Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study

BackgroundClinicians often disregard potentially beneficial clinical decision support (CDS). ObjectiveIn this study, we sought to explore the psychological and behavioral barriers to the use of a CDS tool. MethodsWe conducted a qualitative study involv...

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Bibliografiska uppgifter
Huvudupphovsmän: Safiya Richardson, Katherine L Dauber-Decker, Thomas McGinn, Douglas P Barnaby, Adithya Cattamanchi, Renee Pekmezaris
Materialtyp: Artikel
Språk:English
Publicerad: JMIR Publications 2021-08-01
Serie:JMIR Human Factors
Länkar:https://humanfactors.jmir.org/2021/3/e25046
Beskrivning
Sammanfattning:BackgroundClinicians often disregard potentially beneficial clinical decision support (CDS). ObjectiveIn this study, we sought to explore the psychological and behavioral barriers to the use of a CDS tool. MethodsWe conducted a qualitative study involving emergency medicine physicians and physician assistants. A semistructured interview guide was created based on the Capability, Opportunity, and Motivation-Behavior model. Interviews focused on the barriers to the use of a CDS tool built based on Wells’ criteria for pulmonary embolism to assist clinicians in establishing pretest probability of pulmonary embolism before imaging. ResultsInterviews were conducted with 12 clinicians. Six barriers were identified, including (1) Bayesian reasoning, (2) fear of missing a pulmonary embolism, (3) time pressure or cognitive load, (4) gestalt includes Wells’ criteria, (5) missed risk factors, and (6) social pressure. ConclusionsClinicians highlighted several important psychological and behavioral barriers to CDS use. Addressing these barriers will be paramount in developing CDS that can meet its potential to transform clinical care.
ISSN:2292-9495