QR Code Integration in Retail Pharmacy: A Service Quality Framework Analysis using PLS-SEM on Customer Outcomes
1Catrina Mae S. Tulinao,2Nelson C. Bool, 3Dante R. Garcia
1,2,3University of Santo Tomas Graduate School
https://doi.org/10.47191/jefms/v8-i2-16ABSTRACT:
This study critically examines the influence of QR code integration within the retail pharmacy context on key performance metrics, including service quality, store attributes, waiting time, customer satisfaction, trust, and repurchase intention. Employing partial least squares structural equation modeling (PLS-SEM), this research analyzed data from customers to elucidate the underlying interdependencies of variable and service delivery outcomes. Instrumental to the analysis is the assurance of minimal collinearity, as evidenced by the Inner VIF values consistently falling below the threshold of 3, thereby confirming the reliability of the estimated model. Empirical findings indicate that QR code deployment exerts a statistically significant positive effect on service quality (β = 0.43, p < 0.001), store attributes (β = 0.45, p < 0.01), and waiting time (β = 0.38, p < 0.001), collectively accounting for 52% of the variance in customer satisfaction (R² = 0.520). Moreover, customer satisfaction emerged as a pivotal mediator, robustly influencing trust and repurchase intention, with indirect pathways and direct effects substantiating its role in shaping customer loyalty. Although the variance explained by trust is modest (R² = 0.123), the cascading effect on repurchase intention (R² = 0.332) underscores the systemic importance of a holistic digital integration strategy. This study contributes to the extant literature by delineating the multifaceted impact of digital tools in healthcare service environments and underscores the necessity for comprehensive infrastructural support to fully harness the potential of QR code technology.
KEYWORDS:
QR code integration, pharmacy services, service quality, customer satisfaction, repurchase intention, trust, PLS-SEM, digital healthcare technology
REFERENCES:
1) Abdul, F. W. and Purwatmini, N. (2018). Improving service quality of call center using dmaic method and service blueprint.Journal of Management and Business, 15(1). https://doi.org/10.24123/jmb.v15i1.38
2) Ahmed, S., Abd Manaf, N. H., & Islam, R. (2018). Effect of Lean Six Sigma on quality performance in Malaysian hospitals.International Journal of Health Care Quality Assurance, 31(8), 973–987. https://doi.org/10.1108/IJHCQA-07-2017-0138
3) Alam, M. Z., Hoque, M. R., Hu, W., & Barua, Z. (2021). Factors influencing the adoption of mHealth services in a developing country: A patient-centric study. International Journal of Information Management, 56, 102287.
4) Alanazi, A., Al Rabiah, F., Gadi, H., Househ, M., & Al Dosari, B. (2018). Factors influencing pharmacists’ intentions to use Pharmacy Information Systems. Informatics in Medicine Unlocked, 11, 1–8. https://doi.org/10.1016/j.imu.2018.02.004.
5) Alanazi, A., Shah, S., Abbas, G., Musaddiq, H., Saleem, A., Khurram, H., Chand, U. R., Mallhi, T., Khan, Y., Ilyas, K., Tariq, S., Jamil, A., Alzarea, A., & Alzarea, S. (2023). Assessing Patient Satisfaction with Community Pharmacy Services: A Large Regional Study at Punjab, Pakistan. Patient Preference and Adherence, Volume 17, 13–22. https://doi.org/10.2147/PPA.S389053
6) Aldhwaihi, K., Schifano, F., Pezzolesi, C., & Umaru, N. (2016). A systematic review of the nature of dispensing errors in hospital pharmacies. Integrated Pharmacy Research and Practice, 1. https://doi.org/10.2147/iprp.s95733
7) Alkunsol, W. H., Sharabati, A. A., Al-Salhi, N. A., & El-Tamimi, H. S. (2019). Lean six sigma effect on jordanian pharmaceutical industry’s performance. International Journal of Lean Six Sigma, 10(1), 23-43. https://doi.org/10.1108/ijlss-01-2017-0003
8) Alodan, A., Alalshaikh, G., Alqasabi, H., Alomran, S., Abdelhadi, A., & Alkhayyal, B. (2020). Studying the Efficiency of Waiting Time in Outpatient Pharmacy. MethodsX, 7, 100913. https://doi.org/10.1016/j.mex.2020.100913
9) Alshourah, S., & Shourah, A. (2020). An examination between total quality management and hotel financial performance: Evidence from Jordanian international hotels. International Journal of Information and Decision Sciences, 23, 418–431.
