Document Detail


Technological viewpoints (frames) about electronic prescribing in physician practices.
MedLine Citation:
PMID:  20595310     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Physician practices may adopt and use electronic prescribing (eRx) in response to mandates, incentives, and perceived value of the technology. Yet, for the most part, diffusion has been limited and geographically confined, and even when adopted, use of eRx in many practices has been low. One explanation for this phenomenon is that decision-makers in the practices possess different technological viewpoints (frames) related to eRx and these frames have formed the basis for the adoption decision, expectations about the technology, and patterns of use. In this study eRx technological frames were examined.
DESIGN: Focus groups, direct observation, and semi-structured interviews were conducted with physicians, practice managers, nurses, and other medical staff.
MEASUREMENTS: Focus groups were observed, taped, transcribed, and analyzed to reveal themes. These themes guided the observational visits and subsequent interviews. A triangulation process was used to confirm the findings.
RESULTS: Seven frames emerged from the qualitative analysis ranging from positive to neutral to negative: (1) eRx as an efficiency and effectiveness enhancing tool; (2) eRx as the harbinger of new practices; (3) eRx as core to the clinical workflow; (4) eRx as an administrative tool; (5) eRx: the artifact; (6) eRx as a necessary evil; and (7) eRx as an unwelcome disruption.
CONCLUSION: Frames provide a unique perspective within which to explore the adoption and use of eRx and may explain why perceptions of value vary greatly. Some frames facilitate effective use of eRx while others impose barriers. Electronic prescribing can be viewed as a transitional technology on the path to greater digitization at the physician practice level. Understanding the impact of technological frames on the effectiveness of eRx use may provide lessons for the implementation of future health information technology innovations.
Authors:
Ritu Agarwal; Corey M Angst; Catherine M DesRoches; Michael A Fischer
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Medical Informatics Association : JAMIA     Volume:  17     ISSN:  1527-974X     ISO Abbreviation:  J Am Med Inform Assoc     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-10-21     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  9430800     Medline TA:  J Am Med Inform Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  425-31     Citation Subset:  IM    
Affiliation:
Center for Health Information and Decision Systems, Robert H. Smith School of Business, University of Maryland, College Park, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Attitude to Computers*
Decision Making, Organizational
Diffusion of Innovation*
Efficiency, Organizational
Electronic Prescribing*
Health Plan Implementation
Humans
Physician's Practice Patterns*
Practice Management, Medical*
Qualitative Research
United States
Workflow
Grant Support
ID/Acronym/Agency:
R18 HS017151-01/HS/AHRQ HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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