title: Emotional aspects of computer-based provider order entry: a qualitative study.
abstract: OBJECTIVE
  Computer-based provider order entry (CPOE) systems are implemented to increase both efficiency and accuracy in health care, but these systems often cause a myriad of emotions to arise. This qualitative research investigates the emotions surrounding CPOE implementation and use.
  
  
  METHODS
  We performed a secondary analysis of several previously collected qualitative data sets from interviews and observations of over 50 individuals. Three researchers worked in parallel to identify themes that expressed emotional responses to CPOE. We then reviewed and classified these quotes using a validated hierarchical taxonomy of semantically homogeneous terms associated with specific emotions.
  
  
  RESULTS
  The implementation and use of CPOE systems provoked examples of positive, negative, and neutral emotions. Negative emotional responses were the most prevalent, by far, in all the observations.
  
  
  CONCLUSIONS
  Designing and implementing CPOE systems is difficult. These systems and the implementation process itself often inspire intense emotions. If designers and implementers fail to recognize that various CPOE features and implementation strategies can increase clinicians' negative emotions, then the systems may fail to become a routine part of the clinical care delivery process. We might alleviate some of these problems by designing positive feedback mechanisms for both the systems and the organizations.
authors.affiliation: Department of Medical Informatics, Northwest Permanente, P.C., Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, USA. dean.f.sittig@kp.org
authors.forename: Dean F
authors.initials: DF
authors.lastname: Sittig
authors.forename: Michael
authors.initials: M
authors.lastname: Krall
authors.forename: Joann
authors.initials: J
authors.lastname: Kaalaas-Sittig
authors.forename: Joan S
authors.initials: JS
authors.lastname: Ash
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D004644:Emotions; D006739:Hospital Administration; D006751:Hospital Information Systems; D006801:Humans; D016347:Medical Records Systems, Computerized; D009936:Organizational Innovation; D036301:Qualitative Research; D014584:User-Computer Interface