This research strives to fill this gap by investigating the influence of doctor''s perception on the adoption of BYOD in Pakistan by extending the UTAUT2 model to incorporate with security and privacy. This article proposes a conceptual model of BYOD by identifying the factors and then model development. Future work is to validate the proposed model by expert review method.
ISSN:2229-6093 Saima Nisar et al, International Journal of Computer Science & Communication Networks,Vol 7(3),58-65 ICT Transformation through Byod Adoption in Healthcare of Pakistan Saima Nisara *, Wan Rozaini bt Sheik Osmana a School of Computing, College of Arts and Science, UUM, Universiti Utara Malaysia, 06010, Sintok, Kedah, Malaysia saimaanisar@gmail.com; rozai174@uum.edu.my saimaanisar@gmail.com Abstract Information and communication technology (ICT) is intensely transforming our society and economy Organization’s demands a committed plan and a digital agenda to go ahead effectively Medical sectors are progressively looking for portable solutions to meet their Information and Communication Technology (ICT) needs BYOD gains growing recognition as a working device to remotely examine patient's health But, the insufficient study has shed light on practitioners’ adoption of ICT This research strives to fill this gap by investigating the influence of doctor's perception on the adoption of BYOD in Pakistan by extending the UTAUT2 model to incorporate with security and privacy This article proposes a conceptual model of BYOD by identifying the factors and then model development Future work is to validate the proposed model by expert review method Keywords: ICT, BYOD, Doctors, UTATU2, Conceptual Model Introduction 1.1 ICT Transformation Information and Co mmunicat ion Technology (ICT) consists of software, hardware, med ia, and networks for the storage, collection, t ransmission, processing, providing informat ion and related services [1] [2] As with mu ltip lex service industries like banking, airlines, and insurance, the digital innovation needed cannot transpire without notable investment in ICT The dig ital transformation of ICT has stimulated considerably, it not only provides assistance also, empower the progressive redevelopment [3] ICT is the essential enabler to a transformation which will fulfil the necessities of the health system [4] ICT has excellent potential in providing tremendous advantages to the healthcare providers by increasing access, with sufficient investment, delivering performance, extending the range and decreasing the expense [5] Health data is the core of healthcare system, doctors require the complete patient's record IJCSCN | June-July 2017 Available online@www.ijcscn.com before taking decisions However, creating and emp loying information in the constantly changing and data concentrated healthcare system needs numerous expertises [6] ICT is adopted in the health sector for communicat ion of digital data, containing vital data collection, and can be recovered electronically to assist healthcare anywhere ICT has improved efficiency in several areas of the economy Nevertheless, still the adoption of ICT has been comparatively slow in the health sector [7] The latest progress regarding mobile technologies has facilitated mobile devices to perform functions previously not possible with handheld devices [8] ICT mediu m can be utilized to reach a broad variety of technological resolutions for communication, containing collecting data, text messaging, retrieving Electronic Health Records (EHR), and treatment at distances [9] 1.2 Bring Your Own Device Bring Your Own Device (BYOD) is closely associated with IT consumerization [10], which various scholars view as the dual use of IT for business and private purpose [11][12] or as the adoption of employee’s devices, applications, and tools in the workplace [13] Mobility extends the internet providing and computing more independence to employees and their personal life and at work [14] allo wing for the “anything, anywhere, anytime” scenario [15] The word BYOD was first used by Ballagas et al., at UBICOMP 2004 [16] BYOD entered in 2009, courtesy of Intel when it accepted an increasing tendency among its employees to bring their own devices to work and connect them to the corporate network[17] The adoption of BYOD addressed different organizational needs; namely, the need for mobility, the need to keep employees satisfactorily engaged in every aspect of the business process, the need to improve the business environment or workp lace, the need to attract young talents and retain skillfu l workforces, and so forth, and the need for attaining business goals or profits, [18][19][20][21] These needs generally resulted in major improvement in terms of emp loyee mobility enhancement, retention, 58 ISSN:2229-6093 Saima Nisar et al, International Journal of Computer Science & Communication Networks,Vol 7(3),58-65 improved corporate-customers relationship through various innovative ways, improved IT value to the business, a more flexible work environ ment, improved business continuity, the ability to access content from any device anywhere and at any time, familiar technologies and increased motivation, an agile workforce, and greater flexibility in collaboration, familiar technologies and increased motivation, informat