Perceptions regarding the use of Clinical Decision Support Systems in Primary Care
Mariana Oliveira, Andreia Costa, Maria João Brandão, Viviana Barreira
Keywords: Perceptions; Decision support system; General practice; Primary care; Online; Electronic; Virtual
Background:
With the increasing number and complexity of health problems, clinical decision support systems (CDSS) have been developed to assist health professionals in clinical practice, as General Practitioners (GPs) and Family Doctors. CDSS can assist prescription and diagnosis processes and help patients make informed health decisions. Despite evidence that these tools improve GPs performance, their adoption is limited and includes mainly alerts and reminders designed to support treatments and disease management decisions.
Research questions:
What are users' perceptions of CDSS usefulness and the main facilitators and barriers to its use in primary care.
Method:
Bibliographic research of clinical guidelines, classic and systematic reviews, meta-analyses and original articles in PubMed, with the following research terms: “(perceptions) AND (decision support system) AND ((general practice) OR (primary care)) AND ((online) OR (electronic) OR (virtual))”, published in english or portuguese until july 2023.
Results:
In most studies systems are considered useful for clinical practice, emphasizing promotion of guideline adherence, reduction of prescription errors and assistance in differential diagnosis as positive aspects. The main limitations mentioned are related to codification difficulties, impact on consultation style, GP-patient interaction and user interface limitations. CDSS didn’t influence perceptions of GPs’ professionalism and care or general patient satisfaction, contrary to clinicians’ concerns. Moreover, these tools allow patients to complement provider counselling and enhance shared decision-making.
Conclusions:
Worldwide use of CDSS has been adopted as an advantage to daily practice within primary care for efficient consultations. Tools that allow for an overarching evaluation, including diagnostic suggestions, treatment options and adverts for potential interactions have been found useful, despite the identified limitations. A future step will be the development of a similar study regarding a HDSS used currently in the authors’ institution, named “Dioscope”, a preset virtual avatar of a medical doctor, which ensures round-the-clock availability to guide and support physicians.
Points for discussion:
#114