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Housestaff attitudes toward computer-based clinical decision support
1University of Pennsylvania, Philadelphia, USA.
Proceedings. AMIA Symposium
|November 24, 1999
Summary
Most housestaff support computer-based decision support systems (CDSS), especially when alerts have high predictive value. Positive experiences with prior systems predict acceptance of new CDSS tools.
Area of Science:
- Medical Informatics
- Clinical Decision Support
- Health Services Research
Background:
- Computer-based decision support systems (CDSS) offer potential benefits in healthcare quality and safety.
- Understanding physician attitudes is crucial for successful CDSS implementation.
Purpose of the Study:
- To assess housestaff (physicians-in-training) attitudes toward CDSS.
- To determine the acceptable threshold for displaying CDSS alerts.
Main Methods:
- A survey was administered to 770 housestaff physicians.
- 209 surveys were returned and analyzed.
Main Results:
- A majority favored CDSS, believing it improves care and reduces adverse drug events.
- Physicians were neutral on CDSS impact on productivity and autonomy.
- Alerts for surgical consultation and hypokalemia were approved, with a preferred positive predictive value (PPV) threshold of 67%.
- Positive experiences with prior order entry systems correlated with favorable CDSS attitudes.
Conclusions:
- Most housestaff support CDSS implementation.
- Prior system experiences influence CDSS acceptance.
- CDSS design, particularly alert thresholds, is key for housestaff adoption.
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