Implementing complex clinical information systems in complex situations II: facilitating user acceptance of clinical information systems

The decision to implement an automated clinical information system is usually predicated upon satisfying the information needs of a specific group, generally administrators. It is clinicians, however, who will bear the burden of any work that this will entail. McCleery has argued that accuracy of source data will be assured only if "...spinoffs (are) developed for clinical staff that may be applied to their direct patient care activities." And, since the information a clinician provides to an automated system will probably wend its way back into activities that may ultimately affect the life of the clinician (e.g., credentialing or budgeting activities), it becomes even more important to develop credible, high quality "spin-offs" that can offset these potentially more pejorative administrative applications. These spin-offs can run the gamut from hard out puts of the automated system, to research using stored data, to educational programs based on analyses of clinical service delivery patterns, trends and research. This paper will discuss various techniques currently in use to facilitate user (i.e., clinician) acceptance of a large, state-wide clinical information system. The system, the state hospitals the methods being used to facilitate accept ance will be reviewed in the following sections.