Appendix: Interview questions
Establish organisational level of respondent’s commentary. I’d like you to pitch your answers at a level you feel comfortable with. Am I right in thinking that it would mainly be:
Eg:
Yourself and your immediate workgroup
The clinic as a whole
The Department
The Hospital
The Hawaii Region.
Practice culture. And how would you describe the culture of your unit/practice/department/hospital/region? What makes it unique in terms of the way things are done around here?
Eg:
Like a family
Entrepreneurial
Bureaucratic
Is efficiency of operation highly valued?
Other.
Cultural mediation. Would you say that the culture of the unit/organisation(s)/region has affected how CIS was implemented? In what ways?
Eg:
Pace of implementation
Choice of initial implementation sites
Clinical leadership for CIS
Leadership. Do you think leadership styles influenced CIS implementation in this clinic/hospital/region?
Eg:
Senior staff provide highly visible leadership for CIS implementation
Leaders generate confidence that CIS will be implemented successfully
Effective leadership for CIS implementation has been lacking here
Clinicians have not needed leadership to implement CIS
Defining moments/critical events/turning points. Have there been any defining moments in the implementation of the CIS: any critical event marking a turning point in clinicians’ interpretation and use of the system?
Previous IT implementations. How has your experience of CIS implementation been affected by previous IT implementations?
Eg:
Expected CIS would be better than previous systems
Confident that people would have learned not to replicate the same mistakes as occurred when implementing previous systems
Sceptical of the value of the new system
Dreaded the implementation.
Use of EMR. In your experience, what changes has CIS implementation actually made to clinical practice or care processes?
Eg:
Has it changed how consultations are conducted?
How a clinician’s work is organised
How clinical work is coordinated between individuals/across sites.
Automation of existing care processes
Redesign of care processes.
For chronic disease management
Chronic disease management. Would you say that CIS is an effective vehicle to develop more effective chronic disease management programs (at unit/org/regional levels)?
Eg:
Diabetes
Asthma
Congestive heart failure
Depression
Other illnesses?
CIS Functionality. Which, in your view, are the most useful aspects or functions of CIS to improve chronic disease management?
Eg:
Electronic patient record
Access to records from other clinicians and sites
Tests and procedures ordering
Diagnosis and treatment outcomes reporting
Drug order entry
Automated alerts and reminders.
Electronic communication with patients
Health history
The new Epic system. What are your thoughts about the decision to install a new Epic system to all Kaiser Permanente regions?
Eg:
In terms of integration
For chronic disease management
For individual health care
For population health.
Any other comments. Can you think of anything else that might help us to learn from implementing CIS in Hawaii?
Eg:
Including anyone else that we should talk to.