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Acceptance and barriers pertaining to a general practice decision support system for multiple clinical conditions: a mixed methods evaluation

Acceptance and barriers pertaining to a general practice decision support system for multiple clinical conditions: a mixed methods evaluation
Acceptance and barriers pertaining to a general practice decision support system for multiple clinical conditions: a mixed methods evaluation

Background Many studies have investigated the use of clinical decision support systems as a means to improve care, but have thus far failed to show significant effects on patient-related outcomes. We developed a clinical decision support system that attempted to address issues that were identified in these studies. The system was implemented in Dutch general practice and was designed to be both unobtrusive and to respond in real time. Despite our efforts, usage of the system was low. In the current study we perform a mixed methods evaluation to identify remediable barriers which led to disappointing usage rates for our system. Methods A mixed methods evaluation employing an online questionnaire and focus group. The focus group was organized to clarify free text comments and receive more detailed feedback from general practitioners. Topics consisted of items based on results from the survey and additional open questions. Results The response rate for the questionnaire was 94%. Results from the questionnaire and focus group can be summarized as follows: The system was perceived as interruptive, despite its design. Participants felt that there were too many recommendations and that the relevance of the recommendations varied. Demographic based recommendations (e.g. age) were often irrelevant, while specific risk-based recommendations (e.g. diagnosis) were more relevant. The other main barrier to use was lack of time during the patient visit. Conclusion These results are likely to be useful to other researchers who are attempting to address the problems of interruption and alert fatigue in decision support.

1932-6203
1-16
Arts, Derk L.
57cf935a-4152-4a36-9e24-3c4f133885ff
Medlock, Stephanie K.
72b08f6d-044e-42f3-9cbd-6de06eb32adb
Van Weert, Henk C.P.M.
e99da36a-3736-40fc-badf-036eb8197137
Wyatt, Jeremy C.
8361be5a-fca9-4acf-b3d2-7ce04126f468
Abu-Hanna, Ameen
c8d1e7fa-82ec-4ac1-88cc-f5c3f8489824
Arts, Derk L.
57cf935a-4152-4a36-9e24-3c4f133885ff
Medlock, Stephanie K.
72b08f6d-044e-42f3-9cbd-6de06eb32adb
Van Weert, Henk C.P.M.
e99da36a-3736-40fc-badf-036eb8197137
Wyatt, Jeremy C.
8361be5a-fca9-4acf-b3d2-7ce04126f468
Abu-Hanna, Ameen
c8d1e7fa-82ec-4ac1-88cc-f5c3f8489824

Arts, Derk L., Medlock, Stephanie K., Van Weert, Henk C.P.M., Wyatt, Jeremy C. and Abu-Hanna, Ameen (2018) Acceptance and barriers pertaining to a general practice decision support system for multiple clinical conditions: a mixed methods evaluation. PLoS ONE, 13 (4), 1-16, [e0193187]. (doi:10.1371/journal.pone.0193187).

Record type: Article

Abstract

Background Many studies have investigated the use of clinical decision support systems as a means to improve care, but have thus far failed to show significant effects on patient-related outcomes. We developed a clinical decision support system that attempted to address issues that were identified in these studies. The system was implemented in Dutch general practice and was designed to be both unobtrusive and to respond in real time. Despite our efforts, usage of the system was low. In the current study we perform a mixed methods evaluation to identify remediable barriers which led to disappointing usage rates for our system. Methods A mixed methods evaluation employing an online questionnaire and focus group. The focus group was organized to clarify free text comments and receive more detailed feedback from general practitioners. Topics consisted of items based on results from the survey and additional open questions. Results The response rate for the questionnaire was 94%. Results from the questionnaire and focus group can be summarized as follows: The system was perceived as interruptive, despite its design. Participants felt that there were too many recommendations and that the relevance of the recommendations varied. Demographic based recommendations (e.g. age) were often irrelevant, while specific risk-based recommendations (e.g. diagnosis) were more relevant. The other main barrier to use was lack of time during the patient visit. Conclusion These results are likely to be useful to other researchers who are attempting to address the problems of interruption and alert fatigue in decision support.

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journal.pone.0193187
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More information

Accepted/In Press date: 6 February 2018
e-pub ahead of print date: 1 April 2018
Published date: 19 April 2018

Identifiers

Local EPrints ID: 420485
URI: http://eprints.soton.ac.uk/id/eprint/420485
ISSN: 1932-6203
PURE UUID: 9a8c99d8-ee11-4555-9298-842dbd759b51
ORCID for Jeremy C. Wyatt: ORCID iD orcid.org/0000-0001-7008-1473

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Date deposited: 09 May 2018 16:30
Last modified: 17 Dec 2019 01:33

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