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Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study

BACKGROUND: To improve user-centred design efforts and efficiency; there is a need to disseminate information on modern day clinician preferences for technologies such as computerised clinical decision support (CDS). OBJECTIVE: To describe clinician perceptions regarding beneficial features of CDS f...

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Autores principales: Trinkley, Katy E, Blakeslee, Weston W, Matlock, Daniel D, Kao, David P, Van Matre, Amanda G, Harrison, Robert, Larson, Cynthia L, Kostman, Nic, Nelson, Jennifer A, Lin, Chen-Tan, Malone, Daniel C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062316/
https://www.ncbi.nlm.nih.gov/pubmed/31039120
http://dx.doi.org/10.1136/bmjhci-2019-000015
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author Trinkley, Katy E
Blakeslee, Weston W
Matlock, Daniel D
Kao, David P
Van Matre, Amanda G
Harrison, Robert
Larson, Cynthia L
Kostman, Nic
Nelson, Jennifer A
Lin, Chen-Tan
Malone, Daniel C
author_facet Trinkley, Katy E
Blakeslee, Weston W
Matlock, Daniel D
Kao, David P
Van Matre, Amanda G
Harrison, Robert
Larson, Cynthia L
Kostman, Nic
Nelson, Jennifer A
Lin, Chen-Tan
Malone, Daniel C
author_sort Trinkley, Katy E
collection PubMed
description BACKGROUND: To improve user-centred design efforts and efficiency; there is a need to disseminate information on modern day clinician preferences for technologies such as computerised clinical decision support (CDS). OBJECTIVE: To describe clinician perceptions regarding beneficial features of CDS for chronic medications in primary care. METHODS: This study included focus groups and clinicians individually describing their ideal CDS. Three focus groups were conducted including prescribing clinicians from a variety of disciplines. Outcome measures included identification of favourable features and unintended consequences of CDS for chronic medication management in primary care. We transcribed recordings, performed thematic qualitative analysis and generated counts when possible. RESULTS: There were 21 participants who identified four categories of beneficial CDS features during the group discussion: non-interruptive alerts, clinically relevant and customisable support, presentation of pertinent clinical information and optimises workflow. Non-interruptive alerts were broadly defined as passive alerts that a user chooses to review, whereas interruptive were active or disruptive alerts that interrupted workflow and one is forced to review before completing a task. The CDS features identified in the individual descriptions were consistent with the focus group discussion, with the exception of non-interruptive alerts. In the individual descriptions, 12 clinicians preferred interruptive CDS compared with seven clinicians describing non-interruptive CDS. CONCLUSION: Clinicians identified CDS for chronic medications beneficial when they are clinically relevant and customisable, present pertinent clinical information (eg, labs, vitals) and improve their workflow. Although clinicians preferred passive, non-interruptive alerts, most acknowledged that these may not be widely seen and may be less effective. These features align with literature describing best practices in CDS design and emphasise those features clinicians prioritise, which should be considered when designing CDS for medication management in primary care. These findings highlight the disparity between the current state of CDS design and clinician-stated design features associated with beneficial CDS.
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spelling pubmed-70623162020-09-30 Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study Trinkley, Katy E Blakeslee, Weston W Matlock, Daniel D Kao, David P Van Matre, Amanda G Harrison, Robert Larson, Cynthia L Kostman, Nic Nelson, Jennifer A Lin, Chen-Tan Malone, Daniel C BMJ Health Care Inform Original Research BACKGROUND: To improve user-centred design efforts and efficiency; there is a need to disseminate information on modern day clinician preferences for technologies such as computerised clinical decision support (CDS). OBJECTIVE: To describe clinician perceptions regarding beneficial features of CDS for chronic medications in primary care. METHODS: This study included focus groups and clinicians individually describing their ideal CDS. Three focus groups were conducted including prescribing clinicians from a variety of disciplines. Outcome measures included identification of favourable features and unintended consequences of CDS for chronic medication management in primary care. We transcribed recordings, performed thematic qualitative analysis and generated counts when possible. RESULTS: There were 21 participants who identified four categories of beneficial CDS features during the group discussion: non-interruptive alerts, clinically relevant and customisable support, presentation of pertinent clinical information and optimises workflow. Non-interruptive alerts were broadly defined as passive alerts that a user chooses to review, whereas interruptive were active or disruptive alerts that interrupted workflow and one is forced to review before completing a task. The CDS features identified in the individual descriptions were consistent with the focus group discussion, with the exception of non-interruptive alerts. In the individual descriptions, 12 clinicians preferred interruptive CDS compared with seven clinicians describing non-interruptive CDS. CONCLUSION: Clinicians identified CDS for chronic medications beneficial when they are clinically relevant and customisable, present pertinent clinical information (eg, labs, vitals) and improve their workflow. Although clinicians preferred passive, non-interruptive alerts, most acknowledged that these may not be widely seen and may be less effective. These features align with literature describing best practices in CDS design and emphasise those features clinicians prioritise, which should be considered when designing CDS for medication management in primary care. These findings highlight the disparity between the current state of CDS design and clinician-stated design features associated with beneficial CDS. BMJ Publishing Group 2019-04-17 /pmc/articles/PMC7062316/ /pubmed/31039120 http://dx.doi.org/10.1136/bmjhci-2019-000015 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Original Research
Trinkley, Katy E
Blakeslee, Weston W
Matlock, Daniel D
Kao, David P
Van Matre, Amanda G
Harrison, Robert
Larson, Cynthia L
Kostman, Nic
Nelson, Jennifer A
Lin, Chen-Tan
Malone, Daniel C
Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study
title Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study
title_full Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study
title_fullStr Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study
title_full_unstemmed Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study
title_short Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study
title_sort clinician preferences for computerised clinical decision support for medications in primary care: a focus group study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062316/
https://www.ncbi.nlm.nih.gov/pubmed/31039120
http://dx.doi.org/10.1136/bmjhci-2019-000015
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