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A qualitative framework-based evaluation of radiology clinical decision support initiatives: eliciting key factors to physician adoption in implementation

OBJECTIVES: To illustrate key contextual factors that may have effects on clinical decision support (CDS) adoption and, ultimately, success. MATERIALS AND METHODS: We conducted a qualitative evaluation of 2 similar radiology CDS innovations for near-term endpoints affecting adoption and present the...

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Autores principales: Marcial, Laura Haak, Johnston, Douglas S, Shapiro, Michael R, Jacobs, Sara R, Blumenfeld, Barry, Rojas Smith, Lucia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952024/
https://www.ncbi.nlm.nih.gov/pubmed/31984353
http://dx.doi.org/10.1093/jamiaopen/ooz002
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author Marcial, Laura Haak
Johnston, Douglas S
Shapiro, Michael R
Jacobs, Sara R
Blumenfeld, Barry
Rojas Smith, Lucia
author_facet Marcial, Laura Haak
Johnston, Douglas S
Shapiro, Michael R
Jacobs, Sara R
Blumenfeld, Barry
Rojas Smith, Lucia
author_sort Marcial, Laura Haak
collection PubMed
description OBJECTIVES: To illustrate key contextual factors that may have effects on clinical decision support (CDS) adoption and, ultimately, success. MATERIALS AND METHODS: We conducted a qualitative evaluation of 2 similar radiology CDS innovations for near-term endpoints affecting adoption and present the findings using an evaluation framework. We identified key contextual factors between these 2 innovations and determined important adoption differences between them. RESULTS: Degree of electronic health record integration, approach to education and training, key drivers of adoption, and tailoring of the CDS to the clinical context were handled differently between the 2 innovations, contributing to variation in their relative degrees of adoption and use. Attention to these factors had impacts on both near and later-term measures of success (eg, patient outcomes). DISCUSSION: CDS adoption is a well-studied early-term measure of CDS success that directly impacts outcomes. Adoption requires attention throughout the design phases of an intervention especially to key factors directly affecting it, including how implementation across multiple sites and systems complicates adoption, which prior experience with CDS matters, and that practice guidelines invariably require tailoring to the clinical context. CONCLUSION: With better planning for the capture of early-term measures of successful CDS implementation, especially adoption, critical adjustments may be made to ensure that the CDS is effectively implemented to be successful.
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spelling pubmed-69520242020-01-24 A qualitative framework-based evaluation of radiology clinical decision support initiatives: eliciting key factors to physician adoption in implementation Marcial, Laura Haak Johnston, Douglas S Shapiro, Michael R Jacobs, Sara R Blumenfeld, Barry Rojas Smith, Lucia JAMIA Open Research and Applications OBJECTIVES: To illustrate key contextual factors that may have effects on clinical decision support (CDS) adoption and, ultimately, success. MATERIALS AND METHODS: We conducted a qualitative evaluation of 2 similar radiology CDS innovations for near-term endpoints affecting adoption and present the findings using an evaluation framework. We identified key contextual factors between these 2 innovations and determined important adoption differences between them. RESULTS: Degree of electronic health record integration, approach to education and training, key drivers of adoption, and tailoring of the CDS to the clinical context were handled differently between the 2 innovations, contributing to variation in their relative degrees of adoption and use. Attention to these factors had impacts on both near and later-term measures of success (eg, patient outcomes). DISCUSSION: CDS adoption is a well-studied early-term measure of CDS success that directly impacts outcomes. Adoption requires attention throughout the design phases of an intervention especially to key factors directly affecting it, including how implementation across multiple sites and systems complicates adoption, which prior experience with CDS matters, and that practice guidelines invariably require tailoring to the clinical context. CONCLUSION: With better planning for the capture of early-term measures of successful CDS implementation, especially adoption, critical adjustments may be made to ensure that the CDS is effectively implemented to be successful. Oxford University Press 2019-02-22 /pmc/articles/PMC6952024/ /pubmed/31984353 http://dx.doi.org/10.1093/jamiaopen/ooz002 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research and Applications
Marcial, Laura Haak
Johnston, Douglas S
Shapiro, Michael R
Jacobs, Sara R
Blumenfeld, Barry
Rojas Smith, Lucia
A qualitative framework-based evaluation of radiology clinical decision support initiatives: eliciting key factors to physician adoption in implementation
title A qualitative framework-based evaluation of radiology clinical decision support initiatives: eliciting key factors to physician adoption in implementation
title_full A qualitative framework-based evaluation of radiology clinical decision support initiatives: eliciting key factors to physician adoption in implementation
title_fullStr A qualitative framework-based evaluation of radiology clinical decision support initiatives: eliciting key factors to physician adoption in implementation
title_full_unstemmed A qualitative framework-based evaluation of radiology clinical decision support initiatives: eliciting key factors to physician adoption in implementation
title_short A qualitative framework-based evaluation of radiology clinical decision support initiatives: eliciting key factors to physician adoption in implementation
title_sort qualitative framework-based evaluation of radiology clinical decision support initiatives: eliciting key factors to physician adoption in implementation
topic Research and Applications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952024/
https://www.ncbi.nlm.nih.gov/pubmed/31984353
http://dx.doi.org/10.1093/jamiaopen/ooz002
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