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

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

Keywords: alerts; cancer screening; clinical decision support systems; efficiency; primary care.

Figure 1.

Significant differences in perceptions about EMR alerts between MD/DO and NP/PA groups. There were 3 survey questions related to questions surrounding general use of all alerts in the EMR with significant differences: alerts were straightforward to use (P = .0239), the number of alerts was appropriate (P = .0227), and more alerts would be helpful (P = .0335).