McAlearney Ann Scheck, Schweikhart Sharon B, Medow Mitchell A
Division of Health Services Management and Policy, Ohio State University, School of Public Health, 1583 Perry Street, Atwell 246, Columbus, OH 43210-1234, USA.
BMJ. 2004 May 15;328(7449):1162. doi: 10.1136/bmj.328.7449.1162.
To examine doctors' perspectives about their experiences with handheld computers in clinical practice.
Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns.
Six practice settings across the United States and two additional focus group sessions held at a national meeting of general internists.
54 doctors who did or did not use handheld computers.
Doctors who used handheld computers in clinical practice seemed generally satisfied with them and reported diverse patterns of use. Users perceived that the devices helped them increase productivity and improve patient care. Barriers to use concerned the device itself and personal and perceptual constraints, with perceptual factors such as comfort with technology, preference for paper, and the impression that the devices are not easy to use somewhat difficult to overcome. Participants suggested that organisations can help promote handheld computers by providing advice on purchase, usage, training, and user support. Participants expressed concern about reliability and security of the device but were particularly concerned about dependency on the device and over-reliance as a substitute for clinical thinking.
Doctors expect handheld computers to become more useful, and most seem interested in leveraging (getting the most value from) their use. Key opportunities with handheld computers included their use as a stepping stone to build doctors' comfort with other information technology and ehealth initiatives and providing point of care support that helps improve patient care.
探讨医生对其在临床实践中使用手持计算机的体验的看法。
对八个焦点小组进行定性研究,这些小组由训练和实践模式各异的医生组成。
美国的六个医疗机构,以及在内科住院医师全国会议上举行的另外两次焦点小组会议。
54名使用或未使用手持计算机的医生。
在临床实践中使用手持计算机的医生总体上似乎对其感到满意,并报告了不同的使用模式。使用者认为这些设备有助于提高工作效率和改善患者护理。使用的障碍涉及设备本身以及个人和认知方面的限制,诸如对技术的舒适度、对纸质材料的偏好以及认为设备不易使用等认知因素有些难以克服。参与者建议组织可以通过提供购买、使用、培训和用户支持方面的建议来帮助推广手持计算机。参与者对设备的可靠性和安全性表示担忧,但特别担心对设备的依赖以及过度依赖其作为临床思维的替代品。
医生期望手持计算机变得更有用,并且大多数人似乎有兴趣充分利用(从其使用中获取最大价值)。手持计算机的关键机遇包括将其用作让医生适应其他信息技术和电子健康倡议的垫脚石,以及提供有助于改善患者护理的即时护理支持。