A diffusion of innovations model of physician order entry.
OBJECTIVE
To interpret the results of a cross-site study of physician order entry (POE) in hospitals using a diffusion of innovations theory framework.


METHODS
Qualitative study using observation, focus groups, and interviews. Data were analyzed by an interdisciplinary team of researchers using a grounded approach to identify themes. Themes were then interpreted using classical Diffusion of Innovations (DOI) theory as described by Rogers [1].


RESULTS
Four high level themes were identified: organizational issues; clinical and professional issues; technology implementation issues; and issues related to the organization of information and knowledge. Further analysis using the DOI framework indicated that POE is an especially complex information technology innovation when one considers communication, time, and social system issues in addition to attributes of the innovation itself.


CONCLUSIONS
Implementation strategies for POE should be designed to account for its complex nature. The ideal would be a system that is both customizable and integrated with other parts of the information system, is implemented with maximum involvement of users and high levels of support, and is surrounded by an atmosphere of trust and collaboration.
Ash
J S
JS
Library & Medical Informatics, Oregon Health and Science University, Portland, Oregon, USA.
Lyman
J
J
Carpenter
J
J
Fournier
L
L
D004059:Diffusion of Innovation; D006751:Hospital Information Systems / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D016347:Medical Records Systems, Computerized; D015279:Organizational Culture; D009936:Organizational Innovation; D010564:Personnel, Hospital