PURPOSE: Case managers facilitate continuity of care for persons living with HIV (PLWH) by coordination of resources and referrals to social services and medical care. The complexity of HIV care and associated comorbidities drives the need for medical and psychosocial care coordination, which may be achieved through health information exchange (HIE) systems. However, the use of HIE has not been well studied in the context of HIV services. The purpose of this descriptive qualitative study is to explore factors influencing case managers' adoption of electronic clinical data (ECD) summaries as an HIE strategy in HIV care through application of the "fit between individuals, task and technology" (FITT) framework. METHODS: Focus group methodology was used to gather perceptions from 48 participants who provided direct case management services for PLWH in New York City. Questions addressed current quality and efficiency challenges to HIE utilization in the context of case management of PLWH as well as barriers and enablers to use of an ECD summary. Analysis of the data was guided by the FITT framework. RESULTS: Major themes by interaction type were: (1) task-technology fit - resources, time and workflow; (2) individual-task fit - training and technical support; and 3) individual-technology fit - ECD summary functionality, technical difficulties and the need of a computer for each end-user. CONCLUSIONS: Our findings provide evidence for the applicability of the FITT framework to explore case managers' perceptions of factors influencing the adoption of ECD summary systems for HIV care prior to actual implementation. Assessment of fit among individual, task, and technology and addressing the concerns identified prior to implementation is critical to successful adoption of health information technology as a strategy to improve quality and efficiency in health care.
PURPOSE: Case managers facilitate continuity of care for persons living with HIV (PLWH) by coordination of resources and referrals to social services and medical care. The complexity of HIV care and associated comorbidities drives the need for medical and psychosocial care coordination, which may be achieved through health information exchange (HIE) systems. However, the use of HIE has not been well studied in the context of HIV services. The purpose of this descriptive qualitative study is to explore factors influencing case managers' adoption of electronic clinical data (ECD) summaries as an HIE strategy in HIV care through application of the "fit between individuals, task and technology" (FITT) framework. METHODS: Focus group methodology was used to gather perceptions from 48 participants who provided direct case management services for PLWH in New York City. Questions addressed current quality and efficiency challenges to HIE utilization in the context of case management of PLWH as well as barriers and enablers to use of an ECD summary. Analysis of the data was guided by the FITT framework. RESULTS: Major themes by interaction type were: (1) task-technology fit - resources, time and workflow; (2) individual-task fit - training and technical support; and 3) individual-technology fit - ECD summary functionality, technical difficulties and the need of a computer for each end-user. CONCLUSIONS: Our findings provide evidence for the applicability of the FITT framework to explore case managers' perceptions of factors influencing the adoption of ECD summary systems for HIV care prior to actual implementation. Assessment of fit among individual, task, and technology and addressing the concerns identified prior to implementation is critical to successful adoption of health information technology as a strategy to improve quality and efficiency in health care.
Authors: Todd R Johnson; Xiaozhou Tang; Mark J Graham; Juliana Brixey; James P Turley; Jiajie Zhang; Alla Keselman; Vimla L Patel Journal: Jt Comm J Qual Patient Saf Date: 2007-11