Leveraging clinical decision support to improve depression screening and follow-up: insights from a quality...

The primary objective was to evaluate the impact of clinical decision support (CDS) tool integration into primary care visits on depression screening and follow-up rates and to assess whether CDS use improves adherence to Health Resources and Services Administration (HRSA) guidelines for depression screening and follow-up.

This quality improvement evaluation study employed quantitative and qualitative components conducted in parallel to provide complementary insights. Modified Poisson regression with generalised estimating equation (GEE) was used to assess the association between CDS tool use and meeting HRSA criteria for depression screening and follow-up. In addition, semi-structured interviews explored perspectives on the implementation and utility of CDS tools.

This study was conducted at a federally qualified health centre in Minnesota.

The dataset included 12 338 patient encounters attributed to 8647 unique patients, covering 2 years of data. Five care providers were recruited through purposive sampling for the semi-structured interviews.

CDS use was significantly associated with an increased likelihood of meeting HRSA depression screening and follow-up criteria (relative risk 1.44, 95% CI 1.34 to 1.55; p<0.001). Qualitative findings suggested that while providers found CDS tools useful, workflow challenges and human-centred practices shaped their effectiveness.

Integrating CDS tools into primary care workflows can enhance adherence to depression screening and follow-up guidelines. However, their effectiveness relies on supportive person-centred approaches, including collaboration and previsit preparation. These findings highlight the need for a balanced approach that integrates technological interventions with human interaction to enhance clinical practices. Future research should investigate how CDS tools are used in practice, address barriers to their adoption and develop strategies to promote their broader use while fostering continued learning among providers.