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理解临床决策支持系统的用户接受度,以提高初级保健实践中的癌症筛查率。

Understanding User Acceptance of Clinical Decision Support Systems to Promote Increased Cancer Screening Rates in a Primary Care Practice.

机构信息

Mayo Clinic, Rochester, MN, USA.

出版信息

J Prim Care Community Health. 2020 Jan-Dec;11:2150132720958832. doi: 10.1177/2150132720958832.

Abstract

OBJECTIVE

Clinical decision support systems (CDDSs) in the electronic medical record (EMR) have been implemented in primary care settings to identify patients due for cancer screening tests, while functioning as a real time reminder system. There is little known about primary care providers (PCPs) perspective or user acceptance of CDSS. The purpose of this study was to investigate primary care provider perceptions of utilizing CDSS alerts in the EMR to promote increased screening rates for breast cancer, cervical cancer, and colorectal cancer.

METHODS

An electronic survey was administered to PCPs in a Midwest Health Institution community internal medicine practice from September 25, 2019 through November 27, 2019.

RESULTS

Among 37 participants (9 NP/Pas and 28 MD/DOs), the group was more likely to agree that alerts were helpful (50%; -value = .0335) and the number of alerts (89%;  = .0227) in the EMR was appropriate. The group also was more likely to find alerts straightforward to use (78%,  = .0239). Both groups agreed about feeling comfortable using the health maintenance alerts ( = 79%;  = 100%).

CONCLUSION

CDSSs can promote and facilitate ordering of cancer screening tests. The use of technology can promptly identify patients due for a test and act as a reminder to the PCP. PCPs identify these alerts to be a beneficial tool in the EMR when they do not interrupt workflow and provide value to patient care. More work is needed to identify factors that could optimize alerts to be even more helpful, particularly to MD/DO groups.

摘要

目的

临床决策支持系统(CDSS)已在电子病历(EMR)中应用于初级保健环境,以识别需要进行癌症筛查测试的患者,同时作为实时提醒系统。对于初级保健提供者(PCP)对 CDSS 的看法或用户接受程度知之甚少。本研究旨在调查初级保健提供者对利用 EMR 中的 CDSS 警报来提高乳腺癌、宫颈癌和结直肠癌筛查率的看法。

方法

2019 年 9 月 25 日至 11 月 27 日,通过电子方式向中西部医疗机构社区内科实践中的 PCP 进行了电子调查。

结果

在 37 名参与者中(9 名 NP/Pas 和 28 名 MD/DO),组更有可能认为警报有帮助(50%;值=0.0335),并且 EMR 中的警报数量(89%;值=0.0227)是合适的。组也更有可能发现警报易于使用(78%,值=0.0239)。两组都认为使用健康维护警报感到舒适(值=79%;值=100%)。

结论

CDSS 可以促进和便利癌症筛查测试的订购。技术的使用可以及时识别需要进行测试的患者,并提醒 PCP。当 PCP 不中断工作流程并为患者护理提供价值时,他们认为这些警报是 EMR 中的有益工具。需要做更多的工作来确定可以优化警报的因素,使其更有帮助,特别是对 MD/DO 群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fd4/7543103/fb6809b94de8/10.1177_2150132720958832-fig1.jpg

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