Exploring clinician adoption of a novel evidence request feature in an electronic medical record system

Objective: The research evaluated strategies for facilitating physician adoption of an evidence-based medicine literature request feature recently integrated into an existing electronic medical record (EMR) system. Methods: This prospective study explored use of the service by 137 primary care physicians by using service usage statistics and focus group and survey components. The frequency of physiciansʹ requests for literature via the EMR during a 10-month period was examined to explore the impact of several enhanced communication strategies launched mid­way through the observation period. A focus group and a 25-item survey explored physiciansʹ experiences with the service. Results: There was no detectable difference in the proportion of physicians utilizing the service after implementation of the customized communication strategies (11% in each time period, P=1.0, McNemarʹs test). Forty-eight physicians (35%) responded to the survey. Respondents who had used the service (n=19) indicated that information provided through the service was highly relevant to clinical practice (mean rating 4.6, scale 1 ʹʹnot relevantʹʹ-5 ʹʹhighly relevantʹʹ), and most (n=15) reported sharing the information with colleagues. Conclusion: The enhanced communication strategies, though well received, did not significantly affect use of the service. However, physicians noted the relevance and utility of librarian-summarized evidence from the literature, highlighting the potential benefits of providing expert librarian services in clinical workflow.