Physician use of an NICU laboratory reporting system

Clinical workstation developers may gain useful insights from studies of physician acceptance and use of computer systems that have been incorporated into daily practice. We used a physician survey, intrinsic monitors built into the system and an observational study to assess physician acceptance and use of a touchscreen workstation that was put in place in an NICU in 1985. Each of the 87 physicians assigned to the 30 bed NICU during the two academic years beginning July, 1987 was sent a questionnaire that assessed experience and attitudes about the system. The 70 responding physicians (80 percent) were unanimous in agreeing or strongly agreeing that the system was "easy to learn" (57 reported it taking less than five minutes), "easy to use", and "integrates smoothly into patient care activities". Over 94 percent of the physicians agreed or strongly agreed that the system was "fast", "saves time", and was "reliable and dependable." Sixty-three of the responding physicians (90%) reported using the system two or more times a day with 53 using it more than five times daily. The most frequently requested new feature was that of time-trend graphs (51 occurrences). The intrinsic monitors were useful in validating design decisions and survey results but also provided new insights relevant to security issues. Similarly, the observation study reinforced some of the survey results but also highlighted an additional issue not brought out by the other two assessment methods. The overall assessment indicated that the system has been both well-accepted and well-used by its intended clinical clientele.