JMIR Publications

ABSTRACT

Background:

Computerised clinical decision support systems (CDSS) can increase clinician adherence to evidence-based guidelines and reduce variations in care. The Pathway for Acute Coronary Syndrome Assessment (PACSA) are a set of guidelines developed to standardise the management of suspected acute coronary syndrome across emergency departments in New South Wales. However, the routine use of these guidelines is uncertain and there is scope to increase clinician adherence.

Objective:

To assess the utility and acceptability of a clinician created web-based application (app) modelling the PACSA guidelines as a computerised decision support tool in the management of suspected ACS.

Methods:

A web app modelling the PACSA guidelines was created using the REDCap platform by a cardiologist with a total development time of <3 hours. Emergency department doctors were asked to utilise the app and apply it to two hypothetical scenarios. Participants then completed a survey to assess if the PACSA app offered any advantages over the current document.

Results:

Participants (n=31) ranged from junior doctors to senior physicians. Current clinician adherence to the PACSA guidelines was low with 55% (N=17) never using it in their daily practice. Compared to the existing PACSA document, 58% (n=18) found the PACSA app faster to use and 42% (n=13) reported the app to be easier to use.

Conclusions:

The PACSA app offers a more efficient and user-friendly alternative to the current paper based PACSA guidelines and may promote clinician adherence. Additional studies with a larger number of participants are required to assess the transferability of the app to everyday practice. Further, web-based apps are relatively easy to create using existing online platforms, with scope for clinicians to apply such apps to other evidence-based guidelines and across different specialties.