Funding: This research was funded by a Cancer Institute New South Wales Health Services Research Fellowship.
Implementing a web-based oncology protocol system in Australia: evaluation of the first 3 years of operation
Article first published online: 7 JUN 2010
© 2010 The Authors. Internal Medicine Journal © 2010 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 42, Issue 1, pages 57–64, January 2012
How to Cite
Hains, I. M., Ward, R. L. and Pearson, S.-A. (2012), Implementing a web-based oncology protocol system in Australia: evaluation of the first 3 years of operation. Internal Medicine Journal, 42: 57–64. doi: 10.1111/j.1445-5994.2010.02284.x
Conflict of interest: None.
- Issue published online: 26 JAN 2012
- Article first published online: 7 JUN 2010
- Accepted manuscript online: 7 JUN 2010 12:00AM EST
- Received 15 December 2009; accepted 10 May 2010.
- medical oncology;
- clinical decision support system;
- evidence-based practice;
- physician's practice pattern;
- standardising care
Background: EviQ is a web-based oncology protocol system launched across Australia in 2005 (http://www.eviq.org.au). We evaluated eviQ use at the point-of-care and determined the factors impacting on its uptake and routine use in the first three years of operation.
Methods: We conducted a suite of qualitative and quantitative studies with over 200 Australian oncology physicians, nurses and pharmacists working at treatment centres in diverse geographical locations.
Results: EviQ was part of routine care at many hospitals; however, the way in which it was used at the point-of-care varies according to clinician roles and hospital location. We identified a range of factors impacting on eviQ uptake and routine use. Infrastructure, such as availability of point-of-care computers, and formal policies endorsing eviQ are fundamental to increasing uptake. Furthermore, the level of clinical and computer experience of end-users, the attitudes and behaviour of clinicians, endorsement and promotion strategies, and level and type of eviQ education all need to be considered and managed to ensure that the system is being used to its full potential.
Conclusion: Our findings show that the dissemination of web-based treatment protocols does not guarantee widespread use. Organisational, environmental and clinician-specific factors play a role in uptake and utilisation. The deployment of sufficient computer infrastructure, implementation of targeted training programmes and hospital policies and investment in marketing approaches are fundamental to uptake and continued use. This study highlights the value of ongoing monitoring and evaluation to ensure systems like eviQ achieve their primary purpose – reducing treatment variation and improving quality of care.