Accepted for/Published in: JMIR Human Factors
Date Submitted: Feb 25, 2024
Date Accepted: May 28, 2025
Factors Influencing Health Workers’ Acceptance of Guideline-based Clinical Decision Support Systems (CDSS) for Preventive Services in Thailand: A Questionnaire-based Study
ABSTRACT
Background:
The clinical decision support system (CDSS) represents a knowledge-based system designed to collect crucial data from electronic medical records (EMR) to generate decision-making based on a system data requirements and input from standard guidelines. Despite the potential to enhance healthcare delivery, the adoption rate of CDSS in clinical practice remains suboptimal.
Objective:
This study aims to evaluate the determinants influencing the intention to utilize the new CDSS in preventive care within clinical practice.
Methods:
A single-centered, questionnaire-based cross-sectional study conducted among physicians and medical students responsible for providing comprehensive preventive services at the continuity of care clinic located in Siriraj Hospital, Thailand.
Results:
A total of 89 participants were enrolled. The relationships between the factors impacting the adoption of CDSS were analyzed using correlation and regression analysis. The study found that physicians' intention to adopt the CDSS for preventive care is high, with 78.65% of participants expressing their intention to use the system. According to the study's conceptual framework, modified from the original UTUAT model, both positive physician attitudes towards CDSS utilization in preventive services and high effort expectancy emerge as crucial factors influencing the intention to utilize the new CDSS. The odds ratio for these factors was 5.433 (95% CI = 1.615 - 18.344, p-value = 0.006) and 7.603 (95% CI = 1.547 - 31.370, p-value = 0.013), respectively. The most prevalent barriers to CDSS implementation are related to physicians' attitudes, followed by issues such as the accuracy and burden of data input, time constraints for clinicians, and the risk of workflow disruption.
Conclusions:
There is a high intention to adopt CDSS in preventive care. Positive physician attitudes towards CDSS use in preventive services and effort expectancy were found to be critical factors influencing the intention to use the new CDSS.
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