title: An adoption study of a clinical reminder system in ambulatory care using a developmental trajectory approach.
abstract: In this study, we 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. We 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, we 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 information systems more generally.
authors.affiliation: H. John Heinz III School of Public Policy and Management, Carnegie Mellon University, Pittsburgh, PA, USA.
authors.forename: Kai
authors.initials: K
authors.lastname: Zheng
authors.forename: Rema
authors.initials: R
authors.lastname: Padman
authors.forename: Michael P
authors.initials: MP
authors.lastname: Johnson
authors.forename: John
authors.initials: J
authors.lastname: Engberg
authors.forename: Herbert H
authors.initials: HH
authors.lastname: Diamond
mesh_terms: D000553:Ambulatory Care; D001292:Attitude to Computers; D002908:Chronic Disease / Q000628:therapy; D003258:Consumer Behavior; D003625:Data Collection; D020000:Decision Support Systems, Clinical; D004059:Diffusion of Innovation; D006786:Hospitals, Urban; D006801:Humans; D007396:Internship and Residency; D010044:Outpatient Clinics, Hospital; D011314:Preventive Health Services; D017010:Reminder Systems; D013223:Statistics as Topic