BMC Med Inform Decis Mak - Intention to adopt clinical decision support systems in a developing country: effect of physician's perceived professional autonomy, involvement and belief: a cross-sectional study.

Tópicos

{ use(2086) technolog(871) perceiv(783) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ use(1733) differ(960) four(931) }
{ implement(1333) system(1263) develop(1122) }
{ studi(1119) effect(1106) posit(819) }
{ health(3367) inform(1360) care(1135) }
{ medic(1828) order(1363) alert(1069) }
{ can(981) present(881) function(850) }
{ high(1669) rate(1365) level(1280) }
{ patient(2315) diseas(1263) diabet(1191) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ model(3480) simul(1196) paramet(876) }
{ health(1844) social(1437) communiti(874) }
{ method(2212) result(1239) propos(1039) }
{ take(945) account(800) differ(722) }
{ intervent(3218) particip(2042) group(1664) }
{ survey(1388) particip(1329) question(1065) }
{ patient(2837) hospit(1953) medic(668) }
{ sampl(1606) size(1419) use(1276) }
{ activ(1452) weight(1219) physic(1104) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ imag(2830) propos(1344) filter(1198) }
{ assess(1506) score(1403) qualiti(1306) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ care(1570) inform(1187) nurs(1089) }
{ data(3963) clinic(1234) research(1004) }
{ research(1085) discuss(1038) issu(1018) }
{ model(2341) predict(2261) use(1141) }
{ compound(1573) activ(1297) structur(1058) }
{ spatial(1525) area(1432) region(1030) }
{ group(2977) signific(1463) compar(1072) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ bind(1733) structur(1185) ligand(1036) }
{ featur(3375) classif(2383) classifi(1994) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ framework(1458) process(801) describ(734) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ visual(1396) interact(850) tool(830) }
{ perform(1367) use(1326) method(1137) }
{ blood(1257) pressur(1144) flow(957) }
{ record(1888) medic(1808) patient(1693) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ analysi(2126) use(1163) compon(1037) }
{ structur(1116) can(940) graph(676) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ estim(2440) model(1874) function(577) }
{ method(1969) cluster(1462) data(1082) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Computer-based clinical decision support systems (CDSS) are regarded as a key element to enhance decision-making in a healthcare environment to improve the quality of medical care delivery. The concern of having new CDSS unused is still one of the biggest issues in developing countries for the developers and implementers of clinical IT systems. The main objectives of this study are to determine whether (1) the physician's perceived professional autonomy, (2) involvement in the decision to implement CDSS and (3) the belief that CDSS will improve job performance increase the intention to adopt CDSS. Four hypotheses were formulated and tested.METHODS: A questionnaire-based survey conducted between July 2010 and December 2010. The study was conducted in seven public and five private hospitals in Kuala Lumpur, Malaysia. Before contacting the hospitals, necessary permission was obtained from the Ministry of Health, Malaysia and the questionnaire was vetted by the ethics committee of the ministry. Physicians working in 12 hospitals from 10 different specialties participated in the study. The sampling method used was stratified random sampling and the physicians were stratified based on the specialty. A total of 450 physicians were selected using a random number generator. Each of these physicians was given a questionnaire and out of 450 questionnaires, 335 (response rate--74%) were returned and 309 (69%) were deemed usable.RESULTS: The hypotheses were tested using Structural Equation Modeling (SEM). Salient results are: (1) Physicians' perceived threat to professional autonomy lowers the intention to use CDSS (p < 0.01); (2) Physicians involvement in the planning, design and implementation increases their intention to use CDSS (p < 0.01); (3) Physicians belief that the new CDSS will improve his/her job performance increases their intention to use CDSS (p < 0.01).CONCLUSION: The proposed model with the three main constructs (physician's professional characteristic, involvement and belief) explains 47% of the variance in the intention to use CDSS. This is significantly higher than the models addressed so far. The results will have a major impact in implementing CDSS in developing countries.

