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Clinical Decision Support for Surgery: A Mixed Methods Study on Design and Implementation Perspectives From

Hung-Jui Tan¹, Brooke N Spratte², Allison M Deal³

¹Department of Urology, School of Medicine, University of North Carolina, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC.

|May 2, 2024

Summary

This summary is machine-generated.

Urologists generally support clinical decision support (CDS) tools in electronic health records (EHRs) for improving patient care and efficiency. Thoughtful design is essential for successful implementation and maximizing the impact of these data-driven innovations.

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Area of Science:

Urology
Medical Informatics
Health Services Research

Background:

Recent advances in big data and AI fuel interest in personalized, data-driven tools for surgical decision-making.
The impact of current clinical decision support (CDS) tools in electronic health records (EHRs) remains limited.
Assessing urologist attitudes toward CDS is crucial for effective implementation.

Purpose of the Study:

To evaluate urologist attitudes regarding CDS integrated into EHR systems.
To identify design requirements for successful CDS implementation and impact.
To explore how CDS can enhance evidence-based care and personalized medicine in urology.

Main Methods:

A sequential explanatory mixed-methods study conducted from 2019 to 2020.
Survey responses from the 2019 American Urological Association Annual Census assessed attitudes toward an automatic CDS tool.
Qualitative interviews with 25 urologists explored perspectives on CDS impact and design needs, analyzed using thematic analysis.

Main Results:

A majority of urologists (70.9%) agreed CDS would aid decision-making, 78.5% for patient counseling, 58.1% for time savings, and 42.9% for improved outcomes.
Fewer years in practice correlated with greater agreement with CDS benefits (P < .001).
Urologists highlighted potential benefits for evidence-based care, personalized medicine, resource use, and patient experience, while also noting implementation barriers and suggesting design improvements.

Conclusions:

Urologists exhibit positive attitudes towards the potential of CDS within EHR systems.
Strategic design of CDS tools is paramount for ensuring their effective implementation and maximizing their impact on clinical practice and patient outcomes.