Schectman Joel M, Schorling John B, Nadkarni Mohan M, Voss John D
Department of Medicine, University of Virginia, P.O. Box 800744, Charlottesville, VA 22908, USA.
Int J Med Inform. 2005 Sep;74(9):711-7. doi: 10.1016/j.ijmedinf.2005.05.011.
To determine whether physician experience with and attitude towards computers is associated with adoption of a voluntary ambulatory prescription writing expert system.
A prescription expert system was implemented in an academic internal medicine residency training clinic and physician utilization was tracked electronically. A physician attitude and behavior survey (response rate=89%) was conducted six months after implementation.
There was wide variability in system adoption and degree of usage, though 72% of physicians reported predominant usage (> or =50% of prescriptions) of the expert system six months after implementation. Self-reported and measured technology usage were strongly correlated (r=0.70, p<0.0001). Variation in use was strongly associated with physician attitude toward issues of system efficiency and effect on quality, but not with prior computer experience, level of training, or satisfaction with their primary care practice. Non-adopters felt that electronic prescribing was more time consuming and also more likely to believe that their patients preferred hand-written prescriptions.
A voluntary electronic prescription system was readily adopted by a majority of physicians who believed it would have a positive impact on the quality and efficiency of care. However, dissatisfaction with system capabilities among both adopters and non-adopters suggests the importance of user education and expectation management following system selection.
确定医生对计算机的经验和态度是否与采用自愿性门诊处方书写专家系统相关。
在一家学术性内科住院医师培训诊所实施了一个处方专家系统，并通过电子方式跟踪医生的使用情况。在实施六个月后进行了一项医生态度和行为调查（回复率=89%）。
系统采用率和使用程度存在很大差异，不过在实施六个月后，72%的医生报告主要使用（≥50%的处方）专家系统。自我报告的技术使用情况与实际测量的情况高度相关（r=0.70，p<0.0001）。使用差异与医生对系统效率问题和对质量影响的态度密切相关，但与先前的计算机经验、培训水平或对其初级保健实践的满意度无关。未采用者认为电子处方更耗时，也更有可能认为他们的患者更喜欢手写处方。
大多数认为自愿性电子处方系统会对医疗质量和效率产生积极影响的医生很容易采用该系统。然而，采用者和未采用者对系统功能的不满表明，在系统选择后进行用户教育和期望管理很重要。
