Nerissa S Bauer1, Aaron E Carroll2, Chandan Saha3, Stephen M Downs4. 1. Indiana University School of Medicine, Department of Pediatrics, Section of Children's Health Services Research, Indianapolis, Indiana, USA Indiana University School of Medicine, Department of Pediatrics, Section of Pediatric and Adolescent Comparative Effectiveness Research, Indianapolis, Indiana, USA nsbauer@iu.edu. 2. Indiana University School of Medicine, Department of Pediatrics, Section of Pediatric and Adolescent Comparative Effectiveness Research, Indianapolis, Indiana, USA Regenstrief Institute for Healthcare, Indianapolis, Indiana, USA. 3. Indiana University School of Medicine, Department of Biostatistics, Indianapolis, Indiana, USA. 4. Indiana University School of Medicine, Department of Pediatrics, Section of Children's Health Services Research, Indianapolis, Indiana, USA Indiana University School of Medicine, Department of Pediatrics, Section of Pediatric and Adolescent Comparative Effectiveness Research, Indianapolis, Indiana, USA.
Abstract
OBJECTIVE: Clinicians at our institution typically respond to about half of the prompts they are given by the clinic's computer decision support system (CDSS). We sought to examine factors associated with clinician response to CDSS prompts as part of a larger, ongoing quality improvement effort to optimize CDSS use. METHODS: We examined patient, prompt, and clinician characteristics associated with clinician response to decision support prompts from the Child Health Improvement through Computer Automation (CHICA) system. We asked pediatricians who were nonusers of CHICA to rate decision support topics as "easy" or "not easy" to discuss with patients and their guardians. We analyzed these ratings and data, from July 1, 2009 to January 29, 2013, utilizing a hierarchical regression model, to determine whether factors such as comfort with the prompt topic and the length of the user's experience with CHICA contribute to user response rates. RESULTS: We examined 414 653 prompts from 22 260 patients. The length of time a clinician had been using CHICA was associated with an increase in their prompt response rate. Clinicians were more likely to respond to topics rated as "easy" to discuss. The position of the prompt on the page, clinician gender, and the patient's age, race/ethnicity, and preferred language were also predictive of prompt response rate. CONCLUSION: This study highlights several factors associated with clinician prompt response rates that could be generalized to other health information technology applications, including the clinician's length of exposure to the CDSS, the prompt's position on the page, and the clinician's comfort with the prompt topic. Incorporating continuous quality improvement efforts when designing and implementing health information technology may ensure that its use is optimized.
OBJECTIVE: Clinicians at our institution typically respond to about half of the prompts they are given by the clinic's computer decision support system (CDSS). We sought to examine factors associated with clinician response to CDSS prompts as part of a larger, ongoing quality improvement effort to optimize CDSS use. METHODS: We examined patient, prompt, and clinician characteristics associated with clinician response to decision support prompts from the Child Health Improvement through Computer Automation (CHICA) system. We asked pediatricians who were nonusers of CHICA to rate decision support topics as "easy" or "not easy" to discuss with patients and their guardians. We analyzed these ratings and data, from July 1, 2009 to January 29, 2013, utilizing a hierarchical regression model, to determine whether factors such as comfort with the prompt topic and the length of the user's experience with CHICA contribute to user response rates. RESULTS: We examined 414 653 prompts from 22 260 patients. The length of time a clinician had been using CHICA was associated with an increase in their prompt response rate. Clinicians were more likely to respond to topics rated as "easy" to discuss. The position of the prompt on the page, clinician gender, and the patient's age, race/ethnicity, and preferred language were also predictive of prompt response rate. CONCLUSION: This study highlights several factors associated with clinician prompt response rates that could be generalized to other health information technology applications, including the clinician's length of exposure to the CDSS, the prompt's position on the page, and the clinician's comfort with the prompt topic. Incorporating continuous quality improvement efforts when designing and implementing health information technology may ensure that its use is optimized.
Authors: Aaron E Carroll; Nerissa S Bauer; Tamara M Dugan; Vibha Anand; Chandan Saha; Stephen M Downs Journal: JAMA Pediatr Date: 2014-09 Impact factor: 16.193
Authors: Aaron E Carroll; Paul G Biondich; Vibha Anand; Tamara M Dugan; Meena E Sheley; Shawn Z Xu; Stephen M Downs Journal: J Am Med Inform Assoc Date: 2011 Jul-Aug Impact factor: 4.497
Authors: Matthew C Aalsma; Ashley M Zerr; Dillon J Etter; Fangqian Ouyang; Amy Lewis Gilbert; Rebekah L Williams; James A Hall; Stephen M Downs Journal: J Adolesc Health Date: 2017-11-23 Impact factor: 5.012
Authors: Randall W Grout; Erika R Cheng; Aaron E Carroll; Nerissa S Bauer; Stephen M Downs Journal: Int J Med Inform Date: 2018-02-02 Impact factor: 4.046
Authors: Randall W Grout; Jeffrey Buchhalter; Anup D Patel; Amy Brin; Ann A Clark; Mary Holmay; Tyler J Story; Stephen M Downs Journal: Appl Clin Inform Date: 2021-02-17 Impact factor: 2.342