Gaining acceptance for anesthesia information management systems among anesthesiologists

Abstract

To the Editor, I read with interest the recent review article by Stabile and Cooper that identifies the lack of clinician involvement in the implementation, planning, design, and installation of anesthesia information management systems (AIMS) as a barrier to the adoption of health information technology. Many challenges are associated with the implementation of new AIMS in the perioperative setting, including the perception that workload will increase or autonomy will decrease. Even if AIMS use were mandated and early acceptance occur, the negative consequences of resistance may surface over the long term if the information system were viewed as prone to error or slow. Medical directors and anesthesiology department chiefs must actively manage the change process and gain physician acceptance for the new information system. Failure to gain acceptance of the AIMS may result in the unsuccessful launch of the system and huge financial losses. The Technology Acceptance Model, the most widely accepted method of adopting information technology, focuses on interventions taken by managers to change employees’ attitudes toward information technology. The model identifies two main factors that influence an individual’s intention to use information technology, namely, the extent to which the user believes that the information technology will enhance their job performance (perceived usefulness) and require little effort (perceived ease of use). Perceived usefulness is determined by social influence and system characteristics, and perceived ease of use is determined by facilitating factors, individual differences, and system characteristics. Social influence variables include the opinions about use of information technology from people who are important to the user (subjective norm) and the extent to which the user’s standing among their peers will be maintained or raised (image). System characteristics are defined by the degree to which the user thinks the information technology is important to their work (job relevance), effective (output quality), able to deliver results that are easy to observe and share (result demonstrability), enjoyable (perceived enjoyment), and matches their desired level of effort (objective usability). Facilitating factors refer to the user’s belief that the organization supports the information technology and has committed resources to maintain its operation (perception of external control). Individual differences are defined by the degree to which the user believes in their computer skills (computer self-efficacy), is apprehensive about using a computer (computer anxiety), and is motivated to use new technology (computer playfulness). Managers should take well-defined steps to target the determinants of perceived usefulness and perceived ease of use in order to improve the adoption of AIMS and influence acceptance of information systems among anesthesiologists.