Abstract
A Computerized Patient Record System (CPRS) has many benefits and could improve health care outcomes. Reaping these benefits, however, is dependent on successful implementation of a provider order entry system. The literature supports substantial evidence that even systems that are usable, effective and reliable have not been adopted by the intended users. A successful implementation may be substantially a function of the degree to which the processes of care have changed to adapt to the new system. To ensure successful implementation we suggest monitoring the implementation process itself. The purpose of this paper is to report the methodology we developed for assessing how successfully a provider order entry system is being implemented. We adopt a model of diffusion of information technology developed by Fichman (1994) and expanded by Ash (1997). In this model, diffusion is characterized be three categories, "breadth" (infusion) and "depth" (diffusion) and "quality" (appropriateness of use). In this paper we discuss the typology of diffusion and describe specific measures designed to measure infusion and diffusion of a hospital information system.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ash J. S., Gorman P. N., Hersh W. R. Physician order entry in U.S. hospitals. Proc AMIA Symp. 1998:235–239. [PMC free article] [PubMed] [Google Scholar]
- Ash J. Organizational factors that influence information technology diffusion in academic health sciences centers. J Am Med Inform Assoc. 1997 Mar-Apr;4(2):102–111. doi: 10.1136/jamia.1997.0040102. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bates D. W., Kuperman G., Teich J. M. Computerized physician order entry and quality of care. Qual Manag Health Care. 1994 Summer;2(4):18–27. [PubMed] [Google Scholar]
- Lee F., Teich J. M., Spurr C. D., Bates D. W. Implementation of physician order entry: user satisfaction and self-reported usage patterns. J Am Med Inform Assoc. 1996 Jan-Feb;3(1):42–55. doi: 10.1136/jamia.1996.96342648. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lorenzi N. M., Riley R. T., Blyth A. J., Southon G., Dixon B. J. Antecedents of the people and organizational aspects of medical informatics: review of the literature. J Am Med Inform Assoc. 1997 Mar-Apr;4(2):79–93. doi: 10.1136/jamia.1997.0040079. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Massaro T. A. Introducing physician order entry at a major academic medical center: I. Impact on organizational culture and behavior. Acad Med. 1993 Jan;68(1):20–25. doi: 10.1097/00001888-199301000-00003. [DOI] [PubMed] [Google Scholar]
- McDonald C. J., Hui S. L., Smith D. M., Tierney W. M., Cohen S. J., Weinberger M., McCabe G. P. Reminders to physicians from an introspective computer medical record. A two-year randomized trial. Ann Intern Med. 1984 Jan;100(1):130–138. doi: 10.7326/0003-4819-100-1-130. [DOI] [PubMed] [Google Scholar]
- Sittig D. F., Stead W. W. Computer-based physician order entry: the state of the art. J Am Med Inform Assoc. 1994 Mar-Apr;1(2):108–123. doi: 10.1136/jamia.1994.95236142. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tierney W. M., Miller M. E., Overhage J. M., McDonald C. J. Physician inpatient order writing on microcomputer workstations. Effects on resource utilization. JAMA. 1993 Jan 20;269(3):379–383. [PubMed] [Google Scholar]