Abstract:
UNLABELLED:Given the increasing prevalence of multimorbidity in primary care (PC), interdisciplinary PC teams supported by appropriate clinical information systems (CIS) are needed in order to deal with the complexity of multimorbid patients' care. Our team has developed such a system, called the Da Vinci system. However, despite the expected benefits, evidence suggests generally low rates of CIS adoption. To optimize adoption in PC settings, a better understanding of the implementation process of such systems is crucial. PURPOSE:To identify user profiles, investigate the drivers of and barriers to adoption and use of the Da Vinci system, a PC tailored CIS, and understand the dynamics of the CIS adoption for each profile. METHODS:Using a longitudinal approach, we conducted a qualitative study (individual interviews, documentation and observation) based on the Diffusion of Innovation theory. It included 31 participants (primary care physicians, staff or residents, nurses, pharmacists) from two Family Medicine Groups in Quebec (Canada). RESULTS:The different user profiles drawn from the dynamics of implementation are linked to different sets of perceived drivers and barriers that evolve over time. Certain factors favour the decision of adopting Da Vinci early on: e.g. user skills and the system's expected ease of use and usefulness. Certain concerns hinder its adoption: e.g. perceived negative impact on the doctor-patient relationship. Over time, 5 factors appear to be related to more advanced exploitation of the system's functionalities: user skills, ease of use, comfort using the system in front of patients, support from colleagues and, more importantly, perceived positive impacts. CONCLUSIONS:A better understanding of the dynamics of CIS implementation provides insight into how best to encourage clinicians to adopt and make full use of such systems to improve the quality of care for multimorbid patients followed in PC settings.
journal_name
Int J Med Informjournal_title
International journal of medical informaticsauthors
Vedel I,Lapointe L,Lussier MT,Richard C,Goudreau J,Lalonde L,Turcotte Adoi
10.1016/j.ijmedinf.2011.11.002subject
Has Abstractpub_date
2012-02-01 00:00:00pages
73-87issue
2eissn
1386-5056issn
1872-8243pii
S1386-5056(11)00235-8journal_volume
81pub_type
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journal_title:International journal of medical informatics
pub_type: 杂志文章
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journal_title:International journal of medical informatics
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journal_title:International journal of medical informatics
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journal_title:International journal of medical informatics
pub_type: 杂志文章,评审
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journal_title:International journal of medical informatics
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journal_title:International journal of medical informatics
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journal_title:International journal of medical informatics
pub_type: 杂志文章
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journal_title:International journal of medical informatics
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2013.01.009
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journal_title:International journal of medical informatics
pub_type: 杂志文章
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2017.12.002
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2005.10.007
更新日期:2006-10-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
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更新日期:2019-11-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2019.04.008
更新日期:2019-07-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2007.05.009
更新日期:2007-10-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(97)00035-x
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journal_title:International journal of medical informatics
pub_type: 历史文章,杂志文章
doi:10.1016/s1386-5056(99)00008-8
更新日期:1999-06-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2005.03.010
更新日期:2005-06-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2008.06.012
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2008.10.003
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2017.02.002
更新日期:2017-05-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2006.04.010
更新日期:2006-09-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2006.05.035
更新日期:2007-06-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2011.10.003
更新日期:2011-12-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2015.03.001
更新日期:2015-07-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2004.07.003
更新日期:2005-03-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2011.12.011
更新日期:2012-06-01 00:00:00
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journal_title:International journal of medical informatics
pub_type: 杂志文章,评审
doi:10.1016/j.ijmedinf.2010.11.006
更新日期:2011-02-01 00:00:00