Resumo Limpo

ckground computerbas clinic decis support system cdss regard key element enhanc decisionmak healthcar environ improv qualiti medic care deliveri concern new cdss unus still one biggest issu develop countri develop implement clinic system main object studi determin whether physician perceiv profession autonomi involv decis implement cdss belief cdss will improv job perform increas intent adopt cdss four hypothes formul testedmethod questionnairebas survey conduct juli decemb studi conduct seven public five privat hospit kuala lumpur malaysia contact hospit necessari permiss obtain ministri health malaysia questionnair vet ethic committe ministri physician work hospit differ specialti particip studi sampl method use stratifi random sampl physician stratifi base specialti total physician select use random number generat physician given questionnair questionnair respons rate return deem usableresult hypothes test use structur equat model sem salient result physician perceiv threat profession autonomi lower intent use cdss p physician involv plan design implement increas intent use cdss p physician belief new cdss will improv hisher job perform increas intent use cdss p conclus propos model three main construct physician profession characterist involv belief explain varianc intent use cdss signific higher model address far result will major impact implement cdss develop countri

Resumos Similares

Med Decis Making - Why do patients derogate physicians who use a computer-based diagnostic support system? ( 0,723033979355473 )
BMC Med Inform Decis Mak - Applying the theory of planned behaviour to multiple sclerosis patients' decisions on disease modifying therapy--questionnaire concept and validation. ( 0,712641140154294 )
Med Decis Making - Decision to adopt medical technology: case study of breast cancer radiotherapy techniques. ( 0,705486897526843 )
BMC Med Inform Decis Mak - Determinants of use and non-use of a web-based communication system in cerebral palsy care: evaluating the association between professionals' system use and their a priori expectancies and background. ( 0,698438088874348 )
J. Med. Internet Res. - If we offer it, will they accept? Factors affecting patient use intentions of personal health records and secure messaging. ( 0,694896363331774 )
J Chem Inf Model - Creating context for the experiment record. User-defined metadata: investigations into metadata usage in the LabTrove ELN. ( 0,670031630858093 )
J Med Syst - Determinants of RFID adoption in Malaysia's healthcare industry: occupational level as a moderator. ( 0,666552553230229 )
J. Med. Internet Res. - Website quality, expectation, confirmation, and end user satisfaction: the knowledge-intensive website of the Korean National Cancer Information Center. ( 0,661500168688773 )
BMC Med Inform Decis Mak - Differentiating innovation priorities among stakeholder in hospital care. ( 0,640306486640909 )
Perspect Health Inf Manag - The effects of innovation factors on smartphone adoption among nurses in community hospitals. ( 0,638753641592844 )
BMC Med Inform Decis Mak - Factors of accepting pain management decision support systems by nurse anesthetists. ( 0,635004752842879 )
J. Med. Internet Res. - Use of a text message program to raise type 2 diabetes risk awareness and promote health behavior change (part II): assessment of participants' perceptions on efficacy. ( 0,617920747515833 )
Inform Health Soc Care - AmI in good care? Developing design principles for ambient intelligent domotics for elderly. ( 0,616467086518387 )
BMC Med Inform Decis Mak - Barriers and facilitators to implementing Decision Boxes in primary healthcare teams to facilitate shared decisionmaking: a study protocol. ( 0,614538089188043 )
Comput Math Methods Med - Mathematical methods for assessing the prognostic of fixed partial dentures resulting from evaluating a group of dental patients in Romania. ( 0,612088306079477 )
J Med Syst - Health information technology adoption in U.S. acute care hospitals. ( 0,611251640243866 )
BMC Med Inform Decis Mak - User acceptance of a picture archiving and communication system (PACS) in a Saudi Arabian hospital radiology department. ( 0,609285169784768 )