10) Altayeb, M., & Alhasanat, M. (2014). Implementing total quality management (TQM) in the Palestinian construction industry.International Journal of Quality & Reliability Management, 31, 878–887. https://doi.org/10.1108/IJQRM-05-2013-0085
11) Arafah, M., Barghash, M., Haddad, N., Musharbash, N., Nashawati, D., Bashir, A., & Assaf, F. (2018). Using Six Sigma DMAIC Methodology and Discrete Event Simulation to Reduce Patient Discharge Time in King Hussein Cancer Center. Journal of Healthcare Engineering, 2018, 1–18. https://doi.org/10.1155/2018/3832151
12) Astuti, E. R. (2024). Factors that Influence the Satisfaction of Health Service Recipients in Hospitals: Systematic Literature Review. Care : Jurnal Ilmiah Ilmu Kesehatan, 12(2), 353–362. https://doi.org/10.33366/jc.v12i2.5947
13) Baumanns, L., & Rott, B. (2021). Developing a framework for characterising problem-posing activities: A review. Research in Mathematics Education, 0(0), 1–23. https://doi.org/10.1080/14794802.2021.1897036
14) Bayati, M., Gholami, A., Emadi, M., Goudarzi, Z., & Keshavarz, K. (2023). Pharmacies' income and its effective factors in iran:a cross‐sectional study. Health Science Reports, 6(6). https://doi.org/10.1002/hsr2.1317
15) Bhatt, D.A., & Bhanawat., D.S. (2016). Measuring Customer Satisfaction Using ServQual Model – An Empirical Study.
16) Blut, M., Chowdhry, N., Mittal, V., & Brock, C. (2022). Meta-analysis of the impact of digital technologies on customer experience and business performance. Journal of the Academy of Marketing Science, 50(3), 565-583.
17) Brown, L., Davis, M., & Wilson, S. (2018). Service quality and customer loyalty in community pharmacies. Research in Social and Administrative Pharmacy, 14(7), 623-630. https://doi.org/10.1016/j.sapharm.2017.00.000
18) Celik, I., Sahin, I., & Aydın, M. (2014). Reliability and Validity Study of the Mobile Learning Adoption Scale Developed Based on the Diffusion of Innovations Theory. International Journal of Education in Mathematics, Science and Technology, 2, 300–316. https://doi.org/10.18404/ijemst.65217
19) Ciannella, S., & Santos, L. C. (2021). Exploring the influence of lean manufacturing practices on employee social sustainability.Social Responsibility Journal, ahead-of-print(ahead-of-print). https://doi.org/10.1108/SRJ-06-2021-0229
20) Cochran, W. G. (1977). Sampling Techniques (3rd ed.). John Wiley & Sons.
21) Creswell, J. W. (2014). Research Design: Qualitative, Quantitative and Mixed Methods Approaches (4th ed.). London: Sage Publications Ltd.
