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Social impacts: Physicians’ use of handhelds for IR

This study examines the social barriers and impact of physicians' use of handheld devices for information retrieval in clinical settings. It analyzes clinician perceptions and usage patterns through laboratory and field studies.

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Social impacts: Physicians’ use of handhelds for IR

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  1. Danielle Lottridge - HFT Social impacts: Physicians’ use of handhelds for IR Danielle Lottridgea, Mark Chignella, Sharon Strausb,c a Interactive Media Lab, Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada b University Health Network, Toronto, Canada c Knowledge Translation Program, University of Toronto, Toronto, Canada

  2. Danielle Lottridge - HFT Overview • Rationale: The Need for Evidence • EPoCare Project • Post-study interviews • Laboratory Study • Field Study

  3. Danielle Lottridge - HFT Should you give the roommate antibiotics to decrease the risk of meningitis? • 20 year old man with meningococcal meningitis • His roommate wants to know if he should receive treatment for the disease since he lives with the patient

  4. Danielle Lottridge - HFT Clinicians’ Information Needs • Daily need for valid information • Traditional sources are inadequate • Time constraints

  5. Danielle Lottridge - HFT Making evidence available • Information Retrieval on a PDA • Goal: info accessible within seconds to be incorporated into busy clinical rounds or used with clinic patients • Concerns: technology, usability

  6. Danielle Lottridge - HFT Are there social barriers to PDA use with and around patients? • What are physician perceptions? (Laboratory study) • What are the usage patterns? (Field study)

  7. Danielle Lottridge - HFT EPOCare Project Proof of Concept (Phase 0) Needs Analysis(Phase 1)

  8. Danielle Lottridge - HFT Methods: Laboratory Study (Phase II) • Task-focused usability study • 47 participants from 3 user groups • 2 task scenarios with prototypes • Captured audio, video, questionnaires • Interviews • Coded responses

  9. Danielle Lottridge - HFT Lab Study Set-up participant … facilitator Note-taker

  10. Danielle Lottridge - HFT Methods: Field Study (Phase III) • Cohort study design • Setting: Inpatient medicine units at university-affiliated hospital • 23 medicine residents: 11 intervention, 12 control • Intervention: wireless PDA for 1 month • EBM resources • notepad • EBM calculator • Usage patterns? impact? perceptions?

  11. Danielle Lottridge - HFT Results: Lab Study Sample User Groups Age Distribution • 35 used medical DBs • 27 owned PDAs

  12. Danielle Lottridge - HFT Results: Lab Study How would you feel about using handheld device(s) in front of your patient? • Uncomfortable: (-) • No don't want to do that • I don't like to • [It] wouldn’t look good • Comfortable: (+ and neutral) • No problem [I] wouldn't mind it • I feel comfortable I'm not embarrassed, but I wouldn't have the time • Good, show the toys [I am] comfortable to a point • Use of medical DBs ~ self-reported comfort r=-.274, p=.036 2[2, N=44]= 5.61, p=.06

  13. Danielle Lottridge - HFT Common Themes

  14. Danielle Lottridge - HFT Results: Field Study Representative example: • “Yeah, it was mostly if there was someone that came into the hospital on the type of medication I didn’t know of then I would look it up, to find out what class of drug it was.” • “In front of the patient, no.”

  15. Danielle Lottridge - HFT Selected Explanations • (...) I never actually used [the PDA] in front of a patient. I don’t usually like to look things up right in front of a patient unless it a drug or something. Often you are kind of given information about the patient you are about to see and as walking to see that patient I might have looked a few things up. • Well certainly if I was seeing patients in the ER and when I was looking up things afterwards, writing up a note or that sort of thing. I did, not obviously at the bedside. • No [not with patients], it was just mainly in the nursing station if I was looking up things.

  16. Danielle Lottridge - HFT Summary • Trends: GPs more comfortable with PDA Less Medical DB use ~ more comfort • In practice, residents use PDA between, not during, visits.

  17. Danielle Lottridge - HFT Discussion • GPs, different setting, long term relationship • Discrepancy: expectations ≠ practice • unmet usability expectations • complex to incorporate into workflow • Implications for design: • educational intervention • streamline transactions • form factor: shared screen, status symbol

  18. Danielle Lottridge - HFT Discussion • Strengths • novel, sensitive topic • two angles • Limitations • studies not dedicated • sample size

  19. Danielle Lottridge - HFT Future work • Phase IV – eScript and mEMRi

  20. Special thanks to Romana Danicic, Scott Orr, Eric Tursman, Peter Wong & Anna Malandrino Thanks to Bell University Laboratories, CIHR, Health Canada and the Premier’s Research Excellence Award, for their funding contributions Danielle Lottridge - HFT Acknowledgements http://www.cebm.utoronto.ca/projects/epocare/index.htm

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