Standardizing care in medical oncology: are Web-based systems the answer?
BACKGROUND
Medical oncology is embracing information technology to standardize care and improve patient outcomes, with a range of Web-based systems used internationally. The authors' aim was to determine the factors affecting the uptake and use of a Web-based protocol system for medical oncology in the Australian setting.


METHODS
The authors conducted 50 interviews and observed medical oncology physicians, nurses, and pharmacists in their treatment setting at 6 hospitals in different geographic locations.


RESULTS
The Web-based system plays a major role in guiding oncology treatment across participating sites. However, its use varies according to hospital location, clinician roles, and experience. A range of issues impact on clinicians' attitudes toward and use of the Web-based system. Important factors are clinician-specific (eg, their need for autonomy and perceptions of lack of time) or environmental (eg, hospital policy on protocol use, endorsement of the system, and the availability of appropriate infrastructure, such as sufficient computers). The level of education received regarding the system was also found to be integral to its ongoing use.


CONCLUSIONS
Although the provision of high-quality evidence-based resources, electronic or otherwise, is essential for standardizing care and improving patient outcomes, the authors' findings demonstrate that this alone does not ensure uptake. It is important to understand end-users, the environment in which they operate, and the basic infrastructure required to implement such a system. Implementation must also be accompanied by continuing education and endorsement to ensure both long-term sustainability and use of the system to its full potential.
Hains
Isla M
IM
University of New South Wales Cancer Research Centre, University of New South Wales, Sydney, Australia.
Fuller
Joanne M
JM
Ward
Robyn L
RL
Pearson
Sallie-Anne
SA
D001291:Attitude of Health Personnel; D001315:Australia; D003695:Delivery of Health Care / Q000592:standards*; D019317:Evidence-Based Medicine; D020407:Internet; D008495:Medical Oncology; D010818:Practice Patterns, Physicians'