Clinical decision support systems in hospitals: What do physicians expect?

Topic: Technologische ontwikkelingen ten dienste van Farmaceutische Zorg


Clinical decision support systems in hospitals: What do physicians expect?


Pieter Cornu1, Stephane Steurbaut1, Marc De Beukeleer2, Koen Putman3, Rudi Van de Velde4, Alain G Dupont1

1Departement Klinische Farmacologie & Farmacotherapie UZ Brussel, 2Kwaliteitsmanager UZ Brussel, 3Departement Medische Sociologie VUB, 4Departement ICT en facility management UZ Brussel
Laarbeeklaan 101 & 103, 1090 Jette, België

Contactpersoon: Pieter Cornu
Tel: 02 476 3051
e-mail: [email protected]


Introduction
As rational pharmacotherapy and medication safety have become central aspects in current healthcare practice, clinical decision support systems (CDSS) are becoming increasingly important. Because developing and implementing CDSS is time-consuming and costly, prioritization of the most relevant systems is warranted. The physician's perspective is an important factor for determining this prioritization.

Objective
The objective of this study was to investigate the physician's perspective on the perceived usefulness of different types of CDSS in relation to each other and to identify the user needs and expectations regarding future CDSS.

Methods
This study was a cross-sectional single-center survey (web-based) among physicians with a permanent clinical assignment in a 721-bed university hospital. The physicians were questioned about their current experiences with drug prescribing, knowledge regarding CDSS, and the perceived usefulness and desired features of future CDSS.

Results
One hundred and sixty-four physicians completed the survey (52.6%). More than half (61.6%) of the respondents did not know what CDSS were before filling in the survey. The majority of the respondents reported that it is very difficult to take all relevant information into account when prescribing drugs. Drug-drug interaction checking, drug-allergy checking, and dosing guidance were considered as most useful. Automated clinical guidelines and adverse drug event monitoring were considered as least useful. The user-friendliness of the systems, clinical relevance of the alerts, and related with it, prevention of alert fatigue, were perceived as important aspects for a successful implementation.

Conclusions
From the physicians' perspective drug-drug interaction checking, drug-allergy checking, and dosing guidance should receive the highest priority for development and implementation. In order to overcome the physicians' perceived disadvantages, attention should go to making user-friendly systems that deliver clinical relevant alerts.