Evaluation of user acceptance of a clinical expert system.
OBJECTIVE
To measure the attitudes of physicians and nurses who use the Health Evaluation through Logical Processing (HELP) clinical information system.


METHODS
Questionnaire survey of 360 attending physicians and 960 staff nurses practicing at the LDS Hospital. The physicians' responses were signed, permitting follow-up for nonresponse and use of demographic data from staff files. The nurses' responses were anonymous and their demographic data were obtained from the questionnaires.


METHODS
Fixed-choice questions with a Likert-type scale, supplemented by free-text comments. Question categories included: computer experience; general attitudes about impact of the system on practice; ranking of available functions; and desired future capabilities.


RESULTS
The response rate was 68% for the physicians and 39% for the nurses. Age, specialty, and general computer experience did not correlate with attitudes. Access to patient data and clinical alerts were rated highly. Respondents did not feel that expert computer systems would lead to external monitoring, or that these systems might compromise patient privacy. The physicians and nurses did not feel that computerized decision support decreased their decision-making power.


CONCLUSIONS
The responses to the questionnaire and "free-text comments" provided encouragement for future development and deployment of medical expert systems at LDS Hospital and sister hospitals. Although there has been some fear on the part of medical expert system developers that physicians would not adapt to or appreciate recommendations given by these systems, the results presented here are promising and may be of help to other system developers and evaluators.
Gardner
R M
RM
Department of Medical Informatics, University of Utah School of Medicine, Salt Lake City.
Lundsgaarde
H P
HP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003658:Decision Making, Computer-Assisted; D003710:Demography; D005103:Expert Systems; D006801:Humans; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D009726:Nurses / Q000523:psychology; D010820:Physicians / Q000523:psychology; D011795:Surveys and Questionnaires