Andre B et al. 2008 "Experiences with the implementation of computerized tools in health care units: a review article."
Reference
Andre B, Ringdal GI, Loge JH, et al. Experiences with the implementation of computerized tools in health care units: a review article. Int J Hum Comput Interact 2008;24(8):753-775.
Abstract
"Demands for improved patient care as well as improved efficiency in the delivery of health care have increased dramatically in recent years. New technologies, including computers, are expected to play an important role in meeting these demands. The aim of this review is to identify the main challenges to the introduction of computer technology in health care and to identify what kinds of factors may promote or hamper the implementation process. A systematic search of relevant databases resulted in 299 hits related to implementation of computer technology in health care, of which 17 met all criteria for inclusion in this review. The following barriers to the adoption of computer technology were identified: negative attitudes, lack of knowledge, role adjustment related to the disruption of traditional work habits, and changes in established work roles. The dual needs to both assess and change attitudes were identified as crucial factors in allowing for the successful implementation of these new technologies. The challenges for future clinical work and research will be to influence the behavior and intentions of health care personnel, to focus on the benefits of introducing computer technology (CT) in health care units, and to make certain that the institution's leadership is fully supportive of the change. Furthermore, this review showed that if the introduction of computerized tools is going to succeed, an adequate training program is imperative."
Objective
"To identify the main challenges to the introduction of computer technology in health care and to identify what kinds of factors may promote or hamper the implementation process."
Size
not applicable
Type of Health IT
All types
Type of Health IT Functions
The functions varied across the articles reviewed.
Workflow-Related Findings
"Negative attitudes toward computers may cause people to avoid using computerized systems or to resist the introduction of such systems ... Some researchers have argued that persuading physicians to change their attitudes may be a more challenging task than overcoming the problems presented by the technology itself."
"Negative attitudes, resistance to change, and other behavioral aspects were found to be the main barriers [to technology acceptance] in 10 studies."
"The main challenges with respect to role adjustment [by health care workers] resulted principally from the disruption of traditional patterns and routine practices and alterations in previously established work roles and workflow."
A large "group [of articles] described totally paperless medical records, reduced paperwork, more efficient and higher quality medical service, and a reduced number of errors as a result of the use of the computer tool." A "more problem-oriented group reported...that computers were not being used to their fullest potential...or that the system took time away from patient care."
Study Design
Systematic literature review
Study Participants
The search was limited to studies that were English-language, described a health information technology system implementation process affecting hospital patients, and were published before November 2006. The following search engines and databases were used to generate the list of studies: PubMed, Inspec, PsychInfo, Embase, and BIBSYS. After excluding articles that did not describe the effect of the implementation on health care personnel and those that concerned telemedicine or education, 17 studies were the focus of the systematic review.