What may help or hinder the implementation of computerized decision support systems (CDSSs): a focus group study with physicians.
The principal aim of Clinical Decision Support (CDSS) is to provide to clinicians with reliable evidence-based medicine information that can potentially enhance decision-making as well as increase quality of care.
Despite CDSS promise to enhance decision-making at the point of care, there are several barriers preventing the adoption of CDSS. In order to successfully implement CDSS, it is essential to understand users’ preferences and perspectives on Information Technology (IT).
Researchers organized four focus groups in larger towns, two in a small town and one in rural health center. A total of 39 physicians in 7 focus groups were interviewed of whom 22 practiced in primary care and 17 in secondary care.
Three most common recurring barriers for the adoption of CDSS were: earlier experience with dysfunctional computer systems, resistance towards changes in practice and time management issues. Physicians in all focus groups were able to suggest situations where CDSS might be helpful either clinical or administrative issues. Primary physicians suggested that having alerts or reminders to monitor diabetes, hypertension and other chronic disorders could be beneficial. In contrast, secondary physicians had specific interest in having alerts to prevent life-threatening situations such as thrombosis and drug-interactions alerts. Physicians suggested that CDSS could help them to organize and manage information so it could be retrieved it whenever necessary. It was also suggested that CDSS could help to prevent overlapping works such as inquiring and registering the same information from the same patient several times.
In general, physicians had positive attitudes towards the use of CDSS. It was also suggested the implementation of systems that allow turning off certain types of remainders. Physicians also addressed that they expected flexibility, individuality and reliability of the CDSS.
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