2009 Fifth International Conference on Intelligent Information Hiding and Multimedia Signal Processing
Determinants of Satisfaction and Intention to Use Self-service Technology –
Technology Readiness and Computer Self-efficacy
Chien-Lung Chan and Chia-Li Lin
Dept. of Information Management, Yuan Ze University, Chung-Li, Taiwan
clchan@im.yzu.edu.tw, s966214@mail.yzu.edu.tw
Abstract
This study focuses on users’ satisfactions and
behavioral intentions of using self-service technology
(Kiosk). Both the constructs of technology readiness
(TR) and computer self-efficacy (CSE) have been
studied independently for the prediction power of
technology usage; however, we still don’t know which
one has the stronger linkage with the behavioral
intentions of use of self-service technology. We first
review the relevant literature on TR, CSE, satisfaction,
and behavioral intentions of use, then present our
conceptual framework and hypotheses. This model was
tested with a sample of 108 patients. The hypothesized
model was partially supported and the results showed
that CSE has a stronger influence on patients’
satisfaction and behavioral intention with using Kiosk.
Finally, we discussed the implications of the results
and made conclusions.
1. Introduction
In recent years, many firms use information
systems to create the competition advantage. Using
information technology in hospital administration does
not only increase the operation efficiency, but also
reduce the cost. However, with an increasing amount of
administrative and clinical data, it needs continuous
improvement to process the information accurately and
immediately. People consider healthcare services very
personnel and important to them, and demand both the
effectiveness and efficiency of healthcare services.
Therefore, the hospitals compete with each other not
only in the treatment effectiveness but also in the
administrative efficiency.
There are various factors that affect the patients’
satisfaction. Some researchers found waiting time is
very critical. Procedures such as registration, seeing a
doctor, paying fee, and getting medicine can take long
time for waiting. The longer the waiting time is, the
lower the patients’ satisfaction. When there’s waiting
978-0-7695-3762-7/09 $26.00 © 2009 IEEE 893
DOI 10.1109/IIH-MSP.2009.115
line, patients could not get what they need immediately.
Most of the time, the hospitals can’t afford to hire
many receptionists sitting in the front desk. The
hospitals therefore install self-service technologies
(SST) such as ATM, vending machine, and booking
machine to enhance their services. Without increasing
the human resources, the patients can still finish their
procedures quickly. The hospitals can therefore provide
satisfactory services with minimum cost. This is the
concept of self-service technology. The research
questions are who are going to use it and who won’t?
Are there inherent factors to influence the use of SST?
What will be the best predictor of satisfaction and
intention of use? By investigating the above research
questions, we can make better decisions regarding the
adoption and use of SST.
The hospital we studied has a good reputation of
providing patient-centric medical services as well as
the pioneer of adoption of cutting-edged e-services. It
was also the first hospital in Taiwan to provide
self-service Kiosks, which provide financial functions
that patients spend only one minute to paying fee. It
also provides various convenient functions such as the
reservation, registration, clinic searching, guidance of
health services, and refreshing national health
insurance card, etc. The user interface of Kiosk is very
friendly, and people can use it to finish services in
hospital very easily.
The purpose of this study is to investigate the
determinants of satisfaction and behaviors intentions to
use Kiosk. Patient’s satisfaction of using Kiosk is also
affected by patients’ psychologies of technology
readiness. For example, people with high degree of
acceptance to the technology will be very confident of
using the self-service technology. But some people
would prefer to be served by receptionist. Besides, we
need to find out whether both satisfactions and
behavioral intention of using Kiosk are affected by
patients’ degree of the technology readiness.
After reviewing the literature of technology
readiness, computer self-efficacy, users’ satisfaction
and behavioral intention of using self-service
technology, we have the following research questions:
(1) Will Technology Readiness (TR) affect the
patients’ satisfaction of using Kiosk?
(2) Will Computer Self-efficacy (CSE) affect the
patients’ satisfaction of using Kiosk?
(3) What’s the relationship between TR and CSE?