ion sharing, and communicat ion [22][23][24][25] The mainly accepted BYOD devices are smartphones, laptops, mobile, and tablets[15] Nowadays, BYOD is sufficiently advanced to perform better than the traditional devices provided to the emp loyees by their organizations The greater part is that the employees want their own device as it is better than what their organizations supplied in terms of productivity Employees desire devices that reflect them and are not selected by the organization[26][27] In the healthcare industry, BYOD was seen as a helpful trend that conveyed a lot of benefits to healthcare providers, hospital, and patients BYOD-enabled HCP to work in quick, smarter and professional way[28] Some of them are in provided in Table 2.0 Theoretical Background Pakistan is the developing country and has a population 191.75 million in 2015, healthcare facilit ies are overburden, congested, incompetent and shortstaffed that cannot satisfy the necessities of the patients [33][34] Though, the rise in a nu mber o f patients plus a shortage of emerg ing technology has the adverse influence on the overall healthcare performance as the available sources will drop inadequate to match the required quality for healthcare performance [33] [35] [36] The health system of Pakistan is consisting of public and private sectors The process of a health system in Pakistan depends on three layers The layer of healthcare is Basic Health Unit (BHU) and Rural Health Centres (RHC), the second layer is Tehsil Headquarter (THQ) and District Headquarter (DHQ) hospital Although the third layer is Tertiary Care Facilit ies (TCF) which is consist of teaching hospitals mainly established in urban areas [34] The details are given in Figure Table Benefits of BYOD [23] Benefits of BYOD Flexible Description BYOD allows for more flexibility in working hours Creativ e Employees will be more creativ e Effectiv e Employees will use applications that are familiar to them, making their work more effectiv e Employees will be more innovativ e because of the ability to collaborate and share ideas at any giv en moment and from any place Innovativ e BYOD increased patient satisfaction, as it permitted quick access to caretakers and assured real-time responses [29] BYOD brought changes to the medical work process by increasing coordination through communicat ion and cooperation, improving access to data, imp lement interdisciplinary workforce processes which were ext remely vital in today’s healthcare environment, and increasing satisfaction with both physicians and patients [30] BYOD encourage the adoption of evidence-based clinical practices [31] In healthcare, portables electronically help the memory of HCP at the point of care delivery to increase patient safety, to reduce medical errors, and to increase the continuity of services provided to patients [32] IJCSCN | June-July 2017 Available online@www.ijcscn.com Figure Healthcare Delivery in Pakistan Pakistan's healthcare system has gone by devolution with the amend ment of the 18th constitution from 2011 The Ministry of Health (MoH) has now been devolved to the provinces [37] [38] The gathering and measuring of data is a challenge in the developing countries because the shortage of new technologies [39] Many developing countries depend on old methods of data collection With these old data collection becomes time-consuming and complex [40] [41] Due to the development of technology and huge penetration of mobile devices, numerous studies focus on utilizing mobile technology in the developing countries [42][39] According to [43] the seventy percent of cellular mobile phones subscribers in the world are liv ing in the developing world Smartphones are affordable data collect ion method because of their 59 ISSN:2229-6093 Saima Nisar et al, International Journal of Computer Science & Communication Networks,Vol 7(3),58-65 connectivity, long lasting battery, and great memory [44] The world now is undergoing an exceptional growth in the area of co mmunication Many developing nations such as Pakistan have observed an incredible progress of annual cellular mobile subscribers approximately 131,412,658 in 2016 [45] as given below in Table Table Mobile Subscription in Pakistan Date 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 Value 70.1 67.1 61.8 57.3 55.5 52.7 38.3 21.4 8.1 3.2 2003 1.6 understanding of the factors affecting the use and adoption of BYOD 3.0 Methodology In this study the research methodology carried out in two phase activities which are factor’s identificat ion and designing of conceptual model as given below in Figure Change, % 4.57 % 8.49 % 7.91 % 3.28 % 5.24 % 37.45 % 78.80 % 165.26 % 149.72 % 105.23 % 39.03 % Source [46] Mobile phones have changed and will continue to create an influence on most people's lives Mobile phones because of their great penetration levels provide opportunities those never thought before and potential in different areas such as education, communication, emp loyment, and health Furthermore, the area of health has been facing delayed in using mobile technologies for a regular p rocedure, and its selection would great for both providers and patients The doctors are constantly using their personal mobile devices at work because they give a bevy of programs, also efficiency and convenience Doctors in