Main Facilitators Reported in More Than 7 CDSSs, and Their Explanatory Elements, Classified According to the HOT-Fit Framework
| HOT-Fit Framework | Main Facilitatorsa (No. CDSSs Concerned) | Explanatory Elements | ||
|---|---|---|---|---|
| Factors and Dimensions (No. CDSSs concerned) | Evaluation Measures | |||
| Human (n = 41) User satisfaction (n = 31) | Perceived usefulness Training Software satisfaction Motivation to use Overall satisfaction | Perceived usefulness of the CDSS (n = 23) Training before use is appreciated (n = 10) PCPs would continue to use the CDSS (n = 9) Patients’ perceived usefulness of the CDSS increases PCPs motivation to use it (n = 7) CDSSs increase PCPs satisfaction (n = 7) | ||
| Organization (n = 41) Structure (n = 39) | Clinical process | Natural integration of the CDSS in the clinical workflow (n = 13) | ||
| Autonomy | Producing reports of quality measures through collected data increases the value from the CDSS’s use in clinical practice (n = 7) | Expansion of skill set and roles in assisting physicians and patients in meeting care needs | ||
| Teamwork | Other professionals ease physician’s increased workload with the CDSS (n = 6) | |||
| Technology (n = 45) System quality (n = 45) | Ease of use | The CDSS is user-friendly (ergonomic) (n = 30) CDSS recommendations are easy to understand (n = 9) | ||
| Usefulness of system features and functions | Reminders (n = 8) | |||
| Ease of learning | Easy to use after a short learning period (n = 9) | |||
| Information quality (n = 40) | Usefulness | Information provided is useful for the targeted process of care (n = 13) Educational materials for patients are valuable (n = 7) | General agreement with the validity of recommendations | |
| Format | Pleasing visual layout [n = 12] | |||
| Relevance | Recommendations are relevant (n = 11) | |||
| Reliability | Recommendations are reliable (n = 9) | |||
| Service quality (n = 11) | Technical support | Satisfaction with the CDSS service support (n = 7) | CDSS technical staff availability | |
| Net benefits (n = 42) | Effectiveness | Potential to improve the quality of care (n = 23) | Brings preventive care to the forefront | |
| Helps to systematize assessment of every patient | ||||
| Facilitates patient care management | ||||
| CDSS helps PCPs to improve guideline adherence (n = 11) | ||||
| Efficiency | Using CDSS saves time (n = 22) | Shortening documentation time | ||
| Giving a quick patient evaluation from relevant data in patients’ EHRs | ||||
| Decision-making quality | CDSS facilitates decision making (n = 22) | CDSS is facilitating decision making about referral | ||
| Communication | CDSS helps focus on patient education (n = 18) CDSS eases patient-PCP communication (n = 13) | CDSS helps increase patient engagement | ||
| Clinical practice | CDSS is a way to update PCP’s knowledge (n = 17) CDSS leads to better teamwork in primary care (n = 7) CDSS increases PCPs’ self-confidence (n = 7) | |||
| Error reduction | CDSS helps PCPs to identify unrecognized information needs (n = 17) | |||
CDSS = clinical decision support system; EHR = electronic health record; HOT-fit = human, organization, technology, net benefits; PCP = primary care professional.
↵a Main facilitators are ranked by the number of CDSSs concerned.