(4) Which one is stronger relationship, the direct
effect of patients’ technology readiness or the
indirect effect via the satisfaction of using Kiosk?
(5) Which one is more strong relationship, the direct
effect of computer self-efficacy affecting the
behavioral intention to use Kiosk, or the indirect
effect via the satisfaction of using Kiosk?
2. Literature review
2.1. Self-service Technology (SST)
Self-service technology is defined as technology
interfaces that enable consumers to produce services
independent of direct service employee involvement
[1]. Due to the more user-friendly technology, people
can do some works by themselves without contacting
receptionist. The technology has made great progress in
recent year, more and more firms provide SST widely.
Self-service check-in (e.g. Kiosk) in airport and the
multi-media machine in convenient store (e.g. 7-11
ibon) are very common. In recent years, there is a
movement towards using interactive Kiosk in hospitals.
2.2. Technology readiness (TR)
In 2000, Parasuraman developed a brand-new
concept, the technology readiness index (TRI), and TRI
refers to people’s propensity to embrace and use new
technologies for accomplishing goals in home life and
at work [2]. Parasuraman also think this concept was a
whole psychological state. TRI can be categorized into
four distinct components. Two of these components,
optimism and innovativeness, are “contributors” that
increase an individual’s technology readiness, while
the other two, discomfort and insecurity, are
“inhibitors” that suppress technology readiness [3]. The
definition of each TRI component was presented as
follows:
Optimism: View of technology and a belief that it
offers people increased control, flexibility, and
efficiency in their lives.
Innovativeness: A tendency to be a technology
pioneer and thought leader.
Discomfort: A perceived lack of control over
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technology and feeling of being overwhelmed by it.
Insecurity: Distrust of technology and skepticism
about its ability to work properly.
Prior research indicated that the consistency
among person’s attitude toward technology
products/services, the request of technology
products/services, and final result of acceptance of
products/services [4]. Meuter et al. found that
researchers begin to explore the characteristics of
customers for services delivery over technologies
recently [5]. Researchers also support that the
characteristic of customers will affect the adoptions of
self-service technologies [6, 7]. Lin & Hsieh proposed
that when firms want to encourage customers to use
technologies, they should also consider the technology
readiness of customers [8]. Therefore, we hypothesize
that the TR of patients will affect both satisfaction and
the behavioral intentions of using Kiosk.
H1.Technology readiness (TR) has a positive impact
on satisfaction with Kiosks.
H2.Technology readiness (TR) has a positive impact
on behavioral intentions with Kiosks.
2.3. Computer self-efficacy (CSE)
Compeau and Higgins referred to the concept of
computer self-efficacy (CSE), and the definition was
the individual perception, which he (or she) owns skills
to complete a work by computers rather than an
individual’s skills of operating the computer [9]. The
CSE emphasizes an individual’s subjective judgment
and has a confidence with completing a work by
computers. Therefore, CSE can be used to measure
patients’ confidence of finishing services by using
Kiosk.
The prior research also indicated that CSE is one
of the most significant factors to affect an individual’s
acceptance of technology. A person’s self-perceived
abilities to use self-service technology (SST) would
increase the satisfactions and have strong behavioral
intentions toward SST in the future [10].
On the other hand, prior studies found that the
computer self-efficacy for individuals was affected
significantly with different attitudes toward computers
[11]. Consequently, we make the following hypotheses.
H3.Technology readiness (TR) has a positive impact
on Computer self-efficacy (CSE) with Kiosks.
H4. Computer self-efficacy (CSE) has a positive
impact on satisfaction with Kiosks.
 scales ranging from 1 (strongly disagree) to 5 (strongly
H5. Computer self-efficacy (CSE) has a positive agree).
impact on behavioral intentions with Kiosks.
