CurryCorp, Ottawa, Ontario, Canada.
J Am Med Inform Assoc. 2011 May 1;18(3):267-70. doi: 10.1136/amiajnl-2011-000049.
Clinical guideline adherence for diagnostic imaging (DI) and acceptance of electronic decision support in a rural community family practice clinic was assessed over 36 weeks. Physicians wrote 904 DI orders, 58% of which were addressed by the Canadian Association of Radiologists guidelines.
Of those orders with guidelines, 76% were ordered correctly; 24% were inappropriate or unnecessary resulting in a prompt from clinical decision support. Physicians followed suggestions from decision support to improve their DI order on 25% of the initially inappropriate orders. The use of decision support was not mandatory, and there were significant variations in use rate. Initially, 40% reported decision support disruptive in their work flow, which dropped to 16% as physicians gained experience with the software.
Physicians supported the concept of clinical decision support but were reluctant to change clinical habits to incorporate decision support into routine work flow.
在 36 周的时间里，评估了农村社区家庭诊所中诊断成像 (DI) 的临床指南遵循情况和对电子决策支持的接受情况。医生开了 904 份 DI 医嘱，其中 58%符合加拿大放射学家协会的指南。
在有指南的医嘱中，76%的医嘱是正确的；24%是不适当或不必要的，导致临床决策支持发出提示。医生根据决策支持的建议改进了最初不适当医嘱中的 25%。决策支持的使用不是强制性的，使用率存在显著差异。最初，40%的人报告决策支持干扰了他们的工作流程，随着医生对软件的经验增加，这一比例下降到 16%。
医生支持临床决策支持的概念，但不愿改变临床习惯，将决策支持纳入常规工作流程。
