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. 2009 Jan 21:(1):CD006093.
doi: 10.1002/14651858.CD006093.pub2.

Interventions for promoting information and communication technologies adoption in healthcare professionals

Marie-Pierre Gagnon  1 , France Légaré, Michel Labrecque, Pierre Frémont, Pierre Pluye, Johanne Gagnon, Josip Car, Claudia Pagliari, Marie Desmartis, Lucile Turcot, Karine Gravel
Affiliations

Interventions for promoting information and communication technologies adoption in healthcare professionals

Marie-Pierre Gagnon et al. Cochrane Database Syst Rev. .

Abstract

Background: Information and communication technologies (ICT) are defined as digital and analogue technologies that facilitate the capturing, processing, storage and exchange of information via electronic communication. ICTs have the potential to improve information management, access to health services, quality of care, continuity of services, and cost containment. Knowledge is lacking on conditions for successful ICT integration into practice.

Objectives: To carry out a systematic review of the effectiveness of interventions to promote the adoption of ICT by healthcare professionals.

Search strategy: Specific strategies, defined with the help of an information specialist, were used to search the Cochrane Effective Practice and Organisation of Care Group (EPOC) register and additional relevant databases. We considered studies published from January 1990 until October 2007.

Selection criteria: Randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before/after studies (CBAs), and interrupted time series (ITS) that reported objectively measured outcomes concerning the effect of interventions to promote adoption of ICT in healthcare professionals' practices.

Data collection and analysis: Two reviewers independently assessed each potentially relevant study for inclusion. We resolved discrepancies by discussion or a third reviewer. Two teams of two reviewers independently extracted data and assessed the quality of included studies. A meta-analysis of study outcomes was not possible, given the small number of included studies and the heterogeneity of intervention and outcomes measures. We conducted qualitative analyses, and have presented the results in a narrative format.

Main results: Ten studies met the inclusion criteria. Nine of them were RCTs. All studies involved physicians as participants (including postgraduate trainees), and one study also included other participants. Only two studies measured patient outcomes. Searching skills and/or frequency of use of electronic databases, mainly MEDLINE, were targeted in eight studies. Use of Internet for audit and feedback, and email for provider-patient communication, were targeted in two studies. Four studies showed small to moderate positive effects of the intervention on ICT adoption. Four studies were unable to demonstrate significant positive effects, and the two others showed mixed effects. No studies looked at the long-term effect or sustainability of the intervention.

Authors' conclusions: There is very limited evidence on effective interventions promoting the adoption of ICTs by healthcare professionals. Small effects have been reported for interventions targeting the use of electronic databases and digital libraries. The effectiveness of interventions to promote ICT adoption in healthcare settings remains uncertain, and more well designed trials are needed.

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Conflict of interest statement

DECLARATIONS OF INTEREST

No conflicts of interest identified.

Figures

Analysis 1.1
Analysis 1.1
Comparison 1 Dichotomous data, Outcome 1 Proportion of professionals able to provide adequate clinical question.
Analysis 1.2
Analysis 1.2
Comparison 1 Dichotomous data, Outcome 2 Proportion of professionals who performed 3rd search.
Analysis 1.3
Analysis 1.3
Comparison 1 Dichotomous data, Outcome 3 Proportion of professionals who performed 4th search.
Analysis 1.4
Analysis 1.4
Comparison 1 Dichotomous data, Outcome 4 Proportion of professionals using the digital library service.
Analysis 1.5
Analysis 1.5
Comparison 1 Dichotomous data, Outcome 5 Proportion of professionals who searched MEDLINE.
Analysis 1.6
Analysis 1.6
Comparison 1 Dichotomous data, Outcome 6 Proportion of professionals successful at the 4th search.
Analysis 1.7
Analysis 1.7
Comparison 1 Dichotomous data, Outcome 7 Proportion of professionals successful at the 8th search.
Analysis 2.1
Analysis 2.1
Comparison 2 Continuous data, Outcome 1 Quality of the search strategy (post-intervention).
Analysis 2.2
Analysis 2.2
Comparison 2 Continuous data, Outcome 2 Quality of the search strategy (6-month follow up).
Analysis 2.3
Analysis 2.3
Comparison 2 Continuous data, Outcome 3 Mean signs-on.
Analysis 2.4
Analysis 2.4
Comparison 2 Continuous data, Outcome 4 Mean logins/month/user.
Analysis 2.5
Analysis 2.5
Comparison 2 Continuous data, Outcome 5 Mean number of searches.
See this image and copyright information in PMC

References

References to studies included in this review

    1. Bradley DR, Rana GK, Martin PW, Schumacher RE. Real-time evidence-based medicine instruction: a randomized controlled trial in a neonatal intensive care unit. Journal of the Medical Library Association. 2002;90(2):194–201. - PMC - PubMed
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References to studies excluded from this review

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References to studies awaiting assessment

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Additional references

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    1. Berner ES, Detmer DE, Simborg D. Will the wave finally break ? A brief view of the adoption of electronic medical records in the United States. Journal of American Medical Informatics Association. 2005;12(1):3–7. - PMC - PubMed
    1. Brooks RG, Menachemi N. Physicians’ use of email with patients: Factors influencing electronic communication and adherence to best practices. Journal of Medical Internet Research. 2006;8(1):e2. - PMC - PubMed

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