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Submitted on September 29, 2004
Accepted on May 9, 2005
Affiliation of the authors: 1 Department of Medical Informatics, Northwest Permanente, P.C., Portland, OR; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR; 2 Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR
* To whom correspondence should be addressed.
Objectives Computer-based provider order entry (CPOE) systems are implemented to increase both efficiency and accuracy in health care, but these systems often cause a myriad of emotions to arise. This qualitative research investigates the emotions surrounding CPOE implementation and use.
Methods We performed a secondary analysis of several previously collected qualitative data sets from interviews and observations of over 50 individuals. Three researchers worked in parallel to identify themes that expressed emotional responses to CPOE. We then reviewed and classified these quotes using a validated hierarchical taxonomy of semantically homogenous terms associated with specific emotions.
Results The implementation and use of CPOE systems provoked examples of positive, negative, and neutral emotions. Negative emotional responses were the most prevalent, by far, in all of the observations.
Conclusions Designing and implementing CPOE systems is difficult. These systems, and the implementation process itself, often inspire intense emotions. If designers and implementers fail to recognize that various CPOE features and implementation strategies can increase clinicians' negative emotions, then the systems may fail to become a routine part of the clinical care delivery process. We might alleviate some of these problems by designing positive feedback mechanisms, for both the systems and the organizations.
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