22) Demirkesen, S. (2021). From lean manufacturing to lean construction: how principles, tools, and techniques evolved. Lean Manufacturing. https://doi.org/10.5772/intechopen.96191
23) Doroteo, H. J., Jr, A., Teh, D., & Lorenzo, F. (2020). A Research Study on the Patient Experience (PX) in the Philippines: Journey towards Optimal Health. International Journal of Public Health, 5, 188. https://doi.org/10.37421/ijphs.2020.5.188
24) Dubey, R., Gunasekaran, A., Childe, S. J., Papadopoulos, T., Hazen, B. T., & Roubaud, D. (2018). Examining top management commitment to TQM diffusion using institutional and upper echelon theories. International Journal of Production Research, 56(8), 2988–3006. https://doi.org/10.1080/00207543.2017.1394590
25) Eren, B.A. QR code m-payment from a customer experience perspective. J Financ Serv Mark 29, 106–121 (2024). https://doi.org/10.1057/s41264-022-00186-5
26) Faggiano, A., Fioretti, F., Nodari, S., & Carugo, S. (2021). Quick Response (QR) code applications in medical and cardiology settings: A systematic scoping review. European Heart Journal - Digital Health, 2. https://doi.org/10.1093/ehjdh/ztab038
27) Fernandes, A. M., et al. (2015). Development of clinical pharmacy key performance indicators for hospital pharmacists using a modified Delphi approach. *Annals of Pharmacotherapy*, 49(4), 432-440. https://doi.org/10.1177/1060028015577445
28) George, A., Joseph, A. M., Kolencherry, S., Kodath, V. V., Menaka, K., Duraisingh, B., Sherief, S. H., & Shivakumar, T. (2018). Application of Six Sigma DMAIC Methodology to Reduce Medication Errors in a Major Trauma Care Centre in India. Indian Journal of Pharmacy Practice, 11(4), 182–187. https://doi.org/10.5530/ijopp.11.4.38
29) Giannaraki, D., & Kutsikos, K. (2024). The Emergence of Business Ecosystems in the Healthcare Industry (pp. 269–276). https://doi.org/10.1007/978-3-031-41371-1_22
30) González Peña, O. I., López Zavala, M. Á., & Cabral Ruelas, H. (2021). Pharmaceuticals Market, Consumption Trends and Disease Incidence Are Not Driving the Pharmaceutical Research on Water and Wastewater. International Journal of Environmental Research and Public Health, 18(5), 2532. https://doi.org/10.3390/ijerph18052532
31) Gremyr, I., Lenning, J., Elg, M., & Martin, J. (2021). Increasing the value of quality management systems. International Journal of Quality and Service Sciences, 13(3), 381–394. https://doi.org/10.1108/IJQSS-10-2020-0170
32) Gutierrez-Gutierrez, L., Barrales-Molina, V., Fernandez-Giordano, M., & López-Morales, B. (2019). Six Sigma for dynamic capabilities development: Becoming more flexible organizations. International Journal of Lean Six Sigma, 11(1), 35–56. https://doi.org/10.1108/IJLSS-10-2018-0115
33) Gül, İ., Helvacıoğlu, E. T., & Saraçlı, S. (2023). Service quality, outpatient satisfaction and loyalty in community pharmacies in Turkey: A structural equation modeling approach. Exploratory Research in Clinical and Social Pharmacy, 12, 100361. https://doi.org/10.1016/j.rcsop.2023.100361
34) Hartono, Fidelia & Kumar, Suresh. (2022). The Effects of Store Attributes toward Satisfaction and Purchase Intention. 10.33021/icfbe.v3i1.3763
35) Hassali, M. A., Alrasheedy, A. A., & Shakib, S. (2014). Assessment of general public satisfaction with public healthcare services in Australia. *Australasian Medical Journal*, 7(1), 1-6. https://doi.org/10.4066/amj.2014.1936
36) Hesso, I., Kayyali, R., & Nabhani-Gebara, S. (2020). The impact of digital health interventions on the psychological outcomes of patients and families. International Journal of Pharmacy Practice, 28(4), 356-365.
