Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 31, 2023
Open Peer Review Period: Jan 9, 2024 - Mar 5, 2024
Date Accepted: Jun 7, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Impacts of Clinical Decision Support Systems on the relationship, communication and shared decision-making between healthcare professionals and patients: A multi-stakeholder interview study
ABSTRACT
Background:
Clinical Decision Support Systems (CDSS) are increasingly being introduced into various domains of health care. Little is known so far about the impact of such systems on the healthcare professional-patient relationship, and there is a lack of agreement about whether and how patients should be informed about the use of CDSS.
Objective:
This study aims to explore in an empirically informed manner the potential implications for the healthcare professional-patient relationship and to underline the importance of this relationship when using CDSS for both patients and (future) professionals.
Methods:
Using a methodological triangulation, 15 medical students, 12 trainee nurses, and 18 patients from Germany were interviewed in semi-structured interviews and focus groups between April 2021 and April 2022. Three examples of CDSS covering different areas of health care (surgery, nephrology and intensive home care) were used as stimuli in the study to identify similarities and differences regarding the use of CDSS in different fields of application. The interview transcripts were analyzed using structured qualitative content analysis according to Kuckartz.
Results:
From the interviews analyzed, three topics were identified that interdependently address the interactions between patients and healthcare professionals: (1) CDSS and their impact on the roles of and requirements for healthcare professionals, (2) CDSS and their impact on the relationship between healthcare professionals and patients (including communication requirements for shared decision-making), and (3) stakeholders’ expectations for patient education and information about the CDSS and its use.
Conclusions:
The results indicate that using CDSS could restructure established power and decision-making relationships between (future) healthcare professionals and patients. In addition, respondents expected that the use of CDSS would involve more communication, so they anticipated an increased time commitment. The results shed new light on the existing discourse by demonstrating that the anticipated impact of CDSS on the relationship appears to stem less from the function of a CDSS but rather from its integration in the healthcare professional-patient relationship. Therefore, the anticipated effects on the relationship between healthcare professionals and patients could be specifically addressed in patient information about the use of CDSS.
Citation
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Copyright
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