4. Sampling
Many studies provided the evidence for the
significant impact of satisfaction on behavioral The questionnaires were a sample of 120 patients
intentions to use SST [8, 10]. Besides, related studies from a district hospital locating in the northern Taiwan.
indicated that customers’ satisfactions can increase the The respondents all had an experience in using the
behavioral intentions of customers in e-services [12]. hospital’s Kiosk before. They were asked to measure
We hypothesize that users’ satisfactions will affect the both their own Technology Readiness and Computer
behavioral intentions to use SST. Self-efficacy, and then evaluate their experiences with
Kiosk that they had used most frequently as well as
H6. Satisfaction with Kiosks has a positive influence their resulting satisfaction and behavioral intentions.
on behavioral intentions to use SST. The questionnaire used to collect the data was
pre-tested two times to ensure that the questions were
3. Measurement understood with feasibly of the survey methodology.
Finally, the final number of questionnaires collected to
For the measurement of patients’ technology now was 108. To ensure the quality of survey, the
readiness, Technology Readiness Index (TRI) questionnaire is filled up and collected face-to-face by
combines all the research that is related to people’s a well-trained researcher assistant. Therefore there’s no
technology readiness. It has very good reliability and invalid questionnaire.
validity, and is able to describe this construct Table 1 presents the demographics of the
accurately. Prior research suggested that some of the participants. Of the 108 participants, 74.1 percent were
TR items might reflect more than just the core female, the highest percentage of age category was
meanings of the TR factors concerned, and they between 31 and 40 years, and 59.3 percent had a
considered the meaning of original 36-item TR scale to university and graduate degree.
be too ambiguous for it aimed to be a true reflection of
each dimensions [2]. After refinement process, we Table 1. Demographic characteristics of
reduced the TR scale to a shorter-version scale. respondents (n=108)
For the measurement of patients’ confidence to Descriptions Frequency Percentage
use Kiosk to finish services (e.g. registering, paying out Gender
the fee), we use the 10-item computer self-efficacy Male 28 25.9
(CSE) scale developed by Compeau and Higgins [9]. Female 80 74.1
The patients were asked how confident they would
perceive themselves to complete services using Kiosk Age (years)
in each situation based on a five-point Likert scales 20↓ 1 .9
ranging from 1 (have almost no confidence) to 5 (very 21-30 32 29.6
confident). 31-40 38 35.2
Patient’s satisfaction with using Kiosk was 41-50 28 25.9
measured with the three-item American Customer 51-60 9 8.3
Satisfaction Index (ACSI) scale used and discussed by 61↑ 0 0
prior studies. The three-item ACSI scale was developed
using a general index and methodology for measuring Education
patient’s satisfaction with Kiosk experiences [8]. Elementary school 2 1.9
To measure patients’ Behavioral Intention to Use Junior high school 5 4.6
Kiosk, we used the three-item scale to measure Senior high school 36 33.3
patients’ behavioral intention of using Kiosk by Lin et University 54 50.0
al. [8]. Our survey participants were asked the Graduate school 10 9.3
intentions to use Kiosk again based on five-point Likert Missing 1 .9

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 Table 2. Correlation matrix, reliability, and validity
Cronbach’s Composite
OPT INN DIS INS CSE SAT BI AVE
Alpha Reliability
OPT 0.826 0.844 0.896 0.682
INN 0.534 0.733 0.705 0.820 0.537
DIS -0.099 0.103 0.801 0.822 0.877 0.642
INS 0.206 0.139 0.453 0.727 0.831 0.870 0.528
CSE 0.494 0.400 -0.003 0.316 0.712 0.885 0.907 0.508
SAT 0.539 0.323 -0.090 0.228 0.635 0.892 0.872 0.921 0.796
BI 0.424 0.195 -0.082 0.235 0.577 0.769 0.957 0.954 0.970 0.916

5. Tests of reliability and validity (>.9), CFI was .988 (>.9), and demonstrate the data fit
the model well.
