The unmet needs of adopting clinical decision support system among physicians in Palestinian hospitals

Clinical decision support system (CDSS) is an application used to aid decision-making and provide knowledge regarding treatment, diagnosis, and laboratory testing. Despite the associated benefits, the underutilization of CDSS is causing a global challenge. In Palestine, CDSS remains unimplemented, prompting a study on knowledge levels and factors influencing CDSS acceptance among physicians.

The study aimed to assess physicians' knowledge of CDSS and understand factors impacting CDSS adoption, including performance expectancy (PE), effort expectancy (EE), computer self-efficacy, involvement in decision-making, perceived threat to autonomy, and social influence.

A validated questionnaire-based survey consisting of seven constructs was used in this study. The constructs were derived from the unified theory of acceptance and use of technology (UTAUT). The target population was 363 resident physicians and general practitioners (GPs) from three governmental hospitals. In total, 124 participants were enrolled, and data was collected between June 1 and June 30, 2022. Generalized linear regression was used for data analysis.

Most participants were males (75%), with an average of 2.9 years of experience. Despite limited CDSS knowledge, participants strongly intended to adopt it (mean = 3.91, SD = 0.65). Our results showed a significant effect of PE (p = 0.000, r = 0.469), EE (p = 0.001, r = 0.294), computer self-efficacy level (p = 0.015, r = 0.218), perceived threat to professional autonomy (p = 0.001, r = -0.302), and social influence (p = 0.047, r = 0.179) on the intention to adopt CDSS. However, involvement in decision-making about CDSS had no significant impact (p = 0.123, r = 0.140).

This study provides the basis for implementing CDSS in Palestinian settings. Despite the readiness of Palestinian healthcare providers, introducing CDSS as an aiding, effort-free tool is a prerequisite for successful CDSS adoption in Palestine.