Sustained User Engagement in Health Information Technology: The Long Road from Implementation to System Optimization of Computerized Physician Order Entry and Clinical Decision Support Systems for Prescribing in Hospitals in England
Year: 2016
Type: article
Abstract: OBJECTIVE: To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing. STUDY SETTING: Six hospitals in England, United Kingdom. STUDY DESIGN: Qualitative case study. DATA COLLECTION: We undertook qualitative semi-structured interviews, non-participant observations of meetings and system use, and collected organizational documents over three time periods from six hospitals. Thematic analysis was initially undertaken within individual cases, followed by cross-case comparisons. FINDINGS: We conducted 173 interviews, conducted 24 observations, and collected 17 documents between 2011 and 2015. We found that perceived individual and safety benefits among different user groups tended to facilitate engagement in some, while other less engaged groups developed resistance and unsanctioned workarounds if systems were perceived to be inadequate. We identified both the opportunity and need for sustained engagement across user groups around system enhancement (e.g., through customizing software) and the development of user competencies and effective use. CONCLUSIONS: There is an urgent need to move away from an episodic view of engagement focused on the preimplementation phase, to more continuous holistic attempts to engage with and respond to end-users.
Source: Health Services Research
Authors: Kathrin M. Cresswell, Lisa Lee, Hajar Mozaffar, Robin Williams, Aziz Sheikh, on behalf of the NIHR ePrescribing Programme Team
Institution: University of Edinburgh
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Awards: ESRC Centre for Social and Economic Research on Innovation in Genomics (Innogen), The Scottish eHealth Informatics Research Centre, MICA: The Scottish eHealth Informatics Research Centre, Investigating the implementation, adoption and effectiveness of ePrescribing systems in English hospitals: a mixed methods national evaluation
OpenAlex ID: W2528797472