How information retrieval technology may impact on physician practice: an organizational case study in family medicine.

RATIONALE Information retrieval technology tends to become nothing less than crucial in physician daily practice, notably in family medicine. Nevertheless, few studies examine impacts of this technology and their results appear controversial. AIMS AND OBJECTIVES Our article aims to explore these impacts using the medical literature, an organizational case study and the literature on organizations. METHODS The case study was embedded in an evaluation of the implementation of medical and pharmaceutical databases on handheld computers in a Canadian family medicine centre. Six physicians were interviewed on specific events relative to the use of these databases and on their general perception of impacts of this use on clinical decision making and the doctor-patient relationship. A thematic data analysis was performed concomitantly by both authors. RESULTS AND CONCLUSION Findings indicate six types of impact: practice improvement, reassurance, learning, confirmation, recall and frustration. These findings are interpreted in accordance with both a medical and organizational perspective. The fit with the literature on inter-organizational memory supports the transferability of the findings. In turn, this fit suggests how information retrieval technology may change physician routine. This study suggests a new basis for evaluating the impact of information retrieval technology in daily clinical practice. In conclusion, our paper encourages policy-makers to develop, and physicians to use, this technology.