Leveraging point-of-care clinician feedback to study barriers to guideline adherence.
Studies of barriers to guideline adherence have generally surveyed clinicians temporally remote from the clinical scenario in which recommendations were delivered, potentially adversely biasing clinician observations. The user interface of ATHENA DSS, a guideline-based decision support system for hypertension, includes a point-of-care feedback window that accepts clinician-user comments during the display of recommendations. Analysis of this feedback has revealed a number of intriguing patient, provider, and technical barriers to adherence collected during real-time system use.
Chan
A S
AS
VA Palo Alto Health Care System, Palo Alto, CA, USA.
Shankar
R D
RD
Coleman
R W
RW
Matins
S B
SB
Hoffman
B B
BB
Goldstein
M K
MK
D001291:Attitude of Health Personnel; D020000:Decision Support Systems, Clinical; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D016347:Medical Records Systems, Computerized; D019095:Point-of-Care Systems; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D014584:User-Computer Interface