Impact of Implementing a Wiki to Develop Structured Electronic Order Sets on Physicians' Intention to Use Wiki-Based...

Area of Science:

• Health Informatics
• Medical Education
• Clinical Practice Improvement

Background:

• Wikis offer potential for disseminating health system order sets.
• Limited data exists on the impact of wiki use on clinicians' intention to adopt these tools.

Purpose of the Study:

• Describe wiki implementation for emergency department order sets.
• Evaluate changes in emergency physicians' intention to use wiki-based order sets.
• Assess the impact of wiki use on behavioral determinants for adopting order sets.

Main Methods:

• Pre/post-intervention mixed-methods study.
• Intervention: 6-month wiki access for creating electronic order sets.
• Validated Theory of Planned Behavior questionnaire assessing intention, attitude, perceived behavioral control, and subjective norm.

Main Results:

• Physicians' intention to use wiki-based order sets increased (P=.03).
• Positive attitude towards wiki-based order sets also significantly increased (P=.003).
• Easier information sharing, ease of use, and support were key facilitators; poor organization and access were barriers.

Conclusions:

• Six months of wiki access and motivation improved emergency physicians' intention and attitude toward using wiki-based order sets.
• Further studies are needed to confirm sustained use and impact on patient care.
• Barriers identified require addressing for broader wiki implementation.