Abstract
Background: Clinical decision support (CDS) tools improve clinical diagnostic decision making and patient safety. The availability of CDS to health care professionals has grown in line with the increased prevalence of apps and smart mobile devices. Despite these benefits, patients may have safety concerns about the use of mobile devices around medical equipment. Objective: This research explored the engagement of junior doctors (JDs) with CDS and the perceptions of patients about their use. There were three objectives for this research: (1) to measure the actual usage of CDS tools on mobile devices (mCDS) by JDs, (2) to explore the perceptions of JDs about the drivers and barriers to using mCDS, and (3) to explore the perceptions of patients about the use of mCDS. Methods: This study used a mixed-methods approach to study the engagement of JDs with CDS accessed through mobile devices. Usage data were collected on the number of interactions by JDs with mCDS. The perceived drivers and barriers for JDs to using CDS were then explored by interviews. Finally, these findings were contrasted with the perception of patients about the use of mCDS by JDs. Results: Nine of the 16 JDs made a total of 142 recorded interactions with the mCDS over a 4-month period. Only 27 of the 114 interactions (24%) that could be categorized as on-shift or off-shift occurred on-shift. Eight individual, institutional, and cultural barriers to engagement emerged from interviews with the user group. In contrast to reported cautions and concerns about the impact of clinicians' use of mobile phone on patient health and safety, patients had positive perceptions about the use of mCDS. Conclusions: Patients reported positive perceptions toward mCDS. The usage of mCDS to support clinical decision making was considered to be positive as part of everyday clinical practice. The degree of engagement was found to be limited due to a number of individual, institutional, and cultural barriers. The majority of mCDS engagement occurred outside of the workplace. Further research is required to verify these findings and assess their implications for future policy and practice.
| Original language | English |
|---|---|
| Article number | e80 |
| Journal | JMIR mHealth and uHealth |
| Volume | 3 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sept 2015 |
Bibliographical note
Funding Information:This research study was part-funded by Health Education East Midlands. Small financial contributions were also received from the University Hospitals of Leicester NHS Trust and the University of Leicester. The National Institute of Health Research is also acknowledged for funding Dr Patel’s Academic Clinical Lectureship and associated research. The authors would like to thank Maria Martinez Martinez, Chetna Modi, Gill Hartley, Jo Hadley, Reena Valand, and Adam Nawaz, and the rotational junior pharmacists who assisted with the study, as well as Professor Sue Carr and all staff at the John Walls Renal Unit (Leicester General Hospital). All authors actively contributed to the study and paper preparation.
Funding Information:
This research study was part-funded by Health Education East Midlands. Small financial contributions were also received from the University Hospitals of Leicester NHS Trust and the University of Leicester. The National Institute of Health Research is also acknowledged for funding Dr Patel's Academic Clinical Lectureship and associated research. The authors would like to thank Maria Martinez Martinez, Chetna Modi, Gill Hartley, Jo Hadley, Reena Valand, and Adam Nawaz, and the rotational junior pharmacists who assisted with the study, as well as Professor Sue Carr and all staff at the John Walls Renal Unit (Leicester General Hospital). All authors actively contributed to the study and paper preparation.
Publisher Copyright:
© 2015 JMIR Publications. All rights reserved.
Keywords
- Clinical decision support systems
- Health care technology
- Human-centered computing
- Medical education
- Patient safety
- Ubiquitous and mobile computing
ASJC Scopus subject areas
- Health Informatics
