Physicians and the Utilization of Information Technology

Physicians and the Utilization of Information Technology

James W. Holsinger (University of Kentucky, USA)
DOI: 10.4018/978-1-60566-356-2.ch025
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This chapter introduces the issues faced by physicians in interacting with information technology (IT). It argues that the needs of physicians must be taken into consideration in order for successful implementation of information technology systems to occur. Physician professionalism and the development of their IT competence must be understood as well as understanding the need for physicians to acquire IT skills. The personality of physicians and the issues of their dissatisfaction with their profession are key elements for understanding physician engagement with IT. The Dreyfus model of skills acquisition may play a useful role in developing physicians’ IT skills. The author hopes that understanding the need for physician involvement in the development of information technology solutions in healthcare, as well as their level of IT skills, will assist healthcare organizations in the successful implementation of information technology both in heathcare institutions and physician practice settings.
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Professional Competence

Competence is a core component of every profession, including medicine. Professional competence may be defined as “the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served” (Epstein & Hundert, 2002). These authors find that acquiring and using knowledge in the practice of medicine, integrating biomedical and psycho-social data, and relating through communicating effectively are important concomitants in the professional practice of medicine. They point out that competence is based on tacit knowledge which they define as “that which we know but normally do not explain easily, including the informed use of heuristics (rules of thumb), intuition, and pattern recognition” (Epstein & Hundert, 2002). In an editorial, Leach (2002) enumerates the six general competences of a physician regardless of the specialty practiced: “patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice.” The acquisition of skills leading to competence is a developmental process, developed over time and based on understanding experiences resulting in habit formation. As will be discussed later, the utilization of information technology in the practice of medicine is thought to result in a higher quality of health care. “Physicians need to have the integrity, motivation, and capacity to discern good learning and good health care but should be restless until they get it right” (Leach, 2002).

Professionalism is a key component of professional competence. Several factors can impede physicians in their development of professionalism including “stress and lack of experience, support, and training [which] can lead to uncertainty about appropriate professional behavior and attitudes” (Brennan and Coles, 2003). It is a truism that the practice of medicine is always changing and it is clearly important for physicians to stay abreast of current developments and to develop self-motivation in order to undertake the necessary continuing learning required of a professional person (Gibson, Kartsounis, & Kopelman, 2006). The acquisition of skills competence requires being engaged enough in acquiring skills to be accountable. The Dreyfus model of skills acquisition requires moving through a series of five stages in order to become competent. To do so requires “less detachment and greater immersion in particular contexts” (Leach, 2002). The Dreyfus model may be useful in acquiring the skills necessary to become competent in the utilization of information technology.

Key Terms in this Chapter

Physician Competence: The appropriate and habitual use by physicians of clinical, technical, and communication skills and reasoning as well as the reflection of professional values in the practice of medicine.

Dreyfus Model: A five stage developmental process of skill acquisition based on experiential learning and situated performance.

Professionalism: The status, method, conduct, quality, and character of an individual practicing a profession, such as medicine.

Values Framework: A theoretical structure based on concepts worthy of esteem.

Remediation: The action of remedying or overcoming learning problems or deficiencies.

Computerized Physician Order Entry: A method for physicians to electronically order pharmaceutical agents and other therapies and procedures.

Physician Autonomy: The state or practice of self-governance, often considered an ascendant value for physicians.

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