title: Making sense of a new technology in clinical practice: a qualitative study of patient and physician perspectives.
abstract: BACKGROUND
  The number of new technologies for risk assessment available in health care is increasing. These technologies are intended to contribute to both improved care practices and improved patient outcomes. To do so however, there is a need to study how new technologies are understood and interpreted by users in clinical practice. The objective of this study was to explore patient and physician perspectives on the usefulness of a new technology to detect Cardiovascular Autonomic Neuropathy (CAN) in a specialist diabetes clinic. The technology is a handheld device that measures resting heart rate and conducts three cardiac autonomic reflex tests to evaluate heart rate variability.
  
  
  METHODS
  The study relied on three sources of data: observations of medical consultations where results of the CAN test were reported (n = 8); interviews with patients who had received the CAN test (n = 19); and interviews with physicians who reported results of the CAN test (n = 9). Data were collected at the specialist diabetes clinic between November 2013 and January 2014. Data were analysed using the concept of technological frames which is used to assess how physicians and patients understand and interpret the new technology.
  
  
  RESULTS
  Physicians generally found it difficult to communicate test results to patients in terms that patients could understand and to translate results into meaningful implications for the treatment of patients. Results of the study indicate that patients did not recall having done the CAN test nor recall receiving the results. Furthermore, patients were generally unsure about the purpose of the CAN test and the implications of the results.
  
  
  CONCLUSIONS
  Involving patients and physicians is essential when a new technology is introduced in clinical practice. This particularly includes the interpretation and communication processes related to its use.
  
  
  CONCLUSIONS
  The integration of a new risk assessment technology into clinical practice can be accompanied by several challenges. It is suggested that more information about the CAN test be provided to patients and that a dialogue-based approach be used when communicating test results to patients in order to best support the use of the technology in clinical practice.
authors.affiliation: Health Promotion Research, Steno Diabetes Center A/S, Gentofte, Denmark. riap@steno.dk.
authors.forename: Regitze A S
authors.initials: RA
authors.lastname: Pals
authors.affiliation: Health Promotion Research, Steno Diabetes Center A/S, Gentofte, Denmark. uamh@steno.dk.
authors.forename: Ulla M
authors.initials: UM
authors.lastname: Hansen
authors.affiliation: Health Promotion Research, Steno Diabetes Center A/S, Gentofte, Denmark. cbuj@steno.dk.
authors.forename: Clea B
authors.initials: CB
authors.lastname: Johansen
authors.affiliation: Clinical Epidemiology Research, Steno Diabetes Center A/S, Gentofte, Denmark. csvh@steno.dk.
authors.forename: Christian S
authors.initials: CS
authors.lastname: Hansen
authors.affiliation: Clinical Epidemiology Research, Steno Diabetes Center A/S, Gentofte, Denmark. maej@steno.dk.
authors.forename: Marit E
authors.initials: ME
authors.lastname: Jørgensen
authors.affiliation: Medical Research Laboratories, Clinical Institute of Medicine, Aarhus University, Aarhus, Denmark. jesper.fleischer@ki.au.dk.
authors.forename: Jesper
authors.initials: J
authors.lastname: Fleischer
authors.affiliation: Health Promotion Research, Steno Diabetes Center A/S, Gentofte, Denmark. iwtp@steno.dk.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Willaing
mesh_terms: D000328:Adult; D000368:Aged; D020811:Biomedical Technology; D003142:Communication; D003718:Denmark; D005260:Female; D058006:General Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019370:Observation; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D013038:Specialization