Ash J S, Lyman J, Carpenter J, Fournier L
Library & Medical Informatics, Oregon Health and Science University, Portland, Oregon, USA.
Proc AMIA Symp. 2001:22-6.
To interpret the results of a cross-site study of physician order entry (POE) in hospitals using a diffusion of innovations theory framework.
Qualitative study using observation, focus groups, and interviews. Data were analyzed by an interdisciplinary team of researchers using a grounded approach to identify themes. Themes were then interpreted using classical Diffusion of Innovations (DOI) theory as described by Rogers [1].
Four high level themes were identified: organizational issues; clinical and professional issues; technology implementation issues; and issues related to the organization of information and knowledge. Further analysis using the DOI framework indicated that POE is an especially complex information technology innovation when one considers communication, time, and social system issues in addition to attributes of the innovation itself.
Implementation strategies for POE should be designed to account for its complex nature. The ideal would be a system that is both customizable and integrated with other parts of the information system, is implemented with maximum involvement of users and high levels of support, and is surrounded by an atmosphere of trust and collaboration.
运用创新扩散理论框架解读医院中医生医嘱录入(POE)跨机构研究的结果。
采用观察、焦点小组和访谈的定性研究方法。研究数据由一个跨学科研究团队运用扎根理论方法进行分析以确定主题。然后使用罗杰斯[1]所描述的经典创新扩散(DOI)理论对主题进行解读。
确定了四个高层次主题:组织问题;临床和专业问题;技术实施问题;以及与信息和知识组织相关的问题。使用DOI框架进行的进一步分析表明,当除了创新本身的属性之外还考虑沟通、时间和社会系统问题时,POE是一项特别复杂的信息技术创新。
POE的实施策略应设计得能考虑到其复杂的性质。理想的情况是一个既可以定制又能与信息系统的其他部分集成的系统,在用户的最大参与度和高水平支持下实施,并且处于信任与协作的氛围之中。