What may help or hinder the implementation of computerized decision support systems (CDSSs): a focus group study with physicians.
OBJECTIVE
To identify potential barriers and facilitators to implementing computerized decision support systems (CDSSs) in health care as perceived by clinicians.


METHODS
We carried out a qualitative focus group study with primary and secondary health care settings in six areas of Finland. A total of 39 interviewed physicians, of whom 22 practised in primary care and 17 in secondary care. The main outcome measures physicians' expectations, preconceived barriers and facilitators were explicitly identified by the participants during the interviews.


RESULTS
Identified barriers were earlier experience of dysfunctional computer systems in health care, potential harm to doctor-patient relationship, obscured responsibilities, threats to clinician's autonomy and potential extra workload due to excessive reminders. Identified facilitators were self-control of frequency and contents of CDSS and noticeable help of CDSS in clinical practice. It was easy for the physicians to think of applications and clinical topics for CDSS that could help them to avoid mistakes and improve work processes.


CONCLUSIONS
Physicians had relatively positive attitudes towards the idea of CDSS. They expected flexibility, individuality and reliability of the CDSS. The rather high level of computerized practices and wide use of electronic guidelines probably have paved the way for the CDSS in Finland.
Varonen
Helena
H
Department of General Practice and Primary Care, University of Helsinki, Helsinki. helena.varonen@helsinki.fi
Kortteisto
Tiina
T
Kaila
Minna
M
D000328:Adult; D001292:Attitude to Computers; D020000:Decision Support Systems, Clinical; D004059:Diffusion of Innovation; D005260:Female; D005387:Finland; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010820:Physicians