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Implementing new ways of working: interventions and their effect on the use of an electronic medication record

Published: 10 May 2009 Publication History

Abstract

Successful deployment of information technology (IT) involves implementation of new ways of working. Under-recognition of this organizational element of implementation entails considerable risk of not attaining the benefits that motivated deployment, yet knowledge of how to work systematically with organizational implementation is sparse. This study investigates a set of interventions undertaken to implement one mandated procedure associated with an electronic medication record, namely that all information about medication is recorded in the system. Medical record audits show that the interventions, which were devised and performed as part of the study, significantly lowered the number of records that violated the procedure. This positive effect was, however, not achieved until multiple interventions had been employed, and there is some indication that the effect may be wearing off after the interventions have ended. We discuss the implications of these results for efforts to work systematically with the organizational implementation of IT systems.

References

[1]
Aarts, J., and Berg, M. 2006. Same systems, different outcomes: Comparing the implementation of computerized physician order entry in two Dutch hospitals. Methods of Information in Medicine, 45, 1, 53--61.
[2]
Aarts, J., Doorewaard, H., and Berg, M. 2004. Understanding implementation: The case of a computerized physician order entry system in a large Dutch university medical center. Journal of the American Medical Association, 11, 3, 207--216.
[3]
Alapetite, A., Andersen, H.B., and Hertzum, M. 2009. Acceptance of speech recognition by physicians: A survey of expectations, experiences, and social influence. International Journal of Human-Computer Studies, 67, 1, 36--49.
[4]
Ash, J.S., Gorman, P.N., Lavelle, M., Stavri, P.Z., Lyman, J., Fournier, L., and Carpenter, J. 2003. Perceptions of physician order entry: Results of a cross-site qualitative study. Methods of Information in Medicine, 42, 4, 313--323.
[5]
Azad, B., and King, N. 2008. Enacting computer workaround practices within a medication dispensing system. European Journal of Information Systems, 17, 3, 264--278.
[6]
Barker, K.N., Flynn, E.A., Pepper, G.A., Bates, D.W., and Mikeal, R.L. 2002. Medication errors observed in 36 health care facilities. Archives of Internal Medicine, 162, 16, 1897--1903.
[7]
Baskerville, R., and Pries-Heje, J. 1999. Grounded action research: A method for understanding IT in practice. Accounting, Management and Information Technologies, 9, 1, 1--23.
[8]
Berg, M. 1999. Patient care information systems and health care work: A sociotechnical approach. International Journal of Medical Informatics, 55, 2, 87--101.
[9]
Bødker, K., Kensing, F., and Simonsen, J. 2004. Participatory IT design: Designing for business and workplace realities. MIT Press, Cambridge, MA.
[10]
Bossen, C. 2007. Test the artefact - develop the organization. The implementation of an electronic medication plan. International Journal of Medical Informatics, 76, 1, 13--21.
[11]
Brender, J., Ammenwerth, E., Nykänen, P., and Talmon, J. 2006. Factors influencing success and failure of health informatics systems. Methods of Information in Medicine, 45, 1, 125--136.
[12]
Cabana, M.D., Rand, C.S., Powe, N.R., Wu, A.W., Wilson, M.H., Abboud, P.-A.C., and Rubin, H.R. 1999. Why don't physicians follow clinical practice guidelines? Journal of the American Medical Association, 282, 15, 1458--1465.
[13]
Cabitza, F., Sarini, M., Simone, C., and Telaro, M. 2005. When once is not enough: The role of redundancy in a hospital ward setting. In K. Schmidt, M. Pendergast, M. Ackerman and G. Mark (Eds.), Proceedings of the GROUP '05 Conference on Supporting Group Work. ACM Press, New York, 158--167.
[14]
Colón-Emeric, C.S., Lekan, D., Utley-Smith, Q., Ammarell, N., Bailey, D., Corazzini, K., Piven, M.L., and Anderson, R.A. 2007. Barriers to and facilitators of clinical practice guideline use in nursing homes. Journal of the American Geriatrics Society, 55, 9, 1404--1409.
[15]
Cunningham, T.R., Geller, E.S., and Clarke, S.W. 2008. Impact of electronic prescribing in a hospital setting: A process-focused evaluation. International Journal of Medical Informatics, 77, 8, 546--554.
[16]
Fichman, R.G., and Kemerer, C.F. 1999. The illusory diffusion of innovation: An examination of assimilation gaps. Information Systems Research, 10, 3, 255--275.
[17]
Gallivan, M.J. 2001. Organizational adoption and assimilation of complex technological innovations: Development and application of a new framework. The Data Base for Advances in Information Systems, 32, 3, 51--85.
[18]
Gasser, L. 1986. The integration of computing and routine work. ACM Transactions on Office Information Systems, 4, 3, 205--225.
[19]
Granlien, M.F., Hertzum, M., and Gudmundsen, J. 2008. The gap between actual and mandated use of an electronic medication record three years after deployment. In S.K. Andersen, G.O. Klein, S. Schulz, J. Arts, and M.C. Mazzoleni (Eds.), MIE2008: Proceedings of the XXIst International Congress of the European Federation for Medical Informatics. IOS Press, Amsterdam, 419--424.
[20]
