Int J Med Inform - Physicians' beliefs about using EMR and CPOE: in pursuit of a contextualized understanding of health IT use behavior.

Tópicos

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Resumo

RPOSE: To identify and describe physicians' beliefs about use of electronic medical records (EMR) and computerized provider order entry (CPOE) for inpatient and outpatient care, to build an understanding of what factors shape information technology (IT) use behavior in the unique context of health care delivery.METHODS: Semi-structured qualitative research interviews were carried out, following the beliefs elicitation approach. Twenty physicians from two large Midwest US hospitals participated. Physicians were asked questions to elicit beliefs and experiences pertaining to their use of EMR and CPOE. Questions were based on a broad set of behavior-shaping beliefs and the methods commonly used to elicit those beliefs.RESULTS: Qualitative analysis revealed numerous themes related to the perceived emotional and instrumental outcomes of EMR and CPOE use; perceived external and personal normative pressure to use those systems; perceived volitional control over use behavior; perceived facilitators and barriers to system use; and perceptions about the systems and how they were implemented. EMR and CPOE were commonly believed to both improve and worsen the ease and quality of personal performance, productivity and efficiency, and patient outcomes. Physicians felt encouraged by employers and others to use the systems but also had personal role-related and moral concerns about doing so. Perceived facilitators and barriers were numerous and had their sources in all aspects of the work system.CONCLUSION: Given the breadth and detail of elicited beliefs, numerous design and policy implications can be identified. Additionally, the findings are a first step toward developing a theory of health IT acceptance and use contextualized to the unique setting of health care.

Resumo Limpo

rpose identifi describ physician belief use electron medic record emr computer provid order entri cpoe inpati outpati care build understand factor shape inform technolog use behavior uniqu context health care deliverymethod semistructur qualit research interview carri follow belief elicit approach twenti physician two larg midwest us hospit particip physician ask question elicit belief experi pertain use emr cpoe question base broad set behaviorshap belief method common use elicit beliefsresult qualit analysi reveal numer theme relat perceiv emot instrument outcom emr cpoe use perceiv extern person normat pressur use system perceiv volit control use behavior perceiv facilit barrier system use percept system implement emr cpoe common believ improv worsen eas qualiti person perform product effici patient outcom physician felt encourag employ other use system also person rolerel moral concern perceiv facilit barrier numer sourc aspect work systemconclus given breadth detail elicit belief numer design polici implic can identifi addit find first step toward develop theori health accept use contextu uniqu set health care

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