Pluye Pierre, Grad Roland M, Dawes Martin, Bartlett Joan C
Department of Family Medicine, McGill University, Montreal, QC, Canada.
J Eval Clin Pract. 2007 Feb;13(1):39-49. doi: 10.1111/j.1365-2753.2006.00646.x.
Clinical Information-Retrieval Technology (CIRT) is increasingly used, for example in accessing drug databases. However, no comprehensive framework exists to understand why health professionals search for information using CIRT. The present article aims to propose such organizational framework.
Our literature review suggests six reasons, of which three refer to cognitive objectives (C1, C2, C3) and three to organizational objectives (O1, O2, O3): (C1) to answer-solve-support a clinical question-problem-decision; (C2) to fulfil an educational-research objective; (C3) to search in general or for curiosity; (O1) to share information with patients; (O2) to exchange information with other health professionals; (O3) to plan-manage-monitor tasks with other health professionals.
The case study examined the use and impact of the InfoRetriever software on handheld computers in a Canadian family practice centre. Using the Critical Incident Technique, six family doctors were interviewed on specific events. A thematic analysis assigned extracts of interviews to reasons for use.
Findings illustrate the six reasons, and suggest a seventh reason that refers to a cognitive objective, namely (C4) to overcome the limits of health professional memory. These seven reasons are interpreted according to the literature on information science and organization studies, which suggest ordering reasons at three levels of stimulation of learning and knowledge: none (objective not achieved), moderate (cognitive objective achieved), and high (organizational objective achieved). This paves the way toward a new evaluation of relevance of CIRT in everyday practice (judgement based on professionals' objective achievement) using an organizational model of information-retrieving processes.
临床信息检索技术（CIRT）的应用越来越广泛，例如用于访问药物数据库。然而，目前尚无全面的框架来理解健康专业人员为何使用CIRT检索信息。本文旨在提出这样一个组织框架。
我们的文献综述提出了六个原因，其中三个涉及认知目标（C1、C2、C3），三个涉及组织目标（O1、O2、O3）：（C1）回答/解决/支持临床问题/难题/决策；（C2）实现教育/研究目标；（C3）一般性搜索或出于好奇心搜索；（O1）与患者分享信息；（O2）与其他健康专业人员交流信息；（O3）与其他健康专业人员计划/管理/监控任务。
该案例研究考察了InfoRetriever软件在加拿大家庭医疗中心的手持计算机上的使用情况及影响。采用关键事件技术，对六位家庭医生就具体事件进行了访谈。通过主题分析将访谈摘录归类为使用原因。
研究结果阐明了这六个原因，并提出了第七个涉及认知目标的原因，即（C4）克服健康专业人员记忆的局限性。根据信息科学和组织研究的文献对这七个原因进行了解释，这些文献建议在学习和知识激发的三个层面上对原因进行排序：无（目标未实现）、适度（认知目标实现）和高度（组织目标实现）。这为使用信息检索过程的组织模型对CIRT在日常实践中的相关性进行新的评估（基于专业人员目标实现的判断）铺平了道路。