hospital are encountering and treating an increasing number of patients which increased pressures to be cost efficient Business vendors too have taken the chance to show the advancement of mobile device technology which can reduce official burdens and errors [8] According to [47] doctors utilising their personal devices for professional use react more quickly to med ical results, have fewer errors in prescription, and show improved data management and record keeping practices This paper aims to build an integrated conceptual model in o rder to understand what drives perceptions of the doctors towards the adoption of BYOD Th is research will be impo rtant to enable the government and healthcare policy makers in having a clear understanding of the perception of doctors As mentioned earlier, many of the past researchers suggested that BYOD is still suffering fro m lo wer utilizat ion and adoption rate, so requires more IJCSCN | June-July 2017 Available online@www.ijcscn.com Figure Methodology Activities 3.1 Phase I: User-Centered Design This study extends the ideas of the existing technology acceptance model The UTAUT2 model is used as a base model in constructing the proposed model as it is the most widespread one to exp lain technology acceptance among doctors However, it has to be remember that the content of user centered design is different with the existing models because doctor’s acceptance is not only dependent on their perceived benefits, but is also impacted by their perceived concerns, like concerns about privacy and security to adopt BYOD [48] The summary of PMT research is given in Table The summary of PMT research is given below in Table The assessment of concern in the circu mstance of BYOD has been viewed litt le in the Information System (IS) research literature [22] 60 ISSN:2229-6093 Saima Nisar et al, International Journal of Computer Science & Communication Networks,Vol 7(3),58-65 Table Su mmary of PMT in Security Research STUDY Crossler et al., 2014 [49] Theoretical background PMT Target behavior and context Comply with BYOD policies; organization Dependent variable Purpose of study and key findings related to UTATU variable Intentions Actual complianc e (selfreported coded as 1/0 binary) Purpose: Investigate factors that influence employees’ decisions to comply with BYOD policies Findings: Only self-efficacy and response efficacy had a significant impact on intentions Sample (Valid) 250, accounting and nonaccounting college students and white colla r employees Purpose: Jenkins, Grimes, Proudfo ot & Lowry, 2013 [50] PMT Fear Appeals Vance, Siponen, & Pahnila , 2012 [51] PMT Posey, Roberts & Lowry, 2011 [52] Johnsto n& Warkent in, 2010 [53] Create Unique passwords; online web accounts Actual Behavior (actual uniq ue passwords) Purpose: Investigate ways to discourage password reuse 135 univ ersity students Strategy: Used Fear Appeals to manip ula te all PMT variables except self-efficacy study group Findings: Their data revealed that 88% of those who receiv ed fear appeals created unique passwords, compared with only 4.5% of those who did not Comply with security policies related to locking PCs, sharing passwords, etc; organization al Intentions PMT Protect organization' s information assets using measures such as protecting; sensitiv e information, computer; organization al Intentions Actual behavior (selfreported) Purpose: Investigate factors that motiv ate insiders (employees) to protect their organization's information assets Also, proposes fear as a predictor of protection motiv ation in an organizational setting Findings: Intrinsic rewards and coping appraisals significantly influence insiders’ protection motiv ation Response efficacy is the strongest predictor A coping appraisal is a better predictor than threat appraisals Fear is a function of perceiv ed severity and perceiv ed vulnerability but has no significant influence on employees' decision to protect their organization's information assets 380 insiders from v arious organizations and industries in the US PMT Fear appeals Use antispyware software; personal computer Intentions Purpose: Investigate if fear appeals influence user intentions to comply with recommended security measures Strategy: Used Fear Appeals to manip ula te perceiv ed severity and vulnerability, self-efficacy, response efficacy Findings: Fear appeals successfully 275 univ ersity staff and students study groups TH Create IJCSCN | June-July 2017 Available online@www.ijcscn.com Purpose: Examine factors that influence IS security compliance and the role of habit in shaping these factors Habit is based on PMT's assumption that prior experience is an antecedent to threat and coping appraisals 210 participants from one municip al in Finland Findings: Prior habit was found to influence all threat and coping appraisal factors All hypothesized relationships were supported with the exception of perceiv ed vulnerability and intentions Purpose: 61 ISSN:2229-6093 Saima Nisar et al, International Journal of Computer Science & Communication Networks,Vol 7(3),58-65 environment Herath & Rao, 2009 [54] PMT LaRose, Rifon, & Enbody, 2008 [55] PMT Woon, Tan & Low, 2005 [56] PMT DT ELM Persuasiv e messages (SCT) elicited change in perceptions that ultimately influenced intentions to apply anti-spyware security measures