An investigation of clinician acceptance of a guideline based patient registry system for chronic disease management

Abstract

In 2002 federal funds, known as the Primary Care Health Transition Fund (PCHTF) were transferred to the provinces to experiment with different models of health services delivery in primary care. The Northern Health Authority used the fund to implement a Chronic Disease Management Community Collaborative using the Institute for Healthcare Improvement Breakthrough Series and the British Columbia (B.C.) Expanded Chronic Care Model. Included in the Chronic Care Model is an information systems component that enables a population-based approach using guidelines and data to plan, organize, monitor and deliver care for patients with chronic illnesses. In British Columbia a secure web based system, known as the Chronic Disease Management (CDM) Toolkit was developed by the Ministry of Health and made accessible to all physicians in the province to facilitate CDM by collaboratives and individual general practitioners (GPs). Technology acceptance is a mature concept in the information systems literature, and models of technology acceptance are important in health care with the increasing deployment of information systems to support clinical and management work processes. Understanding what variables influence clinicians to use appropriate technology could promote the diffusion of technology in health care. The Unified Theory of Acceptance and Use of Technology (UTAUT) is a recent (2003) model that consolidates eight models of technology acceptance that are prominent in the information systems literature. The UTAUT analysis revealed that social influence, usefulness, and facilitating conditions are important variables for the acceptance of new technology. With some adaptations to fit the health care context, the UTAUT was found to be an effective tool to measure CDM Toolkit acceptance in the Northern Health Authority. The field observations highlighted salient issues not captured by the UTAUT, including security certificate implementation, access and confidentiality, physician participation, data entry, flow sheets, infrastructure and training.