The Digital Transformation of Healthcare Through Intelligent Technologies: A Path Dependence-Augmented–Unified Theory of Acceptance and Use of Technology Model for Clinical Decision Support Systems

<b>Background/Objectives:</b> Integrating Artificial Intelligence Clinical Decision Support Systems (AI-CDSSs) into healthcare can improve diagnostic accuracy, optimize clinical workflows, and support evidence-based medical decision-making. However, the adoption of AI-CDSSs remains uneven, influenced by technological, organizational, and perceptual factors. This study, conducted between November 2024 and February 2025, analyzes the determinants of AI-CDSS adoption among healthcare professionals through investigating the impacts of perceived benefits, technological costs, and social and institutional influence, as well as the transparency and control of algorithms, using an adapted Path Dependence-Augmented-Unified Theory of Acceptance and Use of Technology model. <b>Methods</b>: This research was conducted through a cross-sectional study, employing a structured questionnaire administered to a sample of 440 healthcare professionals selected using a stratified sampling methodology. Data were collected via specialized platforms and analyzed using structural equation modeling (PLS-SEM) to examine the relationships between variables and the impacts of key factors on the intention to adopt AI-CDSSs. <b>Results</b>: The findings highlight that the perceived benefits of AI-CDSSs are the strongest predictor of intention to adopt AI-CDSSs, while technology effort cost negatively impacts attitudes toward AI-CDSSs. Additionally, social and institutional influence fosters acceptance, whereas perceived control and transparency over AI enhance trust, reinforcing the necessity for explainable and clinician-supervised AI systems. <b>Conclusions</b>: This study confirms that the intention to adopt AI-CDSSs in healthcare depends on the perception of utility, technological accessibility, and system transparency. The creation of interpretable and adaptive AI architectures, along with training programs dedicated to healthcare professionals, represents measures enhancing the degree of acceptance.