OBJECTIVE: We quantify the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examine whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic. MATERIALS AND METHODS: Despite much discussion at the theoretic level, the existing literature provides little empirical understanding of barriers to using CDS in ambulatory care. We analyze data from 821 clinics in 117 medical groups, based on in Minnesota Community Measurement's annual Health Information Technology Survey (2014-2016). We examine clinics' use of 7 CDS tools, along with 7 barriers in 3 areas (resource, user acceptance, and technology). Employing linear probability models, we examine factors associated with CDS barriers. RESULTS: Clinics in health systems used more CDS tools than did clinics not in systems (24 percentage points higher in automated reminders), but they also reported more barriers related to resources and user acceptance (26 percentage points higher in barriers to implementation and 33 points higher in disruptive alarms). Barriers related to workflow redesign increased in clinics affiliated with health systems (33 points higher). Rural clinics were more likely to report barriers to training. CONCLUSIONS: CDS barriers related to resources and user acceptance remained substantial. Health systems, while being effective in promoting CDS tools, may need to provide further assistance to their affiliated ambulatory clinics to overcome barriers, especially the requirement to redesign workflow. Rural clinics may need more resources for training.
OBJECTIVE: We quantify the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examine whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic. MATERIALS AND METHODS: Despite much discussion at the theoretic level, the existing literature provides little empirical understanding of barriers to using CDS in ambulatory care. We analyze data from 821 clinics in 117 medical groups, based on in Minnesota Community Measurement's annual Health Information Technology Survey (2014-2016). We examine clinics' use of 7 CDS tools, along with 7 barriers in 3 areas (resource, user acceptance, and technology). Employing linear probability models, we examine factors associated with CDS barriers. RESULTS: Clinics in health systems used more CDS tools than did clinics not in systems (24 percentage points higher in automated reminders), but they also reported more barriers related to resources and user acceptance (26 percentage points higher in barriers to implementation and 33 points higher in disruptive alarms). Barriers related to workflow redesign increased in clinics affiliated with health systems (33 points higher). Rural clinics were more likely to report barriers to training. CONCLUSIONS: CDS barriers related to resources and user acceptance remained substantial. Health systems, while being effective in promoting CDS tools, may need to provide further assistance to their affiliated ambulatory clinics to overcome barriers, especially the requirement to redesign workflow. Rural clinics may need more resources for training.
Authors: Amit X Garg; Neill K J Adhikari; Heather McDonald; M Patricia Rosas-Arellano; P J Devereaux; Joseph Beyene; Justina Sam; R Brian Haynes Journal: JAMA Date: 2005-03-09 Impact factor: 56.272
Authors: Sangeeta C Ahluwalia; Cheryl L Damberg; Marissa Silverman; Aneesa Motala; Paul G Shekelle Journal: Jt Comm J Qual Patient Saf Date: 2017-07-10
Authors: Robert A Greenes; David W Bates; Kensaku Kawamoto; Blackford Middleton; Jerome Osheroff; Yuval Shahar Journal: J Biomed Inform Date: 2017-12-12 Impact factor: 6.317
Authors: Dean F Sittig; Adam Wright; Jerome A Osheroff; Blackford Middleton; Jonathan M Teich; Joan S Ash; Emily Campbell; David W Bates Journal: J Biomed Inform Date: 2007-09-21 Impact factor: 6.317
Authors: Lorenzo Moja; Elisa Giulia Liberati; Laura Galuppo; Mara Gorli; Marco Maraldi; Oriana Nanni; Giulio Rigon; Pietro Ruggieri; Francesca Ruggiero; Giuseppe Scaratti; Alberto Vaona; Koren Hyogene Kwag Journal: Implement Sci Date: 2014-08-28 Impact factor: 7.327