Provider Perceptions of an Electronic Health Record Prostate Cancer Screening Tool

Area of Science:

• Urology
• Primary Care Medicine
• Health Informatics

Background:

• Prostate-specific antigen (PSA) screening guidelines vary, leading to physician confusion.
• Shared decision-making (SDM) in PSA screening can be perceived as burdensome by primary care physicians (PCPs).

Purpose of the Study:

• To assess PCP attitudes towards PSA screening algorithms and decision support tools.
• To identify features for feasible implementation of decision support tools in clinical practice.

Main Methods:

• A focus group of 10 PCPs discussed a developed decision support tool.
• Thematic Content Analysis was used to analyze focus group notes and transcripts.
• A survey was administered to PCPs regarding PSA screening practices and tool perceptions.

Main Results:

• Most PCPs (7/10) found SDM for PSA screening burdensome and had not used decision aids.
• Despite confidence (70%), 90% of PCPs desired a provider-facing platform for PSA screening discussions.
• Key themes included the need for EHR-embedded tools, workflow integration, managing clinical bias, and addressing guideline discrepancies.

Conclusions:

• PCPs strongly supported the need for a provider-facing decision support tool for PSA screening.
• The tool is valued for supporting clinical judgment and documenting SDM.
• Focus group feedback will inform the development of a second-version tool for pilot testing.