Clinicians' adoption and use of electronic prescribing is likely linked to their views on technology
Proponents argue that greater adoption of health information technology such as electronic medical records, computerized physician order entry, and electronic prescribing (eRx) will improve care efficiency and safety. Although recent mandates are accelerating adoption of eRx, fewer than 10 percent of outpatient providers have adopted it.
A new study offers insight into the influence of clinicians' views on technology on their eRx adoption decisions. The researchers examined providers' technological viewpoints ("frames"). Technological frames are the cognitive structures or beliefs through which technology users make sense of the nature and role of technology, its use, and the consequences of use.The researchers conducted focus groups, interviews, and day-long observations of physicians, nurses, office managers, and medical assistants and assessed attitudes toward eRx and patterns of use.
A total of seven basic beliefs about eRx emerged:
- eRx as an efficiency and effectiveness enhancing tool.
- eRx as the harbinger of new practices.
- eRx as core to the clinical workflow.
- eRx as an administrative tool.
- eRx: the artifact.
- eRx as a necessary evil.
- eRx as an unwelcome disruption.
Some frames facilitated effective use of eRx while others imposed barriers. It was not uncommon to find positive, negative, and/or neutral beliefs within a single practice. The researchers conclude that creating an organizational culture with positive beliefs about eRx may be a precursor to meaningful use. This could be accomplished through strong and frequent messaging about the value of eRx. Understanding the impact of technological frames on the effectiveness of eRx use may provide lessons for the implementation of future health information technology innovations. Finally, eRx can be viewed as a transitional technology on the path to greater digitization at the physician practice level. This study was supported by the Agency for Healthcare Research and Quality (HS17151).
See "Technological viewpoints (frames) about electronic prescribing in physician practices," by Ritu Agarwal, Ph.D., Corey M. Angst, Ph.D., Catherine M. DesRoches, Ph.D., and Michael A. Fischer, M.D., M.S., in the Journal of the American Medical Informatics Association 17, pp. 425-431, 2010.
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