Health care providers' perceptions of use and influence of clinical decision support reminders: qualitative study following a randomized trial to improve HPV vaccination rates

Brian E. Dixon, Monica L. Kasting, Shannon Wilson, Amit Kulkarni, Gregory D. Zimet, Stephen M. Downs

Research output: Contribution to journalArticle

8 Scopus citations


BACKGROUND: Human Papillomavirus (HPV) leads to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal. Furthermore, providers recommend the HPV vaccine less than half the time for eligible patients. Prior informatics research has demonstrated the effectiveness of computer-based clinical decision support (CDS) in changing provider behavior, especially in the area of preventative services.

METHODS: Following a randomized clinical trial to test the effect of a CDS intervention on HPV vaccination rates, we conducted semi-structured interviews with health care providers to understand whether they noticed the CDS reminders and why providers did or did not respond to the prompts. Eighteen providers, a mix of medical doctors and nurse practitioners, were interviewed from five publicly-funded, urban health clinics. Interview data were qualitatively analyzed by two independent researchers using inductive content analysis.

RESULTS: While most providers recalled seeing the CDS reminders, few of them perceived the intervention as effective in changing their behavior. Providers stated many reasons for why they did not perceive a change in their behavior, yet the results of the trial showed HPV vaccination rates increased as a result of the intervention.

CONCLUSIONS: CDS reminders may be effective at changing provider behavior even if providers perceive them to be of little use.

TRIAL REGISTRATION: Identifier: NCT02551887 Registered on September 15, 2015.

Original languageEnglish (US)
Number of pages1
JournalBMC medical informatics and decision making
Issue number1
StatePublished - Aug 10 2017



  • Clinical decision support systems
  • Immunization
  • Papillomaviridae
  • Papillomavirus vaccines
  • Public health informatics

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics

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