Defining and measuring physicians' responses to clinical reminders

Area of Science:

• Medical Informatics
• Cognitive Engineering
• Health Services Research

Background:

• Clinical decision-support systems (CDSS), particularly rule-based reminders, are increasingly used in healthcare.
• Physician adoption and utilization of information from these systems remain inconsistent, impacting potential benefits.
• Understanding user responses to automated alerts is crucial for optimizing CDSS effectiveness.

Purpose of the Study:

• To define and empirically measure physician responses to clinical reminders.
• To investigate the distinct response categories: Compliance, Reliance, Spillover, and Reactance.
• To assess the impact of a large-scale clinical reminder system on secondary cardiovascular disease prevention.

Main Methods:

• Utilized cognitive engineering principles to categorize user responses to clinical reminders.
• Developed statistical measures to quantify physician responses.
• Analyzed data from a large-scale clinical reminder system focused on cardiovascular disease secondary prevention.

Main Results:

• Evidence of physician Compliance with reminders was observed, suggesting perceived informativeness.
• No evidence of Reliance was found, supporting the distinction between Compliance and Reliance as separate trust metrics.
• The study demonstrated the potential of CDSS to improve guideline adherence.

Conclusions:

• Physician responses to clinical reminders are multifaceted, including Compliance and Reliance, which reflect different levels of trust.
• CDSS can be instrumental in reducing the treatment gap and enhancing physician adherence to clinical guidelines.
• Further research into user trust and response patterns is needed to maximize CDSS impact.