Reliability, which is that participants in same
conditions, but are tested in different time, can get the 6. Analysis approach and hypotheses test
same consequences. Reliability will examine the
constructs’ dependability, consistency, stability, The six hypotheses presented earlier in this
accuracy, and predictability. article were tested collectively in a structural equation
The purpose of validity is to test participants’ model (see Fig. 1). The results provide evidence that
characteristics and responses. If the validity is higher, the hypothesized positive path between Technology
the participants’ responses are more accurate. The Readiness and Kiosk Satisfaction (H1) is supported (β
construct validity includes convergent validity and = .244, p < .05). Patients’ Computer Self-Efficacy was
discriminant validity. They are very important index to also hypothesized to have a positive influence upon
examine the quality of questionnaire. The average their Kiosk Satisfaction in hypothesis H4 (β = .488, p <
variance extracted (AVE) greater than .50 provides .01), we find support for H4. Additionally, the sample
strong evidence of convergent validity. Discriminant also yielded results that provide evidence for H3,
validity, referring to the degree of separation between where Technology Readiness is hypothesized to have a
constructs. According to the suggestion of prior positive influence upon Computer Self-Efficacy.
researcher, the square root of AVE value of a construct Analysis of the results between the two constructs
should be greater than the square of correlation indicates support for H3 (β = .549, p < .01). These
coefficient with other constructs. results confirm that Kiosk Satisfaction has a strongly
First, we use Cronbach’s alpha (α) to compute positive effect on Kiosk Behavioral Intention to Use (β
the reliability. As Table 2 shows, the values for each = 0.687, p < .01), as stated in Hypothesis H6. However,
construct were all above the acceptable level of .70 the hypothesis H2 and H5 were not supported, because
suggested by prior research, and indicate that all both Technology Readiness and Computer
construct have high internal consistency. Self-Efficacy didn’t have any influence on Kiosk
Second, we use confirmatory factor analysis Behavioral Intention to Use alone.
(CFA) to analyze validity. CFA is also measurement
model in SEM, and the purpose is that test all the
constructs’ quality. To examine the convergent
validity, the AVE values for each constructs were all
above the acceptable level of .50 suggested by prior
research (see Table 2). These values obviously suggest
high levels of convergence among the items measuring
their respective construct. To examine the discriminant
validity, the square root of AVE value of each
construct was greater than the square of correlation
coefficient with other constructs (see Table 2). These
values obviously suggest high levels of discrimination
with other constructs.
Fig 1. The conceptual framework and
After confirming the measurement model, we use
hypotheses test
LISREL 8.72 to estimate our model fit index. All the
goodness-of-fit indexes showed a good overall fit for
our model. The RMSEA index was .0551 (<.08), GFI
was .976 (>.9), AGFI was .915 (>.9), NFI was .959

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7. Conclusions
This study finds Hypotheses H1, H3, H4, and H6
supported, but Hypothesis H2 and H5 not statistically
significant. These findings suggest that two types of
acceptance of technology (TR and CSE) only have an
indirect effect on behavioral intention of using Kiosk
through the patients’ satisfaction. This study has shown
that Computer Self-efficacy (CSE) is a strong
determinant to patients’ satisfaction of using Kiosk. If
patients perceive Kiosk to be more convenient and
don’t worry about the security and privacy issues, they
will be more likely to use it again.
To increase users’ acceptance to technology,
self-service technology providers should help them in
overcoming difficulties when using SSTs. Self-service
technology providers should consult with users’
experiences in the design of SSTs to ensure that SSTs
satisfy users’ needs so that users will be able to accept
technology-based service.
However, self-service technologies can be a
helpful tool for users. But not all the users are
technology ready or willing to use SSTs. In addition to
encouraging users to use SSTs, the firms still need to
provide multi-channels to deliver service for users with
lower TR or unwillingness to try SSTs.
8. Acknowledgement
We need to thank Dr. Yao-Hung Wang(IT
Department Director), Ms. Chueh-Ju Chen(IT
Department System Service Lead) and Ms. Hsiu-Ju
Tsai(Front Desk Department) in Tao-yuan Ming-shen
Hospital for helping our patients survey. This study
was partially supported by the NSC, Taiwan under
Grants NSC 96- 2221- E- 155- 017 MY3-1.
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