37) Hindi, A. M. K., Campbell, S. M., Jacobs, S., & Schafheutle, E. I. (2024). Developing a quality framework for community pharmacy: a systematic review of international literature. BMJ open, 14(2), e079820. https://doi.org/10.1136/bmjopen- 2023-079820
38) Hossain, S., Zhou, X., & Rahman, M. F. (2018). Examining the impact of qr codes on purchase intention and customer satisfaction on the basis of perceived flow. International Journal of Engineering Business Management, 10. https://doi.org/10.1177/1847979018812323
39) Jaén, A., García, A., & López, M. (2022). Analysis of patient satisfaction through the effect of healthcare spending on waiting times for consultations and operations. *Healthcare*, 10(7), 1229. https://doi.org/10.3390/healthcare10071229
40) Jones, D., Williams, E., & Taylor, R. (2019). Patient satisfaction and wait times in community pharmacies. American Journal of Health-System Pharmacy, 76(15), 1151-1158. https://doi.org/10.2146/ajhp180000
41) Kafadarova, N., Stoyanova-Petrova, S., Mileva, N., & Stoyanova, D. (2019). Using QR Codes in Dental Practice. 434–439. https://doi.org/10.21125/edulearn.2019.0147
42) Kebede, M., Schmied, V., Barnett, B., & Essén, B. (2022). Improving medication safety in community pharmacy using Quick Response (QR) codes: A qualitative study of pharmacists' perspectives. Research in Social and Administrative Pharmacy, 18(3), 2538-2545.
43) Keshavarz, K., Kebriaeezadeh, A., Meshkini, A. H., Nikfar, S., Mirian, I., & Khoonsari, H. (2012). Financial perspective of private pharmacies in tehran (iran); is it a lucrative business?. DARU Journal of Pharmaceutical Sciences, 20(1). https://doi.org/10.1186/2008-2231-20-62
44) Khan, M. A., Vivek, Minhaj, S. M., Saifi, M. A., Alam, S., & Hasan, A. (2023). Impact of Store Design and Atmosphere on Shoppers’ Purchase Decisions: An Empirical Study with Special Reference to Delhi-NCR. Sustainability, 15(1), 95. https://doi.org/10.3390/su15010095
45) Leemanza, Y., & Kristin, E. (2024). Effectiveness of Wait Time Targets and Patient Satisfaction Feedback in Decreasing Wait Times for Prescription Services in an Outpatient Pharmacy. The Canadian journal of hospital pharmacy, 77(1), e3438. https://doi.org/10.42112/cjhp.3438
46) M N, M. J. (2024). Lab Inventory Management using QR Code. INTERANTIONAL JOURNAL OF SCIENTIFIC RESEARCH IN ENGINEERING AND MANAGEMENT, 08(03), 1–5. https://doi.org/10.55041/ijsrem29806
47) M. Boyd, A., & W. Chaffee, B. (2019). Critical Evaluation of Pharmacy Automation and Robotic Systems: A Call to Action.Hospital Pharmacy, 54(1), 4–11. https://doi.org/10.1177/0018578718786942
48) Maes, K. A., Ruppanner, J. A., Imfeld-Isenegger, T. L., Hersberger, K. E., Lampert, M. L., & Boeni, F. (2019). Dispensing of Prescribed Medicines in Swiss Community Pharmacies-Observed Counseling Activities. Pharmacy, 7(1), 1. https://doi.org/10.3390/pharmacy7010001
49) Maharaj, S., Brahim, A., Brown, H., Budraj, D., Caesar, V., Calder, A., Carr, D., Castillo, D., Cedeno, K., & Janodia, M. D. (2020). Identifying dispensing errors in pharmacies in a medical science school in Trinidad and Tobago. Journal of Pharmaceutical Policy and Practice, 13(1), 67. https://doi.org/10.1186/s40545-020-00263-x
50) Momattin, H., Arafa, S., Momattin, S., Rahal, R., & Waterson, J. (2021). Robotic Pharmacy Implementation and Outcomes in Saudi Arabia: A 21-Month Usability Study. JMIR Human Factors, 8(3), e28381. https://doi.org/10.2196/28381
51) Nigussie, S., & Edessa, D. (2018). The Extent and Reasons for Dissatisfaction From Outpatients Provided With Pharmacy Services at Two Public Hospitals in Eastern Ethiopia. Frontiers in Pharmacology, 9. https://doi.org/10.3389/fphar.2018.01132
