Clinicians' perceptions of clinical decision support integrated into computerized provider order entry

Abstract

Computerized provider order entry systems can improve patient care by integrating clinical decision support. Decision support is most effective when its content and delivery are acceptable. The authors report the results of a multifaceted survey of the attitudes of housestaff and medical student users of a provider order entry system with integrated decision support at an academic medical center. The survey contained 16 items covering four themes: efficiency, quality of care, results reporting and embedded guidelines. Responses were captured using a five point Likert scale, and were compared using ANOVA and Bartlett's testing. Out of 491 housestaff and 128 medical students, response rates were 47 and 29%, respectively. Among respondents, 72% agreed or strongly agreed that the provider order entry system improves the quality of care that they provide, 54% that the decision support usually help them to provide quality patient care, and 62% that it improves the efficiency of order entry. Respondents were least likely to agree that the display of prior laboratory results influenced their decision to order a subsequent test. There were no significant differences between subspecialties and by advancing years of training among housestaff. Respondents agreed that the integrated clinical decision support enhanced their medical training.