title: Implementing a web-based oncology protocol system in Australia: evaluation of the first 3 years of operation.
abstract: BACKGROUND
  EviQ is a web-based oncology protocol system launched across Australia in 2005 (http://www.eviq.org.au). We evaluated eviQ use at the point-of-care and determined the factors impacting on its uptake and routine use in the first three years of operation.
  
  
  METHODS
  We conducted a suite of qualitative and quantitative studies with over 200 Australian oncology physicians, nurses and pharmacists working at treatment centres in diverse geographical locations.
  
  
  RESULTS
  EviQ was part of routine care at many hospitals; however, the way in which it was used at the point-of-care varies according to clinician roles and hospital location. We identified a range of factors impacting on eviQ uptake and routine use. Infrastructure, such as availability of point-of-care computers, and formal policies endorsing eviQ are fundamental to increasing uptake. Furthermore, the level of clinical and computer experience of end-users, the attitudes and behaviour of clinicians, endorsement and promotion strategies, and level and type of eviQ education all need to be considered and managed to ensure that the system is being used to its full potential.
  
  
  CONCLUSIONS
  Our findings show that the dissemination of web-based treatment protocols does not guarantee widespread use. Organisational, environmental and clinician-specific factors play a role in uptake and utilisation. The deployment of sufficient computer infrastructure, implementation of targeted training programmes and hospital policies and investment in marketing approaches are fundamental to uptake and continued use. This study highlights the value of ongoing monitoring and evaluation to ensure systems like eviQ achieve their primary purpose - reducing treatment variation and improving quality of care.
authors.affiliation: Health Informatics Research and Evaluation Unit, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: I M
authors.initials: IM
authors.lastname: Hains
authors.forename: R L
authors.initials: RL
authors.lastname: Ward
authors.forename: S-A
authors.initials: SA
authors.lastname: Pearson
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D001315:Australia; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D002985:Clinical Protocols; D017144:Focus Groups; D019538:Health Care Surveys; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D008495:Medical Oncology / Q000458:organization & administration*; D008505:Medical Staff, Hospital / Q000523:psychology; D008838:Microcomputers / Q000600:supply & distribution; D009741:Nursing Staff, Hospital / Q000523:psychology; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data; D010595:Pharmacists / Q000523:psychology; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D015397:Program Evaluation; D058996:Quality Improvement