Housestaff attitudes toward computer-based clinical decision support.

Abstract

OBJECTIVE: To measure housestaff attitudes towards computer-based decision support and their threshold for having CDSS messages displayed. DESIGN: 770 self-administered surveys were distributed to housestaff physicians. RESULTS: 209 surveys were returned. 63% of respondents agreed or strongly agreed that CDSS would improve quality of care, while 52% agreed or strongly agreed that it would decrease adverse drug events. Respondents were neutral regarding the impact of CDSS on productivity and on their autonomy. Sixty percent approved of a reminder to consider surgical consultation in a patient with abdominal pain, while 88% approved of alerts about hypokalemia. Respondents felt both reminders should be triggered when their PPV exceeded 67%. Attitudes toward POE correlated positively with attitudes toward CDSS (Pearson's rho 0.56; p < 0.0001). Respondents who were dissatisfied with POE had a higher threshold PPV for seeing reminders. CONCLUSION: The majority of housestaff favor the implementation of a CDSS. Housestaff with favorable POE experiences were more likely to endorse CDSS, and those with negative POE experience were more likely to oppose it. The results suggest that a carefully designed CDSS with rules constructed to exceed a threshold PPV would be accepted by housestaff.