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 Dixon, Monica L. Kasting, Shannon Wilson, Amit Kulkarni, Gregory Zimet, Stephen Downs

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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: ClinicalTrials.gov Identifier: NCT02551887 Registered on September 15, 2015.

Original languageEnglish (US)
Number of pages1
JournalBMC Medical Informatics and Decision Making
Volume17
Issue number1
DOIs
StatePublished - Aug 10 2017

Fingerprint

Clinical Decision Support Systems
Health Personnel
Vaccination
Papillomavirus Vaccines
Interviews
Urban Health
Informatics
Nurse Practitioners
Sexually Transmitted Diseases
Randomized Controlled Trials
Research Personnel
Health
Research

Keywords

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

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics

Cite this

@article{cd65873652eb46bda084f19988a1e305,
title = "Health care providers' perceptions of use and influence of clinical decision support reminders: qualitative study following a randomized trial to improve HPV vaccination rates",
abstract = "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: ClinicalTrials.gov Identifier: NCT02551887 Registered on September 15, 2015.",
keywords = "Clinical decision support systems, Immunization, Papillomaviridae, Papillomavirus vaccines, Public health informatics",
author = "Brian Dixon and Kasting, {Monica L.} and Shannon Wilson and Amit Kulkarni and Gregory Zimet and Stephen Downs",
year = "2017",
month = "8",
day = "10",
doi = "10.1186/s12911-017-0521-6",
language = "English (US)",
volume = "17",
journal = "BMC Medical Informatics and Decision Making",
issn = "1472-6947",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Health care providers' perceptions of use and influence of clinical decision support reminders

T2 - qualitative study following a randomized trial to improve HPV vaccination rates

AU - Dixon, Brian

AU - Kasting, Monica L.

AU - Wilson, Shannon

AU - Kulkarni, Amit

AU - Zimet, Gregory

AU - Downs, Stephen

PY - 2017/8/10

Y1 - 2017/8/10

N2 - 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: ClinicalTrials.gov Identifier: NCT02551887 Registered on September 15, 2015.

AB - 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: ClinicalTrials.gov Identifier: NCT02551887 Registered on September 15, 2015.

KW - Clinical decision support systems

KW - Immunization

KW - Papillomaviridae

KW - Papillomavirus vaccines

KW - Public health informatics

UR - http://www.scopus.com/inward/record.url?scp=85032002658&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032002658&partnerID=8YFLogxK

U2 - 10.1186/s12911-017-0521-6

DO - 10.1186/s12911-017-0521-6

M3 - Article

VL - 17

JO - BMC Medical Informatics and Decision Making

JF - BMC Medical Informatics and Decision Making

SN - 1472-6947

IS - 1

ER -