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

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.