JMIR Publications

ABSTRACT

Background:

Clinical decision support systems (CDSS) are known to improve adherence to clinical practice guidelines and patient outcomes by providing clinicians with timely, accurate, and appropriate knowledge.

Objective:

This study investigates the perceived usefulness and practical implementation of UpHill Route v3, a personalized digital care pathway (PDCP) system, in enhancing clinical decision-making and patient management across various clinical settings.

Methods:

A mixed-methods retrospective study was conducted involving medical doctors and nurses from four NHS Local Health Units in Portugal. Data was collected from May 2023 to April 2024. The primary data source was an anonymous questionnaire assessing healthcare professionals' perceptions of UpHill Route v3's usefulness (Likert scale from 0 to 10). Secondary analysis involved quantifying decisions across heart failure, multimorbidity, diabetes and colorectal and breast cancer clinical pathways (data were collected from user interactions with UpHill Route v3, as well as from its internal database). Descriptive and bivariate statistics were used to analyse the data.

Results:

22 healthcare professionals (mean age 44.7±10.6, 68% females, 41% physicians) participated. High ratings for adherence to clinical protocols (mean score: 8.061.73), clinical decision support (mean score: 8.051.73), patient care improvement (mean score: 7.632.22), and confidence in patient management (mean score: 8.261.56) were reported. Secondary analysis showed that, across 3,574 patients, 25,741 clinical decisions were informed and 9,254 actions were performed with the assistance of the PDCP tool.

Conclusions:

The perceived usefulness paired with the underlying volume of decisions informed and/or tasks performed indicates the potential of the tool to enhance clinical efficiency and patient care. The study's findings align with existing literature on the effectiveness of CDSSs in improving clinical practice and patient outcomes. However, the small sample size and potential response bias limit the generalizability of the results. Further research with larger and more diverse populations is needed. UpHill Route v3 PDCP tool is highly valued by healthcare professionals for its ability to support clinical decision-making and operational efficiency across various clinical settings, suggesting it can effectively bridge the gap between clinical guidelines and real-world practice.