title: Provider perceptions of colorectal cancer screening clinical decision support at three benchmark institutions.
abstract: Implementation of computerized clinical decision support (CDS), and its integration into workflow has not reached its potential. To better understand the use of CDS for colorectal cancer (CRC) screening at benchmark institutions for health information technology (HIT), we conducted direct observation, including opportunistic interviews of primary care providers, as well as key informant interviews and focus groups, to document current challenges to CRC screening and follow-up at clinics affiliated with the Veterans Heath Administration, Regenstrief Institute, and Partners HealthCare System. Analysis revealed six common barriers across institutions from the primary care providers' perspective: receiving and documenting "outside" exam results, inaccuracy of the CDS, compliance issues, poor usability, lack of coordination between primary care and gastroenterology, and the need to attend to more urgent patient issues. Strategies should be developed to enhance current HIT to address these challenges and better support primary care providers and staff.
authors.affiliation: VA HSR&D Center on Implementing Evidence-Based Practice, Roudebush VAMC, Indianapolis, IN, USA.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Saleem
authors.forename: Laura G
authors.initials: LG
authors.lastname: Militello
authors.forename: Nicole
authors.initials: N
authors.lastname: Arbuckle
authors.forename: Mindy
authors.initials: M
authors.lastname: Flanagan
authors.forename: David A
authors.initials: DA
authors.lastname: Haggstrom
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Linder
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
mesh_terms: D001291:Attitude of Health Personnel; D019985:Benchmarking; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D020000:Decision Support Systems, Clinical; D055088:Early Detection of Cancer / Q000523:psychology; D057286:Electronic Health Records; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D009722:Nurse Practitioners; D010823:Physician Assistants; D010820:Physicians