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Clinicians' perceptions of clinical decision support integrated into computerized provider order entry.
S Trent Rosenbloom1, Doug Talbert, Dominik Aronsky
1Tennessee Technological Institute, Cookeville, TN, USA. trent.rosenbloom@vanderbilt.edu
International Journal of Medical Informatics
|June 3, 2004
Summary
Computerized provider order entry systems with integrated decision support are viewed positively by users, enhancing patient care quality and efficiency. However, the impact on test ordering decisions requires further investigation.
Area of Science:
- Medical Informatics
- Health Services Research
- Clinical Decision Support Systems
Background:
- Computerized provider order entry (CPOE) systems integrate clinical decision support (CDS) to enhance patient care.
- The effectiveness of CDS relies on user acceptance of its content and delivery.
Purpose of the Study:
- To survey housestaff and medical students' attitudes towards a CPOE system with integrated CDS.
- To assess user perceptions regarding efficiency, quality of care, results reporting, and embedded guidelines.
Main Methods:
- A multifaceted survey using a five-point Likert scale was administered to users of a CPOE system with CDS.
- Data were analyzed using ANOVA and Bartlett's testing.
- Response rates were 47% for housestaff (n=231) and 29% for medical students (n=37).
Main Results:
- 72% of respondents agreed that the CPOE system improves care quality.
- 62% found the system improved order entry efficiency.
- 54% believed the CDS usually helped provide quality patient care, but agreement was lowest regarding CDS influence on subsequent test ordering based on prior lab results.
Conclusions:
- Integrated CDS within CPOE systems is generally perceived positively by users, enhancing perceived quality of care and training.
- While efficiency and quality of care are positively impacted, the influence on specific clinical decisions like test ordering warrants further study.
- No significant differences in attitudes were found across housestaff subspecialties or training years.