Researchers: Shirly Bar-Lev¹, Nurit Azar², Ayala Gonen¹, Yaffa Ben-Avraham², Dizza Beimel¹

Background: The underuse of Health Information Systems designed to support various clinical procedures, can attest to a lack of fit between the system's design, and the implementing work environment. "Ofek" – a health information exchange system – was designed to allow the sharing of relevant clinical information between clinicians in the hospital and the community.

Objectives: To examine how physicians and nurses working in a large public hospital integrated "Ofek" into their work environment, and affected knowledge sharing behaviors, and time management.

Method: The study was conducted in 2016 and combined three research methods:
1. In-depth interviews with physicians, nurses and administrators;
2. Content analysis of the system's screens,
3. A quantitative survey.
The three combined allowed us to track the computational, organizational, personal and professional factors affecting clinicians' use.

Findings: Physicians and nurses consulted the system on specific occasions, rather than routinely.
Nurses' more than physicians claimed that the "ofek" was irrelevant to their work.
Consequently, physicians' level of satisfaction was slightly higher than nurses'.
System's use was predicted on clinicians' positive perception of its technical attributes, contribution to patients' care, and to their work processes.

Conclusions: The clinicians referred to "Ofek" as a backup system, useful mainly when encountering substantial difficulties in extracting crucial and relevant information from patients. Underuse was mainly attributable to the system's unfriendliness.

Recommendations: There is a need of an integrated system that allows for fast and simple feeding of relevant into the Electronic Medical Record system. A mechanism that alarms the clinicians of abnormalities, pathologies, allergies and sensitivities should be placed

Research end date: 11/2017