications, this
study offers recommendations for policy makers and
122 April–June 2017 r Volume 26 r Number 2
managers in the health care industry. Gaining a thor-
ough understanding of the determinants of continu-
ance intention of users toward RFID use will enable
policy makers to grasp the factors that result in contin-
ued RFID use. With such understanding, policy makers
can improve their policies and strategies to ensure the
successful implementation of the RFID technology in
the health care industry. Finally, health care managers
can use this knowledge to promote the use of RFID in
their hospitals or clinics.
LIMITATIONS AND FUTURE STUDIES
Before generalizing the discussed results, the limi-
tations of the study should be taken into account.
First, only a short-term snapshot or user behavior was
used for the research. Using longitudinal studies would
have produced a more accurate representation of the
changes in RFID users and in the relationship among
the variables. Second, this study used data on the
health care industry only in Malaysia. However, future
studies may obtain more interesting results by collect-
ing and comparing data from other countries.
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