Grimshaw, J.M., Shirran, L., Thomas, R., Mowatt, G., Fraser, C., Bero, L., Grilli, R., Harvey, E., Oxman, A., and O'Brien, M.A. 2001. Changing provider behavior: An overview of systematic reviews of interventions. Medical Care, 39, 8, Supplement 2, 2--45.
[21]
Haux, R., Ammenwerth, E., Herzog, W., and Knaup, P. 2002. Health care in the information society. A prognosis for the year 2013. International Journal of Medical Informatics, 66, 1--3, 3--21.
[22]
Huysman, M., Steinfield, C., Jang, C.-Y., David, K., Veld, M.H.I.T., Poot, J., and Mulder, I. 2003. Virtual teams and the appropriation of communication technology: Exploring the concept of media stickiness. Computer Supported Cooperative Work, 12, 4, 411--436.
[23]
Lærum, H., Ellingsen, G., and Faxvaag, A. 2001. Doctors' use of electronic medical records systems in hospitals: Cross sectional survey. BMJ, 323, 7325, 1344--1348.
[24]
Landauer, T.K. 1995. The trouble with computers: Usefulness, usability, and productivity. MIT Press, Cambridge, MA.
[25]
Landry, M.D., and Sibbald, W.J. 2002. Changing physician behavior: A review of patient safety in critical care medicine. Journal of Critical Care, 17, 2, 138--145.
[26]
Leonard-Barton, D. 1988. Implementation as mutual adaptation of technology and organization. Research Policy, 17, 5, 251--267.
[27]
Lium, J.-T., Lærum, H., Schulz, T., and Faxvaag, A. 2006. From the front line, report from a near paperless hospital: Mixed reception among health care professionals. Journal of the American Medical Informatics Association, 13, 6, 668--675.
[28]
Mabeck, H. 2008. Implementation of an electronic medication system and disregarded power of the record. In S.K. Andersen, G.O. Klein, S. Schulz, J. Aarts, and M.C. Mazzoleni (Eds.), MIE2008: Proceedings of the XXIst International Congress of the European Federation for Medical Informatics. IOS Press, Amsterdam, 443--448.
[29]
Mark, G., and Poltrock, S. 2003. Shaping technology across social worlds: Groupware adoption in a distributed organization. In Proceedings of the GROUP '03 Conference on Supporting Group Work. ACM Press, New York, 284--293.
[30]
Markus, M.L. 2004. Technochange management: Using IT to drive organizational change. Journal of Information Technology, 19, 1, 4--20.
[31]
Markus, M.L., and Benjamin, R.I. 1997. The magic bullet theory in IT-enabled transformation. Sloan Management Review, 38, 2, 55--68.
[32]
Mayo, E. 1933. The human problems of an industrial civilization. MacMillan, New York.
[33]
Mikkelsen, G., and Aasly, J. 2001. Concordance of information in parallel electronic and paper based patient records. International Journal of Medical Informatics, 63, 3, 123--131.
[34]
Orlikowski, W.J., and Hofman, J.D. 1997. An improvisational model for change management: The case of groupware technologies. Sloan Management Review, 38, 2, 11--22.
[35]
Paré, G., and Trudel, M.-C. 2007. Knowledge barriers to PACS adoption and implementation in hospitals. International Journal of Medical Informatics, 76, 1, 22--33.
[36]
Scott, J.T., Rundall, T.G., Vogt, T.M., and Hsu, J. 2005. Kaiser Permanente's experience of implementing an electronic medical record: A qualitative study. BMJ, 331, 7528, 1313--1316.
[37]
Senderovitz, T., Christophersen, A.B., Christensen, H.R., and Kampmann, J.P. 1998. Discrepancies between medical records and dispensing records in two large hospital departments in Copenhagen. Ugeskrift for Læger, 160, 27, 4055--4058.
[38]
Simonsen, J., and Hertzum, M. 2008. Participative design and the challenges of large-scale systems: Extending the iterative PD approach. In J. Simonsen, T. Robertson and D. Hakken (Eds.), PDC2008: Proceedings of the Tenth Anniversary Conference on Participatory Design. ACM Press, New York, 1--10.
[39]
Sobol, M.G., Alverson, M., and Lei, D. 1999. Barriers to the adoption of computerized technology in health care systems. Topics in Health Information Management, 19, 4, 1--19.
[40]
Tyre, M.J., and Orlikowski, W.J. 1994. Windows of opportunity: Temporal patterns of technological adaptation in organizations. Organization Science, 5, 1, 98--118.
[41]
Wensing, M., van der Weijden, T., and Grol, R. 1998. Implementing guidelines and innovations in general practice: Which interventions are effective? British Journal of General Practice, 48, 427, 991--997.
[42]
Wulf, V., and Rohde, M. 1995. Towards an integrated organization and technology development. In Proceedings of the DIS '95 Symposium on Designing Interactive Systems. ACM Press, New York, 55--64.

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cover image ACM Conferences
GROUP '09: Proceedings of the 2009 ACM International Conference on Supporting Group Work
May 2009
412 pages
ISBN:9781605585000
DOI:10.1145/1531674
Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]

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Published: 10 May 2009

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Author Tags

  1. adoption
  2. diffusion
  3. electronic medication record
  4. healthcare
  5. organizational implementation

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GROUP09
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GROUP09: ACM 2009 International Conference on Supporting Group Work
May 10 - 13, 2009
Florida, Sanibel Island, USA

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GROUP '09 Paper Acceptance Rate 40 of 110 submissions, 36%;
Overall Acceptance Rate 125 of 405 submissions, 31%

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