The mean response to the same statements about e-mail was 2.58. There was significant individual house staff variability in preferences, however. In the inpatient setting, medical interns and residents prefer to receive many types of clinical information by pager. The most likely explanation for this result is that they otherwise have to poll clinical information systems for these data, which is wasteful of their time and introduces delays into the process of care. There is significant variability in their preferences, however, suggesting that the notification services of an enterprise should collect, store, and utilize user profiles for the delivery of clinical information.
Information systems can employ two basic paradigms in support of such workers.
These paradigms have recently come to be called pull and push . Push refers to anticipating the information needs of users and providing the information in advance. Two characteristics of medical practice dictate that designers of information systems use push as much as possible. First, clinicians just do not have time to pull all of the information they need. It is much more efficient for an information system to notify a clinician when a result becomes available than for the clinician to poll the system repeatedly for the result.