Compliance with security policies; organization Intentions, mediated by attitude towards security policy Purpose: Conduct a field study of employee intentions to comply with security policies Simila r to Woon et al (2005), proposes no direct link between threat severity and threat probability to intentions Proposes that attitudes mediate the effects of threat concern, self-efficacy, Response efficacy and response cost on intentions Findings: Threat concern is a function of threat severity and threat probability Although threat concern, self-efficacy, response efficacy and response cost all had a significant impact on attitudes towards organizational security policy, the attitude has no direct impact on intentions 312 participants from 78 organizations in the western areas of New York, USA Adopt security measures such as firewalls, anti- virus, antispyware; home Internet use Intentions Purpose: Investigate ways to motiv ate internet users to take personal responsibility and take the internet safety measures Strategy: Used persuasiv e messages to manipulate personal responsib ility Findings: Personal responsib ility, response efficacy, and selfefficacy were found to be the best predictors of online security behavior 206 students Adoption of wireless security measures; home network Actual Behavior (selfreported using yes/no binary measure) Purpose: Use PMT to examine factors that predict adoption of wireless security measures on home computers Findings: Their study found support for all hypothesized direct rela tionships except for the relationship between perceiv ed vulnerability and adoption of recommended behavior 189 home computer users who own a wireless network at their home recruited from a large univ ersity 4study groups PMT = Protection Motiv ation Theory; TTAT = Technology Threat Av oidance Theory; TAM = Technology Acceptance Model; SCT = Social Cognitiv e Theory ; ELM = Elaboration Likelihood Model; TPB = Theory of Pla nned Behavior; CET = Cognitiv e Evaluation Theory; GDT = General Deterrence Theory; IDF = Innovation Diffusion Theory; DT = Deterrence Theory; TH = Theory of Habit; IJCSCN | June-July 2017 Available online@www.ijcscn.com 62 ISSN:2229-6093 Saima Nisar et al, International Journal of Computer Science & Communication Networks,Vol 7(3),58-65 So, based on the existing guidelines, and theories, this study has identified the factors which can affect the perception of doctors to adopt BYOD Those factors were essential to identified fo r developing the conceptual model through systematic review and comparative analysis Earlier to designing the model, a comparative analysis of the literature was carried out After user-centered approach and comparative analysis the designing of the conceptual model has been conducted 3.2 Phase II: Model Development A theoretical model is a collection of interrelated concepts that leads to this study, determining what things will be measured and what relationships will be required fro m the data [57] A theoretical framework is described as how one theorized or makes logical sense of the relationships among several factors that have been identified as important to the problems [58] Sekaran (2003) emphasised that the research framework is the basic foundation upon which other research structures extend the frontier of knowledge Furthermore, a theoretical framework is a presentation of reality, it explains in greater detail those variables of the real world the scientist considers to be relevant to the problem investigated, and clarifies the significant relationship between them Thus, to comprehensively understand doctor’s adoption of BYOD, the researchers propose an insight into the determinants of doctor’s decision to take part in BYOD, and impact of security and privacy on doctor’s intention to use BYOD To the best of the researcher’s knowledge, this study will be first to comprehensively examine the intention to adopt BYOD among doctors of Pakistan not only fro m a technological perspective as well as fro m behavioral perspective The researchers proposed a conceptual model by integrating Unified Theory of Acceptance and Use of Technology (UTAUT2), and Protection Motivation Theory (PMT) theories as the theoretical foundations for proposed model Considering the specific attributes of BYOD, the researcher proposes their conceptual research model as shown in Figure Figure Proposed Conceptual Model The basic objective of the present study is to investigate the intention to adopt BYOD, and to unveil those factors which influence the BYOD intention and privacy concerns related to HCP in Pakistan Unfortunately, Pakistan faces short-staffed of different groups of HCP [35] The scope of this study is given in Figure Figure Scope of the Study In this respect, the point of importance is whether the HCP intent to adopt BYOD or not, their decision would largely depend upon the security and privacy concerns IJCSCN | June-July 2017 Available online@www.ijcscn.com 63 ISSN:2229-6093 Saima Nisar et al, International Journal of Computer Science & Communication Networks,Vol 7(3),58-65 4.0 Conclusion and Future Work This article presents the ongoing research regarding the identification of factors which can affect the intention to adopt BYOD In this study BYOD, user-centered 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