Table 2.
Representative Quotes from Physicians
| Barrier Type | Representative Quotes from physician respondents |
|---|---|
| Organizational Barriers | |
| Lack of Integration and Institutional Support | “It would make a lot of sense to have that capability to have a program that allows you to generate notes, to write a prescription, and to give you alerts and all those kinds of things, that would be useful, but this institution doesn’t lend itself to that kind of concept at least where I work.” – Attending Physician |
| Legal Issues | “On top of the fact that the hospital lawyers have made it almost impossible to drag a note from yesterday to today and start fresh with stuff that has been entered yesterday.” –Attending Physician |
| Usability Barriers | |
| Usability Issues | “There were too many screens and you couldn’t see everything at one time.” –1st Year Resident; “I wish it was smaller, lighter, things like that.” –Attending Physician |
| Not User Friendly/Lack of User Knowledge | “If I figured out how to do it, I might.” –2nd Year Resident |
| Battery Life Issue | “I’d be afraid of chewing up the battery.” –Attending Physician |
| Perceived Delicacy of PDAs | “…a PDA becomes just a burden, keeping track of it, not sitting on it, things like that becomes more of a hassle than the benefit I would get from using it.” –3rd year Resident |
| Additional Accessories Needed | “I guess I could get a mobile charger if I wanna pay 30 bucks but I’m too cheap, so...” –2nd year Resident |
| Inadequate Technology/Support/Access Barriers | |
| Inadequate/Unavailable tech support or expired warranty | “…called whoever the “tech support” is and still couldn’t get it to work.” –3rd Year Resident |
| Unavailable features or applications on PDA | “Not loaded. If it was loaded, I’d use it.” (Diagnostic Algorithms) – Attending Physician |
| Lack of Need/Motivation | |
| Application or function perceived as unnecessary | “Because I remember all my appointments if I look at them in the beginning of the day. If I look at my PDA and it says I have a meeting at 2 o’clock, I don’t need to be reminded at 1:45 (calendar alerts).” – Attending Physician |
| Information integrated into profession | “And so I rarely get the answers I need from any of these things (electronic textbooks) and I use them infrequently because of that.” – Attending Physician |
| Application or function perceived as too general for practice | “If there had been pull down menus that were appropriate for the cases that I was doing, that would have been easier. But the pull down menus didn’t have the cases I was performing. Not specific enough for what I needed it to be.” –Chief Resident |
| Dissatisfied with previous experience | “I was writing down my information for the operative cases and it was just too cumbersome a program to use in an efficient manner. So I quickly abandoned it and went back to writing things down in a conventional manner.” –Chief Resident |
| Manual method preferred | “I’d rather just go up to a book and open it or go into the internet and the computers and read off of that.” –Intern. |
| Function performed by other personnel | “I don’t do billing. Attendings do all the billing.” –2nd Year Resident |
| Function performed with other hardware/methods | “We use this (pointing to PC tablet). ” –Attending Physician |