but-high-usage GPs using the system
only to obtain a second opinion.
Supporting but no/low usage. Implementers should beware of viewing this
ambivalent group as resisting users just
because they do not use the system.
Through a mechanism of self-fulfilling
prophecy, this group can easily turn into
hardened system opponents. Managers
and other implementers should explicitly recognize their support and reward
it by helping them detect and minimize
any related obstacle they may face.
Here, both people- and system-ori-ented interventions8 may help:
Implementers can inquire about the technological
and practical issues confronting users.
The supporting-but-no/low-usage GPs
were eager to report their difficulties
adopting the system when we interviewed them. Implementers should
acknowledge potential users who willingly provide such constructive feedback, telling them how and when the
system will be improved to reinforce
their promise to use the system.
Technical barriers. People often do
not use a system due to lack of skills
and/or knowledge. For example, implementers could help the GPs who
said they did not know how to use the
ICSPC coding system, offering a course
through, say, the GPs’ own professional association, accrediting it as credit
points health professionals must earn
annually to maintain their licenses.
High sunk14 or switching costs.
13 People locked into a particular system find
it difficult to switch to any other system. Many of the 50 interviewed GPs reported they could not use the EPS due
to incompatibilities with their current
computers and networks. Implementers mitigate these barriers by providing
extra support to upgrade equipment,
including grants and tax deductions.
Resisting and no/low usage. The largest percentage of interviewed GPs (36%)
was in this quadrant, mostly experienced doctors practicing independently
in small towns who valued their close
relationships with their patients, usually
knowing them by first name. Moving actors in this quadrant to the desired behavior is especially challenging.
Though implementers try to ratio-
nally convince users to adopt support-
ing-and-high-usage behavior, such an
approach may also bring unintended
side effects for GPs, in light of their val-
ues and limited resources.
The model introduced here defines
ambivalent adoption behavior and ex-
plores their occurrence in a real-world
context. Moving intended users from
low to high use involves system-related
support; moving intended users and
other actors from resistance to support
involves a wider context (such as power
shifts, feelings of insecurity, and work-
ing environments). These ideas shed
light on a gray area previously ignored
in the literature on system acceptance
and resistance, contributing a new
perspective on IS adoption and help-
ing practitioners work with ambivalent
groups. We invite researchers to specify
the antecedents of ambivalent adop-
tion behavior, as well as the conditions
under which intended users might
move from quadrant to quadrant. Inter-
action among the six different groups is
another promising area for research.
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DongBack Seo ( firstname.lastname@example.org) is an assistant professor
of management information systems in the Faculty of
economics and business at the university of groningen,
Albert Boonstra ( email@example.com) is a professor
of information management at the Faculty of economics
and business at the university of groningen, the
Marjolein van Offenbeek ( m.a.g.va
is an assistant professor of organizational behavior and
technological change in the Faculty of economics and
business at the university of groningen, the netherlands.