Perceptions of care providers on the implementation of an antenatal psychosocial clinical decision support system: the Born in Belgium Professionals platform

Abstract

Background: Clinical decision support systems (CDSS) can enhance care processes and clinical outcomes. Adoption depends not only on perceived usefulness but also on contextual human, organisational, and technical factors. Understanding care providers' perception and how these factors influence adoption is essential for implementing systems that can be embedded in routine perinatal practice.

Aim: To examine the real-world adoption (or uptake) of the Born in Belgium Professionals antenatal psychosocial decision-support platform, describing how and why care providers use it and identifying facilitators and barriers to sustained implementation.

Methods: A cross-sectional survey of all active users (March-July 2024) captured frequency of use, motivations, and perceptions. Frequent versus non-frequent users were compared with chi-square and Mann-Whitney tests (p < .05).

Findings: Of 313 users, 127 responded; most were midwives working in large organisations. About 46% were frequent users. Motivators were the psychosocial questionnaire, continuity of care and preventive benefit. Frequent users more often attended training (64.4% vs 30.9%; p < 0.001), perceived greater patient benefit (median 4.5 vs 4.0; p = .046) and rated the platform's integration in electronic health record (EHR) higher (median 5.5 vs 5.0; p = .002). Non-frequent users cited time pressure and interoperability issues.

Discussion: Positive perceptions of benefits, adequate training, and seamless workflow integration promote sustained use. Organisational support and robust interoperability further facilitate uptake, whereas time pressures and suboptimal EHR embedding hinder regular use.

Conclusion: Implementation strategies that emphasise training, interoperability, and alignment with existing workflows are essential to optimise adoption of antenatal psychosocial decision-support systems.

Keywords: Clinical decision support systems; Digital health technology; Implementation science; Integrated care; Pregnancy; Psychosocial care.