Telemed J E Health - Physicians' perceptions and use of a health information exchange: a pilot program in South Korea. ( 0,606869096003379 )
BMC Med Inform Decis Mak - Stages of use: consideration, initiation, utilization, and outcomes of an internet-mediated intervention. ( 0,603986101683902 )
J Med Syst - Assessing the relationship between technology readiness and continuance intention in an E-appointment system: relationship quality as a mediator. ( 0,60293623396307 )
Health Informatics J - Provider impressions of the use of a mobile crowdsourcing app in medical practice. ( 0,602240674751749 )
Telemed J E Health - Older adults' perceptions of home telehealth services. ( 0,598399223665939 )
Int J Med Inform - The determinants of home healthcare robots adoption: an empirical investigation. ( 0,596540819130248 )
Med Decis Making - Australian Public Preferences for the Funding of New Health Technologies: A Comparison of Discrete Choice and Profile Case Best-Worst Scaling Methods. ( 0,59530148630462 )
BMC Med Inform Decis Mak - Comparative evaluation of different medication safety measures for the emergency department: physicians' usage and acceptance of training, poster, checklist and computerized decision support. ( 0,594292719578675 )
J Am Med Inform Assoc - Factors affecting home care patients' acceptance of a web-based interactive self-management technology. ( 0,594137102915558 )
J. Med. Internet Res. - Understanding the factors that influence the adoption and meaningful use of social media by physicians to share medical information. ( 0,590544506743503 )
BMC Med Inform Decis Mak - Risk assessment and decision making about in-labour transfer from rural maternity care: a social judgment and signal detection analysis. ( 0,58972084385515 )
Methods Inf Med - Understanding behavioral intent to participate in shared decision-making in medically uncertain situations. ( 0,588288101538213 )
Int J Med Inform - Do hospital physicians' attitudes change during PACS implementation? A cross-sectional acceptance study. ( 0,587664731325968 )
AMIA Annu Symp Proc - An empirical study of opinion leader effects on mobile information technology adoption in healthcare. ( 0,587598597849724 )
J. Med. Internet Res. - Speech perception benefits of internet versus conventional telephony for hearing-impaired individuals. ( 0,586961327355888 )
J Med Syst - High-level managers' considerations for RFID adoption in hospitals: an empirical study in Taiwan. ( 0,585656897627912 )
Int J Med Inform - Modeling factors explaining the acceptance, actual use and satisfaction of nurses using an Electronic Patient Record in acute care settings: an extension of the UTAUT. ( 0,585495939848738 )
Telemed J E Health - An empirical study of physicians' acceptance of hospital information systems in Taiwan. ( 0,585083547290875 )
BMC Med Inform Decis Mak - An investigation of the effect of nurses' technology readiness on the acceptance of mobile electronic medical record systems. ( 0,584981491533472 )
BMC Med Inform Decis Mak - Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform. ( 0,584208027138539 )
J Am Med Inform Assoc - Modeling nurses' acceptance of bar coded medication administration technology at a pediatric hospital. ( 0,583365355791581 )
Med Decis Making - Contributions of Second Opinions, Outcome Forecasts, and Testimonials to Patient Decisions about Knee Replacement Surgery. ( 0,582099057904203 )
AMIA Annu Symp Proc - Study of the factors that promoted the implementation of electronic medical record on iPads at two emergency departments. ( 0,577797587179019 )
J Med Syst - Barriers to physicians' adoption of healthcare information technology: an empirical study on multiple hospitals. ( 0,576577585324018 )
Int J Med Inform - Antecedents of open source software adoption in health care organizations: a qualitative survey of experts in Canada. ( 0,575698986133685 )
Methods Inf Med - Evaluation of the USE IT-questionnaire for the evaluation of the adoption of electronic patient records by healthcare professionals. ( 0,572551552133658 )
Med Decis Making - What is known about parents' treatment decisions? A narrative review of pediatric decision making. ( 0,572116300674929 )
