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. 2012 Aug 1;3(3):309-17.
doi: 10.4338/ACI-2012-04-RA-0013. Print 2012.

Understanding why clinicians answer or ignore clinical decision support prompts

A E Carroll  1 , V Anand, S M Downs
Affiliations

Understanding why clinicians answer or ignore clinical decision support prompts

A E Carroll et al. Appl Clin Inform. .

Abstract

Introduction: The identification of key factors influencing responses to prompts and reminders within a computer decision support system (CDSS) has not been widely studied. The aim of this study was to evaluate why clinicians routinely answer certain prompts while others are ignored.

Methods: We utilized data collected from a CDSS developed by our research group--the Child Health Improvement through Computer Automation (CHICA) system. The main outcome of interest was whether a clinician responded to a prompt.

Results: This study found that, as expected, some clinics and physicians were more likely to address prompts than others. However, we also found clinicians are more likely to address prompts for younger patients and when the prompts address more serious issues. The most striking finding was that the position of a prompt was a significant predictor of the likelihood of the prompt being addressed, even after controlling for other factors. Prompts at the top of the page were significantly more likely to be answered than the ones on the bottom.

Conclusions: This study detailed a number of factors that are associated with physicians following clinical decision support prompts. This information could be instrumental in designing better interventions and more successful clinical decision support systems in the future.

Keywords: CHICA; Clinical decision support systems; EMR; prompts; screening.

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Figures

Fig. 1
Fig. 1
Sample Physician Worksheet (PWS) with prompt position labeled
See this image and copyright information in PMC

References

    1. Anand V, Biondich PG, Liu G, Rosenman M, Downs SM. Child Health Improvement through Computer Automation: the CHICA system. Stud Health Technol Inform 2004; Pt 1: 187–91 doi: D040004973 [pii]. - PubMed
    1. Anand V, Carroll AE, Downs SM. Automated Primary Care Screening in Pediatric Waiting Rooms. Pediatrics In Press. - PMC - PubMed
    1. Ash JS, Sittig DF, Campbell EM, Guappone KP, Dykstra RH. Some unintended consequences of clinical decision support systems. AMIA Annual Symposium proceedings / AMIA Symposium AMIA Symposium 2007: 26–30 - PMC - PubMed
    1. Bates DW, Kuperman GJ, Wang S, Gandhi T, Kittler A, Volk L, Spurr C, Khorasani R, Tanasijevic M, Middleton B. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Inform Assoc 2003; 6: 523–530 doi: 10.1197/jamia.M1370. - PMC - PubMed
    1. Biondich PG, Overhage JM, Dexter PR, Downs SM, Lemmon L, McDonald CJ. A modern optical character recognition system in a real world clinical setting: some accuracy and feasibility observations. Proc AMIA Symp 2002: 56–60 doi: D020002364 [pii] - PMC - PubMed

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