Exposure to and experiences with a computerized decision support intervention in primary care: results from a process evaluation

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Computerized decision support systems (CDSS) are being implemented to help with improving the quality of healthcare; one particular CDSS that was integrated in a clinical setting was the NHGDoc. After the implementation of the CDSS, the use of NHGDoc after implementation and how the quality of care changed were tracked. This paper shows the results of the tracking after implementation after a period of two years.


A process evaluation was used as part of a large-scale cluster-randomized controlled trial on how NHGDoc affected the quality of care.[1] The types of data collected were data based on exposure to the system and experiences to the system. Questionnaires were distributed to couple with the data from the system itself. Descriptive statistics were also used in the analysis.


99 percent of the practices that included NHGDoc collected data but only 50 percent of the participants responded to the questionnaire.[1] The users of NHGDoc had a positive outlook overall but still had some perceived barriers; these barriers were a lack of learning capacity of the system, the additional time and work it requires to use the CDSS, irrelevant alerts, too high intensity of alerts and insufficient knowledge regarding the system.[1]


Because of the amount of perceived barriers, it is thought that these perceived barriers negatively impacted the implementation of the CDSS. Also, a number of users are unaware of some features included in NHGDoc.


This paper is interesting due to its research on the reactions of the providers involved after an implementation of a new CDSS. Since it looks at what reactions happen from the first days of implementation, it gives an idea of initial reactions from providers. The perceived barriers show that there is more work to be done to make integrations of CDSS and other electronic tools more seamless.


  1. 1.0 1.1 1.2 Lugtenberg, M., Pasveer, D., van der Weijden, T., Westert, G. P., & Kool, R. B. (2015). Exposure to and experiences with a computerized decision support intervention in primary care: results from a process evaluation. BMC Family Practice, 16(141). http://doi.org/10.1186/s12875-015-0364-0