Warning: This is an author submission that is not peer-reviewed or edited.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.
Electronic Clinical Decision Support System to Screen for Stroke Risk among Patients with Atrial Fibrillation: Perspectives of Clinicians in a Mental Healthcare Setting
ABSTRACT
Background:
Electronic Clinical Decision Support Systems (eCDSSs) have been an integral component of the digital transformation in healthcare.
Objective:
This study aims to explore mental health clinician experience in screening for stroke risk among patients with atrial fibrillation and their perception of the potential impact of an eCDSS in improving care quality.
Methods:
A mixed method study, employing a questionnaire and individual semi-structured interviews, was conducted in a large London national health service trust. Interviews were analysed using an inductive thematic approach.
Results:
The sample comprised 10 clinicians. Two overarching themes related to prevention of AF-related stroke were identified from interviews: challenges faced on wards and strategies needed to improve practice. Challenges included difficulty identifying relevant medical histories of patients, clinician perceived lack of expertise, fragmented medical care, and mental health symptoms Suggestions to improve clinical practice included clinicians receiving alerts containing the latest guidelines and policies on stroke management, and bespoke training sessions designed to advance the knowledge, competencies and confidence of clinicians. As for the potential impact of an eCDSS in improving quality of care, two themes emerged: perceived benefits and perceived risks. Potential benefits included enhanced clinical effectiveness, saving time and improved outcomes. Reported perceived risks were rigidity in decision making, annoyance, and increased workload.
Conclusions:
A positive attitude towards an eCDSS to screen for stroke risk was identified although some concerns were noted. Understanding clinician perceptions of how an eCDSS may enhance health care and outcomes could serve as a basis for creating impactful digital health tools.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.