Department of Electronics and Informatics, Vrije Universiteit Brussel, Brussel, Belgium.
Faculty of Computing, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia.
JMIR Hum Factors. 2024 Jun 11;11:e47631. doi: 10.2196/47631.
A clinical decision support system (CDSS) based on the logic and philosophy of clinical pathways is critical for managing the quality of health care and for standardizing care processes. Using such a system at a point-of-care setting is becoming more frequent these days. However, in a low-resource setting (LRS), such systems are frequently overlooked.
The purpose of the study was to evaluate the user acceptance of a CDSS in LRSs.
The CDSS evaluation was carried out at the Jimma Health Center and the Jimma Higher Two Health Center, Jimma, Ethiopia. The evaluation was based on 22 parameters organized into 6 categories: ease of use, system quality, information quality, decision changes, process changes, and user acceptance. A Mann-Whitney U test was used to investigate whether the difference between the 2 health centers was significant (2-tailed, 95% CI; α=.05). Pearson correlation and partial least squares structural equation modeling (PLS-SEM) was used to identify the relationship and factors influencing the overall acceptance of the CDSS in an LRS.
On the basis of 116 antenatal care, pregnant patient care, and postnatal care cases, 73 CDSS evaluation responses were recorded. We found that the 2 health centers did not differ significantly on 16 evaluation parameters. We did, however, detect a statistically significant difference in 6 parameters (P<.05). PLS-SEM results showed that the coefficient of determination, R, of perceived user acceptance was 0.703. More precisely, the perceived ease of use (β=.015, P=.91) and information quality (β=.149, P=.25) had no positive effect on CDSS acceptance but, rather, on the system quality and perceived benefits of the CDSS, with P<.05 and β=.321 and β=.486, respectively. Furthermore, the perceived ease of use was influenced by information quality and system quality, with an R value of 0.479, indicating that the influence of information quality on the ease of use is significant but the influence of system quality on the ease of use is not, with β=.678 (P<.05) and β=.021(P=.89), respectively. Moreover, the influence of decision changes (β=.374, P<.05) and process changes (β=.749, P<.05) both was significant on perceived benefits (R=0.983).
This study concludes that users are more likely to accept and use a CDSS at the point of care when it is easy to grasp the perceived benefits and system quality in terms of health care professionals' needs. We believe that the CDSS acceptance model developed in this study reveals specific factors and variables that constitute a step toward the effective adoption and deployment of a CDSS in LRSs.
基于临床路径的逻辑和理念的临床决策支持系统（CDSS）对于管理医疗保健质量和标准化护理流程至关重要。如今，在护理点使用这样的系统变得越来越普遍。然而，在资源匮乏的环境（LRS）中，此类系统经常被忽视。
本研究旨在评估 LRS 中 CDSS 的用户接受度。
该 CDSS 评估在埃塞俄比亚 Jimma 的 Jimma 健康中心和 Jimma 高等二级健康中心进行。评估基于组织成 6 类的 22 个参数：易用性、系统质量、信息质量、决策变更、流程变更和用户接受度。使用 Mann-Whitney U 检验来调查 2 个卫生中心之间的差异是否显著（双侧，95%CI；α=.05）。Pearson 相关性和偏最小二乘结构方程模型（PLS-SEM）用于识别在 LRS 中影响 CDSS 整体接受度的关系和因素。
根据 116 例产前保健、孕妇保健和产后保健病例，记录了 73 份 CDSS 评估回复。我们发现，2 个卫生中心在 16 个评估参数上没有显著差异。然而，我们确实检测到 6 个参数存在统计学上的显著差异（P<.05）。PLS-SEM 结果表明，感知用户接受度的确定系数 R 为 0.703。更准确地说，感知易用性（β=.015，P=.91）和信息质量（β=.149，P=.25）对 CDSS 接受度没有积极影响，而是对系统质量和 CDSS 的感知收益有影响，具有统计学意义，β 值分别为 0.321 和 0.486。此外，感知易用性受信息质量和系统质量的影响，R 值为 0.479，这表明信息质量对易用性的影响是显著的，但系统质量对易用性的影响不显著，β 值分别为 0.678（P<.05）和 0.021（P=.89）。此外，决策变更（β=.374，P<.05）和流程变更（β=.749，P<.05）对感知收益的影响均具有统计学意义（R=0.983）。
本研究得出的结论是，当医疗保健专业人员的需求方面易于理解感知收益和系统质量时，用户更有可能在护理点接受和使用 CDSS。我们相信，本研究中开发的 CDSS 接受模型揭示了构成有效采用和部署 LRS 中 CDSS 的具体因素和变量。
Zotero 插件
