Implementing Clinical Decision Support for Primary Care Preventive Screenings for People with Physical Disabilities.

Area of Science:

• Health disparities research
• Primary care innovation
• Clinical informatics

Background:

• People with physical disabilities face significant health disparities and are at risk for preventable multimorbidity.
• Primary care settings present an opportunity to improve health outcomes for this population.

Purpose of the Study:

• To evaluate the implementation of a clinical decision support (CDS) tool aimed at enhancing preventive screenings for individuals with physical disabilities within primary care.
• To assess provider utilization and identify barriers and facilitators to CDS tool adoption.

Main Methods:

• A convergent mixed methods pilot study integrating quantitative and qualitative data.
• Implementation of a CDS tool within the electronic health record at a family medicine clinic.
• Data collection included provider usage logs and semi-structured interviews/group meetings.

Main Results:

• The CDS tool was triggered for 1,668 encounters but used in only 10% of cases.
• Preventive screening orders were placed in 40% of CDS tool use cases.
• Key themes identified included inadequate incentives, cognitive burden, competing priorities, and provider acceptance of the alert.

Conclusions:

• Primary care providers showed receptiveness but infrequently utilized the CDS tool.
• Opportunities for improvement include reducing cognitive load, clarifying order justifications, and integrating the tool more seamlessly into clinical workflows.