An Adoption Study of a Clinical Reminder System in Ambulatory Care Using a Developmental Trajectory Approach

Published in: Medinfo 2004: Proceedings of the Eleventh World Congress on Medical Informatics, Volume 107, Studies in Health Technology and Informatics / Edited by: M. Fieschi, E. Coiera and Y.-C.J. Li, Aug. 2004, p. 1115-1119

Posted on RAND.org on August 01, 2004

by Kai Zheng, Rema Padman, Michael P. Johnson, John Engberg, Herbert H. Diamond

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In this study, the authors assess 41 medical residents' acceptance and adoption of a clinical reminder system for chronic disease and preventive care management in the ambulatory care environment using a novel developmental trajectory approach. This group-based, semi-parametric statistical modeling method identifies distinct groups, following distinct usage trajectories, among those who recorded use of the reminder system within an evaluation period of 10 months. The authors trace system use within these groups over time using computer-generated logs and user satisfaction surveys. Our preliminary analysis of this small sample of users delineates three categories of users. Feedback from these categories of users is being used to re-engineer the application and adapt it better to their workflow and functionality requirements. Despite the small sample size in this particular study, they conclude that this methodology has considerable promise to provide new insights into system usability and adoption issues that may benefit clinical decision support systems as well as in-formation systems more generally.

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