Critical factors of hospital adoption on CRM system: Organizational and information system perspectives Shin-Yuan Hung a, ⁎, Wei-Hsi Hung a,1 , Chia-An Tsai a,2 , Shu-Chen Jiang b,2 a Department of Information Management, National Chung Cheng University, Chia-Yi 62117, Taiwan, ROC b Graduate Institute of Healthcare Information Management, National Chung Cheng University, Chia-Yi 62117, Taiwan, ROC abstract article info Article history: Received 18 September 2008 Received in revised form 5 August 2009 Accepted 30 November 2009 Available online 4 December 2009 Keywords: Healthcare information technology Customer relationship management Information systems adoption Hospitals The recent rapid increase in the amount of medical information has pushed hospitals to confront an essential issue which is how to utilize healthcare information technology to improve healthcare services quality. Customer relationship management system (CRMS) is an innovative technology which facilitates the process to acquire, develop, and maintain customer relationships more efficiently and effectively. From the business perspective, patients represent the major customers of the hospital who receive and feel the healthcare services directly and realistically. Although the critical factors for the adoption of information systems have been identified in previous studies, few have specifically explored CRMS adoption in hospitals despite the fact that it has dramatic impacts on the quality of healthcare services and customer satisfaction. To fill this gap, this study proposes an integrated model that incorporates both organizational and system related factors as primary determiners of CRMS adoption in hospitals. A series of surveys were conducted with three levels of health institutions in Taiwan: medical centers, regional hospitals, and community hospitals. The results indicated that hospital size, IS capabilities of staff, innovation of senior executives, knowledge management capabilities, and relative advantage have significant influence on the CRMS adoption. The research results also reveal constructive suggestions to researchers, hospitals, CRMS vendors, and the government to increase the likelihood of adopting CRMS. Crown Copyright © 2009 Published by Elsevier B.V. All rights reserved. 1. Introduction Improving quality of care and customer satisfaction are the key business drivers, and these will have the most impact on healthcare in the next 2 years as indicated by a research report from the Healthcare Information and Management Systems Society (HIMSS) [24]. In a recent investigation, the chief information officers (CIO) in hospitals ranked consumer considerations as the second most important business issue that has an impact on the healthcare sector [25].The American College of Healthcare Executives (ACHE) [3], a renowned international professional society, identified the top issues confront- ing hospitals based on a survey among 1080 hospitals in 2007. CRM related issues (care for the uninsured, physician/hospital relations, and customer satisfaction) which most concern the chief executive officers (CEO) have been in the top-nine list for three consecutive years. In addition to the results in the United States, CRM has also become more important in the United Kingdom and Germany since a series of interview investigations have discovered that a large proportion of customers feel dissatisfied with current healthcare services [30,44,45]. This dissatisfaction needs to be remedied through the use of CRM in hospitals. Customer relationship management (CRM) for healthcare provi- ders is an approach to learn all they can about their customers and prospects, to communicate relevant, timely information to them, and to track results to make program adjustments necessary [7]. From a non-profit organization's perspective, hospitals should provide quality medical services to those who are insured and not insured. In order to keep finance in balance, it is critical for hospitals to manage customer relationships, target those who can afford the health insurance, increase their loyalty, and generate more profits in order to cover the extra expenses of the uninsured. From the business perspective, patients represent the major customers of the hospital who receive and feel the healthcare services directly. Customer satisfaction is the key to maintaining hospitals' profitability since the customers' choice of a favorable hospital is frequently based on their inquiry into healthcare information and the experiences of their friends, family members, or colleagues. In the United States, customers who have medical insurance still have the right to choose a hospital from among several alternatives given by the insurance company. Thus, hospitals need to provide quality CRM to their customers in order to build a positive public image. Decision Support Systems 48 (2010) 592–603 ⁎ Corresponding author. Tel.: + 886 5 2724711x34601; fax: + 886 5 2721501. E-mail addresses: syhung@mis.ccu.edu.tw (S.-Y. Hung), fhung@mis.ccu.edu.tw (W.-H. Hung), homeanking@gmail.com (C.-A. Tsai), cindralla@mis.ccu.edu.tw (S.-C. Jiang). 1 Tel.: +886 5 2724711x24620; fax: +886 5 2721501. 2 Tel.: +886 5 2724711x16813; fax: +886 5 2721501. 0167-9236/$ – see front matter. Crown Copyright © 2009 Published by Elsevier B.V. All rights reserved. doi:10.1016/j.dss.2009.11.009 Contents lists available at ScienceDirect Decision Support Systems journal homepage: www.elsevier.com/locate/dss