A six-year repeated evaluation of computerized clinical decision support system user acceptability

Area of Science:

• Health Informatics
• Pediatric Healthcare Technology
• Clinical Decision Support Systems

Background:

• Long-term user acceptability of computerized clinical decision support systems (CDSS) in pediatric settings remains largely unexamined.
• Understanding user acceptance is crucial for the successful integration and sustainability of CDSS in clinical workflows.

Purpose of the Study:

• To investigate user acceptance patterns of a CDSS over a six-year period in pediatric community clinics.
• To identify factors influencing user acceptability of the Child Health Improvement through Computer Automation (CHICA) system.

Main Methods:

• Annual surveys assessing user acceptability of CHICA were administered to users over six years (2011-2016).
• Logistic regression analysis was employed to evaluate the association between survey year, user characteristics (role, employment status, frequency of use), and acceptability ratings.
• Data were collected from 380 completed surveys across two healthcare systems.

Main Results:

• User acceptability of CHICA significantly improved from 2011 to 2016 across most measures.
• Increasing system maturity correlated with enhanced perceived function (OR range 4.24-7.58).
• Greater user familiarity was linked to improved perceptions of system function (OR range 3.44-8.17) and usability (OR range 9.71-15.89).

Conclusions:

• User acceptability of CDSS in pediatrics can increase over time with system maturation and user familiarity.
• Frequent users, physicians, advanced practitioners, and full-time workers reported more favorable opinions.
• Sustained CDSS acceptance requires continuous system quality improvement, robust user support, and user patience.