i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s 8 1 ( 2 0 1 2 ) 73–87 j ourna l homepage: www.ijmijournal.com Healthcare professionals’ adoption and use of a clinical information system (CIS) in primary care: Insights from the Da Vinci study Isabelle Vedel a,b , Liette Lapointe b , Marie-Thérèse Lussier c,d,* , Claude Richard c , Johanne Goudreau c,e , Lyne Lalonde c,f , Alain Turcotte c,d a Solidage, Lady Davis Institute, McGill University, Montreal, Quebec, Canada b Desautels Faculty of Management, McGill University, Montreal, Quebec, Canada c Équipe de recherche en soins de première ligne, Centre de Santé et des Services Sociaux de Laval, Québec, Canada d Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Quebec, Canada e Faculty of Nursing, Université de Montréal, Quebec, Canada f Faculty of Pharmacy, Université de Montréal, Quebec, Canada a r t i c l e i n f o Article history: Received 18 August 2011 Received in revised form 31 October 2011 Accepted 23 November 2011 Keywords: Patient Physician Communication Information systems Computers Diffusion of innovation Health information technology Chronic disease Primary health care a b s t r a c t Given the increasing prevalence of multimorbidity in primary care (PC), interdisciplinary PC teams supported by appropriate clinical information systems (CIS) are needed in order to deal with the complexity of multimorbid patients’ care. Our team has developed such a system, called the Da Vinci system. However, despite the expected benefits, evidence suggests generally low rates of CIS adoption. To optimize adoption in PC settings, a better understanding of the implementation process of such systems is crucial. Purpose: To identify user profiles, investigate the drivers of and barriers to adoption and use of the Da Vinci system, a PC tailored CIS, and understand the dynamics of the CIS adoption for each profile. Methods: Using a longitudinal approach, we conducted a qualitative study (individual inter- views, documentation and observation) based on the Diffusion of Innovation theory. It included 31 participants (primary care physicians, staff or residents, nurses, pharmacists) from two Family Medicine Groups in Quebec (Canada). Results: The different user profiles drawn from the dynamics of implementation are linked to different sets of perceived drivers and barriers that evolve over time. Certain factors favour the decision of adopting Da Vinci early on: e.g. user skills and the system’s expected ease of use and usefulness. Certain concerns hinder its adoption: e.g. perceived negative impact on the doctor–patient relationship. Over time, 5 factors appear to be related to more advanced exploitation of the system’s functionalities: user skills, ease of use, comfort using the system in front of patients, support from colleagues and, more importantly, perceived positive impacts. Conclusions: A better understanding of the dynamics of CIS implementation provides insight into how best to encourage clinicians to adopt and make full use of such systems to improve the quality of care for multimorbid patients followed in PC settings. © 2011 Elsevier Ireland Ltd. All rights reserved. ∗ Corresponding author at: Équipe de recherche en soins de première ligne, Cité de la Santé, Centre de Santé et de Services Sociaux de Laval, 1755, René-Laennec Blvd., Office # DS-075, Laval, Quebec, Canada H7M 3L9. Tel.: +1 450 668 1010x23709; fax: +1 450 975 5089. E-mail address: ell4400@videotron.ca (M.-T. Lussier). 1386-5056/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijmedinf.2011.11.002