Case Study, International

Integration of clinical decision support in primary care study highlights adoption and motivation

A recent study published by BMC Primary Care examines the experiences and perceptions of introducing new information systems in primary care organisations, focusing on the use of a clinical decision support system (CDSS) to identify and diagnose malignant melanoma.

The qualitative study aims to explore the attitudes and belief systems of stakeholders from three different organisational levels in primary care, surrounding digital technology and how these views can significantly impact the role and implementation of new tools and systems.

Researcher Ann Frisinger conducted semi-structured interviews with a variety of primary care stakeholders, asking them the following research derived questions: what can be improved in current digital transformation efforts?; what are the success factors for deploying new technology?; and what is specific for healthcare?

For the application provider, the questions focused on the CDSS application functionality and value proposition. Whereas the other stakeholders were asked about their individual roles, digitisation and the CDSS application for malignant melanoma.

Many of the respondents believed that the initial time and effort required to implement new IT solutions created high levels of stress for professionals and that if the solution “does not provide direct value, it will not be used.”

Several respondents also noted that there is little time to learn about new technical solutions and are often viewed as “disturbing” – one interviewee said: “High workload – to learn a new way of working in parallel is disturbing and the new tool gets unused”.

Many participants expressed concerns regarding the change process, saying that if the solution was designed by people far away from the daily operation or lacking in medical experience and clinical knowledge, it would be highly likely that important requirements would be left out and prove unsuccessful for the end-user.

Scepticism was another defining determinant, with many participants discussing the need for proven evidence in order to convince medical staff of the efficacy of new systems and technology. One interviewee said: “Doctors can be very sceptical, they only trust science and well proven experiences.”

Another voice added that there is a lack of inspiration amongst medical professionals as they are more focusses on the medical issues themselves, rather than the opportunities modern technology can offer.

The conditions for enabling successful digital transformation were discussed by the participants, with motivation emerging as a key aspect of driving change.

Firstly, “motivation by stimulation” which provides initiatives to encourage practitioners to commit to the technology/system and mandatory application. One interviewee gave the example of the digital patient contacts that were implanted during the pandemic, explaining that there were no other options and so the need for the new technology was universally understood.

The interviews also highlighted that an accessible and user friendly interface is necessary in order to incentivise people to engage with technology on a sustainable level. In addition, the doctors being interviewed felt that patients would be more likely to accept the new solution if the procedure “was presented in a comprehensive and trustful way” by a doctor who was well-informed and confident of it.

Overall, the study revealed the complexities of introducing new technology in healthcare whilst offering insight into the positive factors which could help facilitate its wider adoption and implementation on a larger scale. It is hoped that the findings of this study will help healthcare to accelerate digitalisation.