title: Organizational and physician perspectives about facilitating handheld computer use in clinical practice: results of a cross-site qualitative study.
abstract: OBJECTIVE
  To describe strategies that organizations select to support physicians' use of handheld computers (HHCs) in clinical practice and to explore issues about facilitating HHC use.
  
  
  METHODS
  A multidisciplinary team used focus groups and interviews with clinical, administrative, and information technology (IT) staff to gather data from 161 informants at seven sites. Transcripts were coded using a combination of deductive and inductive approaches to both answer research questions and identify patterns and themes that emerged in the data.
  
  
  METHODS
  Answers to questions about strategies for HHC support and themes about (1) how to facilitate physician adoption and use and (2) organizational concerns.
  
  
  RESULTS
  Three main organizational strategies for HHC support were characterized among sites: (1) active support for broad-based use, (2) active support for niche use, and (3) basic support for individual physician users. Three high-level themes emerged around how to best facilitate physician adoption and use of HHCs: (1) improving usability and usefulness, (2) promoting HHCs and device use, and (3) providing training and support. However, four major themes also emerged related to organizations' concerns about HHC use: (1) security-related concerns, (2) economic concerns, (3) technical concerns, and (4) strategic concerns.
  
  
  CONCLUSIONS
  An organizational approach to HHC support that involves individualized attention to existing and potential physician users rather than one-size-fits-all, organization-wide implementation efforts was an important facilitator promoting physician use of HHCs. Health care organizations interested in supporting HHC use must consider issues related to security, economics, and IT strategy that may not be prominent concerns for physician users.
authors.affiliation: ScD, Division of Health Services Management and Policy, The Ohio State University, 1583 Perry Street, Atwell 246, Columbus, OH 43210-1234, USA. mcalearney.1@osu.edu
authors.forename: Ann Scheck
authors.initials: AS
authors.lastname: McAlearney
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Schweikhart
authors.forename: Mitchell A
authors.initials: MA
authors.lastname: Medow
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D034201:Computers, Handheld / Q000706:statistics & numerical data*; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D019982:Organizational Case Studies; D015279:Organizational Culture; D009936:Organizational Innovation; D010820:Physicians; D036301:Qualitative Research