52) Nguyen, M.T., Alang , T. When do shoppers prefer using QR codes? Empirical evidence from Vietnam. Futur Bus J 10, 105 (2024). https://doi.org/10.1186/s43093-024-00391-9
53) Paske, R., Vervloet, M., Linn, A. J., Brabers, A. E. M., van Boven, J. F. M., & van Dijk, L. (2023). The impact of trust in healthcare and medication, and beliefs about medication on medication adherence in a Dutch medication-using population.Journal of Psychosomatic Research, 174, 111472. https://doi.org/10.1016/j.jpsychores.2023.111472
54) Pribadi P, Satibi, Susi Ari Kristina, Suci Paramitasari Syahlani. Building Patient Loyalty in Pharmacy Service: A Comprehensive Model. Indonesian J Pharm. published online June 28, 2021:241-250. doi:10.22146/ijp.1326
55) Slowiak, Julie M. PhD; Huitema, Bradley E. PhD. Reducing Pharmacy Wait Time to Promote Customer Service: A Follow-up Study. Quality Management in Health Care 24(1):p 9-20, January/March 2015. | DOI: 10.1097/QMH.0000000000000045
56) Sng, Y., Ong, C. K., & Lai, Y. F. (2019). Approaches to outpatient pharmacy automation: A systematic review. European Journal of Hospital Pharmacy: Science and Practice, 26(3), 157–162. https://doi.org/10.1136/ejhpharm-2017-001424
57) Stupina, M. V., Anistratenko, K. V., & Pazina, L. O. (2021). Using the QR code as a means of automating the process of accounting for attendance at educational classes. Journal of Physics: Conference Series, 2131(2), 022077. https://doi.org/10.1088/1742-6596/2131/2/022077
58) Smith, J., Johnson, A., & Brown, K. (2020). Customer satisfaction in retail pharmacies: The role of communication and medication availability.
59) Sundram, S., Tambvekar, S. E., S.Sekar, Ghada-elkady, Tiwari, S. K., & R.Gopinathan. (2022). THE EFFECT OF SERVICE QUALITY ON PATIENT LOYALTY MEDIATED BY PATIENT SATISFACTION. Journal of Pharmaceutical Negative Results, 1393–1400. https://doi.org/10.47750/pnr.2022.13.S06.184
60) Teves, L. (2024). Smart Educational Resource Management: A QR Code-Enabled System with Notification and Alerting Capabilities. Journal of Innovative Technology Convergence, 6(2), 59–66. https://doi.org/10.69478/jitc2024v6n002a06
61) To, W. M., Yu, B., & Lee, P. (2018). How Quality Management System Components Lead to Improvement in Service Organizations: A System Practitioner Perspective. Administrative Sciences, 8, 73. https://doi.org/10.3390/admsci8040073
62) Teleron, J. I. (2023). Efficient Management of Pharmacy Operations through Operations Research Techniques. And Technology Journal, 8(7), 2462–2472. https://doi.org/10.47191/etj/v8i7.13
63) Trakulsunti, Y., Antony, J., Dempsey, M., & Brennan, A. (2020). Reducing medication errors using lean six sigma methodology in a Thai hospital: An action research study. International Journal of Quality & Reliability Management, 38(1), 339–362. https://doi.org/10.1108/IJQRM-10-2019-0334
64) Tseng, M.-H., & Wu, H.-C. (2014). A cloud medication safety support system using QR code and Web services for elderly outpatients. Technology and Health Care: Official Journal of the European Society for Engineering and Medicine, 22(1), 99–113. https://doi.org/10.3233/THC-140778
65) Upadhyai, R., Upadhyai, N., Jain, A., Roy, H., & Pant, V. (2020). Health care service quality: A journey so far. Benchmarking: An International Journal, ahead-of-print. https://doi.org/10.1108/BIJ-03-2019-0140
66) Zhang, Y., & Thompson, R. (2023). Digital transformation: A multidisciplinary perspective and future research agenda. International Journal of Consumer Studies, 47(6), 2531-2547. https://doi.org/10.1111/ijcs.13015