J Am Med Inform Assoc - The impact of computer self-efficacy, computer anxiety, and perceived usability and acceptability on the efficacy of a decision support tool for colorectal cancer screening. ( 0,570316707281175 )
J Med Syst - Family physicians' perceptions and use of electronic clinical decision support during the first year of implementation. ( 0,56978248517565 )
BMC Med Inform Decis Mak - Perceived barriers of heart failure nurses and cardiologists in using clinical decision support systems in the treatment of heart failure patients. ( 0,569660801433961 )
Int J Med Inform - Understanding physicians' acceptance of the Medline system for practicing evidence-based medicine: a decomposed TPB model. ( 0,568677990412737 )
Med Decis Making - Getting ahead of illness: using metaphors to influence medical decision making. ( 0,56838525212226 )
BMC Med Inform Decis Mak - The design of a low literacy decision aid about rheumatoid arthritis medications developed in three languages for use during the clinical encounter. ( 0,567751503432084 )
BMC Med Inform Decis Mak - Genders of patients and clinicians and their effect on shared decision making: a participant-level meta-analysis. ( 0,564631620384532 )
Med Decis Making - Advance care planning norms may contribute to hospital variation in end-of-life ICU use: a simulation study. ( 0,563581440200903 )
Perspect Health Inf Manag - Health information technology and physician career satisfaction. ( 0,561619981808102 )
AMIA Annu Symp Proc - Role of physicians' reactance in e-iatrogenesis: a case study with ASTI guiding mode on the management of hypertension. ( 0,561434448430541 )
J Biomed Inform - The effects of organizational contextual factors on physicians' attitude toward adoption of Electronic Medical Records. ( 0,560877527318098 )
Med Decis Making - All stories are not alike: a purpose-, content-, and valence-based taxonomy of patient narratives in decision aids. ( 0,559863632449679 )
J Am Med Inform Assoc - Understanding the acceptability of a computer decision support system in pediatric primary care. ( 0,557557877732095 )
J Am Med Inform Assoc - Professional and geographical network effects on healthcare information exchange growth: does proximity really matter? ( 0,55742949167671 )
BMC Med Inform Decis Mak - A socio-technical assessment of the success of Picture Archiving and Communication Systems: the radiology technologist's perspective. ( 0,555803543603814 )
BMC Med Inform Decis Mak - Adoption of telemedicine: from pilot stage to routine delivery. ( 0,555363612101456 )
AMIA Annu Symp Proc - Epinome - a novel workbench for epidemic investigation and analysis of search strategies in public health practice. ( 0,554494088222679 )
J. Med. Internet Res. - Patient perceptions of a personal health record: a test of the diffusion of innovation model. ( 0,554037383477129 )
Int J Med Inform - Determinants of physicians' technology acceptance for e-health in ambulatory care. ( 0,553506676689897 )
Int J Med Inform - Physicians' acceptance of electronic medical records exchange: an extension of the decomposed TPB model with institutional trust and perceived risk. ( 0,553072767522026 )
Int J Med Inform - Factors influencing acceptance of technology for aging in place: a systematic review. ( 0,551004229068186 )
J. Med. Internet Res. - Patients' reported reasons for non-use of an internet-based patient-provider communication service: qualitative interview study. ( 0,550974838788431 )
Telemed J E Health - Developing the Native People for Cancer Control Telehealth Network. ( 0,55026878597114 )
Methods Inf Med - Information technology acceptance in health information management. ( 0,547930881110094 )
Perspect Health Inf Manag - Are physicians likely to adopt emerging mobile technologies? Attitudes and innovation factors affecting smartphone use in the Southeastern United States. ( 0,547200306432257 )
Med Decis Making - Framing Options as Choice or Opportunity: Does the Frame Influence Decisions? ( 0,546825161436159 )
BMC Med Inform Decis Mak - Decision aids for respite service choices by carers of people with dementia: development and pilot RCT. ( 0,546792024584556 )
