A review and a framework of handheld computer adoption in healthcare
Abstract
Wide adoption of mobile computing technology can potentially improve information access, enhance workflow, and promote evidence-based practice to make informed and effective decisions at the point of care. Handheld computers or personal digital assistants (PDAs) offer portable and unobtrusive access to clinical data and relevant information at the point of care. This article reviews the literature on issues related to adoption of PDAs in health care and barriers to PDA adoption. Studies showed that PDAs were used widely in health care providers' practice, and the level of use is expected to rise rapidly. Most care providers found PDAs to be functional and useful in areas of documentation, medical reference, and access to patient data. Major barriers to adoption were identified as usability, security concerns, and lack of technical and organizational support. PDAs offer health care practitioners advantages to enhance their clinical practice. However, better designed PDA hardware and software applications, more institutional support, seamless integration of PDA technology with hospital information systems, and satisfactory security measures are necessary to increase acceptance and wide use of PDAs in healthcare.
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Competing priorities, lack of motivation, and low awareness of the intervention were shown to impede implementation.
“Competing priorities [42, 57, 59, 62, 63, 70, 82], lack of motivation [31, 39, 42, 57, 68, 81] and low awareness of the intervention [31, 35, 38, 39, 43, 44, 68, 75, 80, 81] were shown to impede implementation.”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [42]
Patient values and preferences and concerns about clinician-patient relationships impeded implementation.
“patient values and preferences [3, 33] and concerns about clinician-patient relationships [42, 77] impeded implementation”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [42]
Competencies, e.g. adequate training and good computer experience/skills, facilitated implementation.
“competencies, e.g. adequate training and good computer experience/skills were shown to facilitate implementation [16, 17, 31, 32, 34, 41, 42, 44, 54–58, 60, 67, 70, 77, 80, 81, 84–86].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [42]
The costs of an intervention and whether practices could obtain a positive return on investment, particularly the time invested, were considered features that would promote implementation.
“The costs of an intervention and whether practices could obtain a positive return on investment [51] and in particular the time invested [42, 51] were considered to be features that would promote implementation.”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [42]
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- Authors
- Lu, Y.-C., Xiao, Y., Sears, A., & Jacko, J. A.
- Affiliations
- University of Maryland, Baltimore (US)
- University of Maryland, Baltimore County (US)
- Georgia Institute of Technology (US)
- Corresponding author
- Xiao, Yan
- ORCID
- Xiao, Yan
- Venue
- International Journal of Medical Informatics
- Publisher
- Elsevier BV
- Published
- 2005-06
- Volume
- 74
- Issue
- 5
- Pages
- 409-422
- ISSN
- 1386-5056 (ISSN-L)
- OpenAlex
- W2016477529
- Cited by
- 315
- References
- 84
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 9 · 2021: 2 · 2020: 7 · 2019: 8 · 2018: 18 · 2017: 9 · 2016: 15 · 2015: 15 · 2014: 24 · 2013: 23 · 2012: 18
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Medical Informatics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Decision Sciences › Information Systems and Management › Technology Adoption and User Behaviour
- Keywords
- personal digital assistants, technology adoption, barriers to adoption, clinical documentation, patient data access, usability, data security, organizational support, hospital information system integration
- MeSH terms
- Attitude to Computers, Delivery of Health Care, Diffusion of Innovation, Health Personnel, United States, Access to Information, Computers, Handheld
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