title: Physicians' perceptions of an electronic health record-based clinical trial alert approach to subject recruitment: a survey.
abstract: BACKGROUND
  Physician participation in clinical research recruitment efforts is critical to many studies' success, but it is often limited. Use of an Electronic Health Record (EHR)-based, point-of-care Clinical Trial Alert (CTA) approach has led to significant increases in physician-generated recruitment and holds promise for wider benefit. However, little is known about physicians' decision-making regarding recruitment in EHR-equipped settings or the use of such EHR-based approaches. We sought to assess physicians' perceptions about recruitment in general and using the CTA approach in particular.
  
  
  METHODS
  We developed and delivered a Web-based survey consisting of 15 multiple-choice and free-text questions. Participants included the 114 physician subjects (10 endocrinologists and 104 general internists) who were exposed to CTAs during our preceding 4-month intervention study. Response data were descriptively analyzed, and key findings were compared between groups using appropriate statistical tests.
  
  
  RESULTS
  Sixty-nine physicians (61%) responded during the 10-week survey period. Respondents and non-respondents did not differ significantly. Twenty-seven percent of respondents felt very comfortable recruiting patients to trials in general, and 77% appreciated being reminded about a trial via a CTA. Only 11% percent felt the CTA was difficult to use, and 27% felt it was more than somewhat intrusive. Among those who ignored all CTAs, 37% cited a lack of time, 28% knowledge of the patient's ineligibility, and 13% limited knowledge about the trial as their most common reason. Thirty-eight percent wanted more information about the trial presented in the CTA, and 73% were interested in seeing CTAs for future trials. Comments and suggestions were submitted by 33% of respondents and included suggestions for improvement of the CTA approach.
  
  
  CONCLUSIONS
  Most physicians were comfortable recruiting patients for clinical trials at the point-of-care, found the EHR-based CTA approach useful and would like to see it used in the future. These findings provide insight into the perceived utility of this EHR-based approach to subject recruitment, suggest ways it might be improved, and add to the limited body of knowledge regarding physicians' attitudes toward clinical trial recruitment in EHR-equipped settings.
authors.affiliation: Center for Health Informatics and Department of Medicine, University of Cincinnati Academic Health Center, 231 Albert Sabin Way, PO Box 670840, Cincinnati, Ohio, USA. peter.embi@uc.edu
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Embi
authors.forename: Anil
authors.initials: A
authors.lastname: Jain
authors.forename: C Martin
authors.initials: CM
authors.lastname: Harris
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D002986:Clinical Trials as Topic; D003625:Data Collection; D004704:Endocrinology; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D018579:Patient Selection; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D019095:Point-of-Care Systems; D017010:Reminder Systems; D011795:Surveys and Questionnaires