Adoption of computers by rural primary care physicians: A social worlds approach

Incorporating health information technologies into physicians' medical work has recently gained public prominence after prolonged discussion within medical communities. This study investigated gaps between desired and actual physicians' use of computers focusing less on technology itself and more on social factors influencing physicians' computer use. The guiding question was: How does the social environment of physicians' medical practice relate to the perceived gap in physicians' hands-on use of information systems? The study used a social worlds approach.; Rural medicine provided an ideal setting because past studies suggested physician specialization and managed care penetration associate with differences in perceived best practice among physicians. Selection of rurally located primary care physicians reduced effects of these extraneous sources of variation. Data are from 26 confidential, in-depth interviews of approximately 45 minutes duration and 129 mail survey responses.; The study found that computer use by rural primary care physicians is more a function of medical group settings than computer skills and preferences of individual physicians. Computers promote cooperative care of patients among physicians and also provide infrastructure for medical ownership of patients.