Electronic Clinical Decision Support System for Stroke Risk Screening in Patients With Atrial Fibrillation in Mental...

Area of Science:

• Geriatric Psychiatry
• Clinical Informatics
• Cardiology

Background:

• Electronic clinical decision support systems (eCDSSs) are increasingly adopted in healthcare.
• Little is known about mental health clinicians' perspectives on using eCDSSs for physical health management in mental health settings.

Purpose of the Study:

• To explore how clinicians in older adult mental health services manage stroke risk in patients with atrial fibrillation (AF) and serious mental illness.
• To examine clinicians' views on the potential role of eCDSSs in enhancing stroke risk assessment and management.

Main Methods:

• Cross-sectional mixed methods study conducted in 3 inpatient wards for older adult mental health.
• Data collected via web-based surveys and semistructured interviews with psychiatrists and pharmacists.
• Descriptive analysis of survey data and thematic analysis of interview data.

Main Results:

• Clinicians reported challenges including accessing medical histories, limited physical health expertise, fragmented care, and impact of mental illness on stroke prevention.
• Strategies for improvement include electronic alerts, clear policies, and tailored training.
• Clinicians saw eCDSS potential for effectiveness, risk identification, care consistency, and time-saving, but noted risks like rigidity and overreliance.

Conclusions:

• Managing AF-related stroke risk in mental health settings presents challenges and opportunities.
• eCDSSs can improve care quality and efficiency, but design and implementation must address clinician concerns.
• Insights can guide the development of effective eCDSS tools to improve patient outcomes.