McAlearney Ann Scheck, Schweikhart Sharon B, Medow Mitchell A
ScD, Division of Health Services Management and Policy, The Ohio State University, 1583 Perry Street, Atwell 246, Columbus, OH 43210-1234, USA.
J Am Med Inform Assoc. 2005 Sep-Oct;12(5):568-75. doi: 10.1197/jamia.M1816. Epub 2005 May 19.
To describe strategies that organizations select to support physicians' use of handheld computers (HHCs) in clinical practice and to explore issues about facilitating HHC use.
A multidisciplinary team used focus groups and interviews with clinical, administrative, and information technology (IT) staff to gather data from 161 informants at seven sites. Transcripts were coded using a combination of deductive and inductive approaches to both answer research questions and identify patterns and themes that emerged in the data.
Answers to questions about strategies for HHC support and themes about (1) how to facilitate physician adoption and use and (2) organizational concerns.
Three main organizational strategies for HHC support were characterized among sites: (1) active support for broad-based use, (2) active support for niche use, and (3) basic support for individual physician users. Three high-level themes emerged around how to best facilitate physician adoption and use of HHCs: (1) improving usability and usefulness, (2) promoting HHCs and device use, and (3) providing training and support. However, four major themes also emerged related to organizations' concerns about HHC use: (1) security-related concerns, (2) economic concerns, (3) technical concerns, and (4) strategic concerns.
An organizational approach to HHC support that involves individualized attention to existing and potential physician users rather than one-size-fits-all, organization-wide implementation efforts was an important facilitator promoting physician use of HHCs. Health care organizations interested in supporting HHC use must consider issues related to security, economics, and IT strategy that may not be prominent concerns for physician users.
描述各机构为支持医生在临床实践中使用手持计算机（HHC）而选择的策略，并探讨促进HHC使用的相关问题。
一个多学科团队通过焦点小组以及对临床、行政和信息技术（IT）人员进行访谈，从7个地点的161名受访者那里收集数据。对访谈记录采用演绎法和归纳法相结合的方式进行编码，以回答研究问题，并识别数据中出现的模式和主题。
关于HHC支持策略的问题答案，以及关于（1）如何促进医生采用和使用HHC，和（2）机构关注点的主题。
各地点呈现出三种主要的HHC支持机构策略：（1）积极支持广泛使用，（2）积极支持特定用途，（3）对个体医生用户提供基本支持。围绕如何最好地促进医生采用和使用HHC出现了三个高层次主题：（1）提高可用性和实用性，（2）推广HHC及设备使用，（3）提供培训和支持。然而，也出现了与机构对HHC使用的关注点相关的四个主要主题：（1）安全相关问题，（2）经济问题，（3）技术问题，（4）战略问题。
一种针对HHC支持的机构方法，即对现有和潜在的医生用户进行个性化关注，而不是采用一刀切的全机构范围实施措施，是促进医生使用HHC的一个重要因素。对支持HHC使用感兴趣的医疗保健机构必须考虑与安全、经济和IT战略相关的问题，而这些问题可能不是医生用户的主要关注点。
