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NHS Scotland's Decision Support Platform: a formative qualitative evaluation.

Kathrin Cresswell¹, Margaret Callaghan², Hajar Mozaffar³

¹Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK kathrin.beyer@ed.ac.uk.

BMJ Health & Care Informatics

|June 5, 2019

Summary

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The Scottish Government

Area of Science:

Health Informatics
Health Services Research
Sociotechnical Systems

Background:

The Scottish Government prioritizes computerised decision support systems to enhance knowledge management in health and social care.
A national program funded the development of a pilot Decision Support Platform in 2015.

Purpose of the Study:

To conduct a formative evaluation of the Decision Support Platform.
To inform the national rollout strategy for the platform in primary care settings.

Main Methods:

Conducted 30 in-depth, semistructured interviews with policymakers and clinical opinion leaders.
Performed non-participant observations of workshops demonstrating decision support systems.
Utilized sociotechnical principles and NVivo software for qualitative data analysis.

Keywords:

Qualitative information systems medical informatics primary healthcare

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Main Results:

Strong stakeholder support exists for the Decision Support Platform and its national rollout.
Key strategic drivers include care integration, preventive care, and patient self-management.
Identified needs for strong eHealth leadership, sustained funding, improved system usability, and monitoring of unintended consequences like increased clinical workload.

Conclusions:

National ownership is crucial to manage tensions between national strategy and local usability.
Local customization of systems and alerts, alongside carefully evaluated pilots, can mitigate risks.
Addressing potential unintended consequences early is key for successful implementation.