Jousimaa J, Kunnamo I, Mäkelä M
University of Kuopio, Department of Community Health and General Practice, Finland.
Scand J Prim Health Care. 1998 Sep;16(3):149-53. doi: 10.1080/028134398750003098.
To study the implementation of electronic guidelines designed for general practitioners (GPs).
A descriptive 3-year follow-up study.
All new subscribers to Physician's Desk Reference and Database (PDRD) in 1992.
Locations of computers, where PDRD software was installed for the first time in 1992.
Expectations of the program and changes in attitudes towards it, getting started with the system, frequency and continuity of use and estimated usefulness of the program.
The guidelines were expected to enhance diagnostic accuracy (60% of subscribers), save time (45%), and reduce costs (11%). After 1 year's use, the opinions of the users on these topics had become slightly more positive. Technical problems delayed starting to use the program in 27%. After 1 year 72% were using the program at least weekly. Using frequency was associated with having the computer in the office. The subscribers who renewed their subscription after one year often became regular users.
The study provides insight into the implementation phase of computer-based guidelines in a population of early adopters. Technical support was essential to overcome the barriers associated with computer technology. The perceived need for information was independent of the age and experience of the physicians.
研究为全科医生（GPs）设计的电子指南的实施情况。
一项为期3年的描述性随访研究。
1992年所有新订阅《医师案头参考与数据库》（PDRD）的用户。
1992年首次安装PDRD软件的计算机所在位置。
对该项目的期望以及对其态度的变化、开始使用该系统的情况、使用频率和持续性以及该项目的估计有用性。
预计该指南能提高诊断准确性（60%的订阅者）、节省时间（45%）和降低成本（11%）。使用1年后，用户在这些方面的看法变得稍微更积极了一些。技术问题导致27%的用户延迟开始使用该项目。1年后，72%的用户至少每周使用一次该项目。使用频率与办公室配备计算机有关。一年后续订的订阅者往往成为经常用户。
该研究为早期采用者群体中基于计算机的指南的实施阶段提供了见解。技术支持对于克服与计算机技术相关的障碍至关重要。对信息的感知需求与医生的年龄和经验无关。
