Box 1:Non-technological barriers to information systems need to be overcome too

Someone once said that the only person who welcomes change is a wet baby. To be most comfortable with the status quo, unless it is inflicting discomfort, seems to be part of the human make up. Probably every doctor has experienced the feeling of being overwhelmed with medical information, whether about a patient or with the ever increasing amount of information in the literature. Most doctors have recognised that integrating information systems into their clinical practice is not just a good idea but has become mandatory. Yet, major issues need to be overcome—not just technological ones—which if not considered for a new information system will lead to a “system failure” (box 1). It would be wonderful if we could create the new electronic medical environment with a “big bang” and avoid all of the issues outlined. Unfortunately that is not possible. The first requirement is to become comfortable and assured that an information system is important. To reach a “yes” conclusion, most people go through several stages to reduce their personal resistance and to reach a level of comfort with using information technology actively in the daily workflow of a medical practice. This editorial introduces these stages and makes suggestions for overcoming an issue with each stage.

The following stages are adapted from the …