Contextual implemenation model

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Sandy Mendel BMI 512


Callen,J, Braithwaite,J, Westbrook,JI. Contextual Implementation Model: A Framework for Assisting Clinical Information System Implementations. J Am Med Inform Assoc. 2007 Dec 20.

Question: How can implementation of clinical information systems be facilitated?

Abstract: This paper presents the Contextual ImplementModel(CIM), a “multiple perspectives model” of clinical information system implementation.

Study Design: This was a qualitative data study performed in four clinical units in two large Australian teaching hospitals. Data analyzed included nonparticipatory observations of physicians using CPOE and interviews with health professionals about test management work practices. The data were analyzed by two researchers independently using an iterative grounded approach.

Results: The core theme of “contextual differences” that arose from the analysis was used to develop the Contextual Implementation Model which focuses on diversity at three levels: the organizational, the clinical/departmental, and the individual. Within each level are “dimensions for consideration.” The model views clinical system implementations from a sociotechnical perspective, and the paper compares this model to others(Rogers DOI Model, the FITT theory, TAM/ITAM model, and Ash’s principles)

Conclusion: The CIM suggests a way of examining the implementation of CPOE from three contextual levels, and within each, other dimensions for consideration, prior to implementation, to better prepare for factors that may impact clinicians’ use of the system(i.e. work practices at individual and departmental levels, evaluation of computer literacy and keyboard skills, interdepartmental evaluations, work requirements at various levels, and evaluation of organizational and team cultures)

Comment: I couldn’t find much new in the CIM as compared to Ash’s principles.