Background Limited research has focused on understanding if and how evidence of health information technology (HIT) effectiveness drives the selection and implementation of technologies in practice. This study aimed to explore the views of senior hospital staff on the role evidence plays in the selection and implementation of HIT, with a particular focus on clinical decision support (CDS) alerts in electronic medication management systems. Methods A qualitative descriptive design was used. Twenty senior hospital staff from six Australian hospitals in New South Wales and Queensland took part in a semi-structured interview. Interviews were audio-recorded, transcribed, and a general inductive content analysis approach used to identify themes. Results Participants acknowledged the importance of an evidence-base, but reported that selection of CDS alerts, and HIT more broadly, was rarely underpinned by evidence that technologies improve patient care. Instead, investments in technologies were guided by the expectation that benefits will be achieved, bolstered by vendor assurances, and a perception that implementation of HIT is unavoidable. Postponing implementation of a technology until an evidence-base is available was not always feasible. Although some technologies were seen as not requiring an evidence-base, stakeholders viewed evidence as extremely valuable for informing decisions about selection of CDS alerts. Conclusion : Decisions to implement CDS, and technology more broadly, are rarely evidence-based. In the absence of evidence, evaluation or monitoring of technologies post-implementation is critical, particularly to identify new errors or risks associated with HIT implementation and use. Increased transparency from vendors, with technology evaluation outcomes made directly available to healthcare organizations, may result in less reliance on logic, intuition, and vendor assertions, and more evidence-based selection of HIT.

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The use of an electronic medical record (EMR) during a student’s clinical placement is intricately linked with student learning and skill development necessary to become a competent healthcare professional. However, significant variation currently exists in student EMR access and use within healthcare. In this study, we bring to light evidence of this variability amongst medical, nursing, pharmacy, and allied health student placements, both in policy and in practice. We found some health districts lack student policies on EMR use, as well as prohibiting important tasks including record writing capabilities. There was also variation in exposure to EMR training. In order to provide healthcare students with optimal education that includes technological competency, we identify a need for changes to both policies and practices.