A clinical decision support needs assessment of community-based physicians

Area of Science:

• Health Informatics
• Human-Computer Interaction
• Medical Practice Management

Background:

• Community-based physicians' perspectives on clinical decision support (CDS) are crucial for effective tool development.
• Current CDS often focuses on alerts and prompts, potentially neglecting broader practice needs.

Purpose of the Study:

• To assess community physicians' views on existing CDS and identify desired capabilities for future designs.
• To inform the development of user-centered CDS for community-based practices.

Main Methods:

• Grounded theory and human-computer interaction models informed the study.
• Conducted 30 interviews and 25 observations of primary care providers across 15 clinics.
• Analyzed data to define CDS and identify desired functionalities.

Main Results:

• Physicians perceive CDS narrowly as alerts/prompts, not for patient management or workflow optimization.
• Desire CDS to improve physician-patient interactions, staff task redirection, and time efficiency.
• Expressed general dissatisfaction with current CDS and electronic health record usability.

Conclusions:

• Physicians require decision support for both clinical tasks (e.g., medication) and cognitive aspects (e.g., patient interactions).
• Future CDS must integrate diverse functions to support a wider range of decisions and improve resource alignment.