Sitasuwan Tullaya, Suriyaphol Prapat, Lawpoolsri Saranath, Soonthornworasiri Ngamphol, Pan-Ngum Wirichada
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Medical Bioinformatics, Department of Health Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
JMIR Hum Factors. 2025 Jul 16;12:e57314. doi: 10.2196/57314.
A guideline-based clinical decision support system (CDSS) is a knowledge-based system designed to collect crucial data from electronic medical records to generate decision-making based on system data requirements and inputs from standard guidelines. Despite the potential to enhance health care delivery, the adoption rate of CDSSs in clinical practice remains suboptimal.
This study aimed to evaluate the determinants influencing the intention to use a new CDSS in preventive care within clinical practice.
A single-center, questionnaire-based, cross-sectional study was conducted among physicians and medical students responsible for providing comprehensive preventive services at the Continuity of Care Clinic, Siriraj Hospital, Thailand.
In total, 89 participants were enrolled. Relationships between factors impacting the adoption of CDSSs were analyzed using correlation and regression analysis. We found that physicians' intentions to adopt the CDSS for preventive care were high, with 79% (70/89) of participants expressing their intention to use the system. According to the study's conceptual framework, modified from the original unified theory of acceptance and use of technology model, physicians' positive attitudes toward CDSS use in preventive services and a high level of effort expectancy emerged as crucial factors influencing the intention to use the new CDSS. The odds ratios for these factors were 5.44 (95% CI 1.62-18.34, P=.006) and 7.60 (95% CI 1.55-31.37, P=.01), respectively. Similar results were observed for medical students and for physicians who had graduated. The most prevalent barriers to CDSS implementation were related to physicians' attitudes, followed by issues such as the accuracy and burden of data input, time constraints for clinicians, and the risk of workflow disruption.
There was a high intention to adopt the CDSS in preventive care. Positive physician attitudes toward CDSS use in preventive services and effort expectancy were found to be critical factors influencing the intention to use the new CDSS.
基于指南的临床决策支持系统（CDSS）是一种基于知识的系统，旨在从电子病历中收集关键数据，以根据系统数据要求和标准指南的输入生成决策。尽管有提高医疗服务质量的潜力，但CDSS在临床实践中的采用率仍然不理想。
本研究旨在评估影响临床实践中使用新型CDSS进行预防保健意愿的决定因素。
在泰国诗里拉吉医院连续护理诊所负责提供全面预防服务的医生和医学生中进行了一项单中心、基于问卷的横断面研究。
共纳入89名参与者。使用相关性和回归分析来分析影响CDSS采用的因素之间的关系。我们发现医生采用CDSS进行预防保健的意愿很高，79%（70/89）的参与者表示打算使用该系统。根据该研究从原始技术接受与使用统一理论模型修改而来的概念框架，医生对在预防服务中使用CDSS的积极态度和较高的努力期望是影响使用新型CDSS意愿的关键因素。这些因素的优势比分别为5.44（95%CI 1.62 - 18.34，P = 0.006）和7.60（95%CI 1.55 - 31.37，P = 0.01）。医学生和已毕业的医生也观察到了类似结果。CDSS实施最普遍的障碍与医生的态度有关，其次是数据输入的准确性和负担、临床医生的时间限制以及工作流程中断的风险等问题。
在预防保健中采用CDSS的意愿很高。发现医生对在预防服务中使用CDSS的积极态度和努力期望是影响使用新型CDSS意愿的关键因素。
