Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Mar 16, 2020
Date Accepted: May 14, 2020
Barriers and Facilitators to Implementation of Medication Decision Support Systems in Electronic Medical Records: A Mixed Methods Approach Based on Structural Equation Modeling and Qualitative Analysis
ABSTRACT
Background:
Adverse drug events (ADEs) resulting from medication error (ME) are some of the most common causes of iatrogenic injuries in hospitals. With appropriate use of medication, ADEs can be prevented and ameliorated. Efforts to reduce MEs and prevent ADEs have been made by implementing a medication decision support system (MDSS) in electronic health records (EHRs). However, physicians tend to override most MDSS alerts.
Objective:
To improve MDSS functionality, it is crucial to understand what factors users consider important in successfully incorporating an MDSS into their clinical setting. This study described the entire process of implementing an MDSS in a comprehensive EHR system and analyzed the relevant barriers and facilitators.
Methods:
A mixed research methodology was adopted. Data from a structured survey and 15 in-depth interviews were integrated. Structural equation modeling (SEM) was conducted to quantitatively analyze the factors related to users’ adoption of MDSSs. Qualitative analysis based on semi-structured interviews with physicians was conducted to collect various opinions on MDSS implementation.
Results:
Quantitative analysis based on SEM revealed that physicians’ expectations regarding ease of use and performance improvement are crucial factors. Qualitative analysis identified four major barriers to MDSS implementation: alert fatigue, lack of accuracy, poor user interface design, and lack of customizability.
Conclusions:
This study revealed barriers and facilitators to implementation of MDSSs. The findings can be applied to effectively upgrade MDSSs in the future.
Citation
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Copyright
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