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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书目详细资料
Main Authors: Safiya Richardson, Katherine L Dauber-Decker, Thomas McGinn, Douglas P Barnaby, Adithya Cattamanchi, Renee Pekmezaris
格式: 文件
语言:English
出版: JMIR Publications 2021-08-01
丛编:JMIR Human Factors
在线阅读:https://humanfactors.jmir.org/2021/3/e25046
实物特征
总结: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