Int J Med Inform - Different usage of the same oncology information system in two hospitals in Sydney--lessons go beyond the initial introduction.

Tópicos

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Resumo

CKGROUND AND PURPOSE: The experience of clinicians at two public hospitals in Sydney, Australia, with the introduction and use of an oncology information system (OIS) was examined to extract lessons to guide the introduction of clinical information systems in public hospitals.METHODS AND MATERIALS: Semi-structured interviews were conducted with 12 of 15 radiation oncologists employed at the two hospitals. The personnel involved in the decision making process for the introduction of the system were contacted and their decision making process revisited. The transcribed data were analyzed using NVIVO software. Themes emerged included implementation strategies and practices, the radiation oncologists' current use and satisfaction with the OIS, project management and the impact of the OIS on clinical practice.RESULTS: The hospitals had contrasting experiences in their introduction and use of the OIS. Hospital A used the OIS in all aspects of clinical documentation. Its implementation was associated with strong advocacy by the Head of Department, input by a designated project manager, and use and development of the system by all staff, with timely training and support. With no vision of developing a paperless information system, Hospital B used the OIS only for booking and patient tracking. A departmental policy that data entry for the OIS was centrally undertaken by administrative staff distanced clinicians from the system. All the clinicians considered that the OIS should continuously evolve to meet changing clinical needs and departmental quality improvement initiatives.CONCLUSIONS: This case study indicates that critical factors for the successful introduction of clinical information systems into hospital environment were an initial clear vision to be paperless, strong clinical leadership and management at the departmental level, committed project management, and involvement of all staff, with appropriate training. Clinician engagement is essential for post-adoption evolution of clinical information systems.

Resumo Limpo

ckground purpos experi clinician two public hospit sydney australia introduct use oncolog inform system oi examin extract lesson guid introduct clinic inform system public hospitalsmethod materi semistructur interview conduct radiat oncologist employ two hospit personnel involv decis make process introduct system contact decis make process revisit transcrib data analyz use nvivo softwar theme emerg includ implement strategi practic radiat oncologist current use satisfact oi project manag impact oi clinic practiceresult hospit contrast experi introduct use oi hospit use oi aspect clinic document implement associ strong advocaci head depart input design project manag use develop system staff time train support vision develop paperless inform system hospit b use oi book patient track department polici data entri oi central undertaken administr staff distanc clinician system clinician consid oi continu evolv meet chang clinic need department qualiti improv initiativesconclus case studi indic critic factor success introduct clinic inform system hospit environ initi clear vision paperless strong clinic leadership manag department level commit project manag involv staff appropri train clinician engag essenti postadopt evolut clinic inform system

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