Telemed J E Health - Predicting medical staff intention to use an online reporting system with modified unified theory of acceptance and use of technology. ( 0,5464964442595 )
Int J Med Inform - An investigation on physicians' acceptance of hospital information systems: a case study. ( 0,545531081432058 )
J Med Syst - The adoption of mobile health management services: an empirical study. ( 0,54515803336404 )
J Med Syst - Determinants of telemedicine acceptance in selected public hospitals in Malaysia: clinical perspective. ( 0,544393336574593 )
Telemed J E Health - Impact of information technology reliance and innovativeness on rural healthcare services: study of dindigul district in Tamilnadu, India. ( 0,542475244005932 )
Int J Med Inform - ICT and the future of health care: aspects of health promotion. ( 0,542231584127325 )
BMC Med Inform Decis Mak - Development and pilot testing of a decision aid for drivers with dementia. ( 0,540416209315341 )
J Biomed Inform - Comparing risks of alternative medical diagnosis using Bayesian arguments. ( 0,539937042153831 )
J. Med. Internet Res. - Supporting health care professionals to improve the processes of shared decision making and self-management in a web-based intervention: randomized controlled trial. ( 0,539794198539863 )
Med Decis Making - The impact of a novel computer-based decision aid on shared decision making for colorectal cancer screening: a randomized trial. ( 0,53902499653992 )
Med Decis Making - The DECISIONS study: a nationwide survey of United States adults regarding 9 common medical decisions. ( 0,538152623057649 )
J Am Med Inform Assoc - Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support. ( 0,537349892243031 )
Int J Med Inform - Perceptions of e-prescribing efficiencies and inefficiencies in ambulatory care. ( 0,537086640076107 )
AMIA Annu Symp Proc - Clinical information system post-adoption evaluation at the georges pompidou university hospital. ( 0,5366665469703 )
Med Decis Making - Breast cancer patients' treatment expectations after exposure to the decision aid program adjuvant online: the influence of numeracy. ( 0,535360528248283 )
J. Med. Internet Res. - Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid. ( 0,535045683869512 )
Appl Clin Inform - Evaluating a federated medical search engine: tailoring the methodology and reporting the evaluation outcomes. ( 0,533262800590403 )
Appl Clin Inform - Understanding why clinicians answer or ignore clinical decision support prompts. ( 0,53102698466002 )
Int J Med Inform - Theorizing the health service usage behavior of family caregivers: a qualitative study of an internet-based intervention. ( 0,530433215173182 )
Med Decis Making - Physicians' tacit and stated policies for determining patient benefit and referral to cardiac rehabilitation. ( 0,53028801113582 )
Int J Med Inform - Implementing a bar-code assisted medication administration system: effects on the dispensing process and user perceptions. ( 0,528992038010761 )
Int J Med Inform - Healthcare professionals' adoption and use of a clinical information system (CIS) in primary care: insights from the Da Vinci study. ( 0,528698162153375 )
Med Decis Making - Are medical outcomes fungible? A survey of voters, medical administrators, and physicians. ( 0,528340099279675 )
J Med Syst - Provider stakeholders' perceived benefit from a nascent health information exchange: a qualitative analysis. ( 0,527419146038907 )
J Med Syst - Engagement in E-learning opportunities: an empirical study on patient education using expectation confirmation theory. ( 0,527044504290577 )
BMC Med Inform Decis Mak - A qualitative study of professional and client perspectives on information flows and decision aid use. ( 0,525199992707056 )
J. Med. Internet Res. - A comparison of physician pre-adoption and adoption views on electronic health records in Canadian medical practices. ( 0,524994443111858 )
Appl Clin Inform - Telemedicine: What have we learned? ( 0,523273761120041 )
J Med Syst - Evaluating acceptance and user experience of a guideline-based clinical decision support system execution platform. ( 0,519885193617057 )