title: A clinical decision support needs assessment of community-based physicians.
abstract: OBJECTIVE
  To conduct a grounded needs assessment to elicit community-based physicians' current views on clinical decision support (CDS) and its desired capabilities that may assist future CDS design and development for community-based practices.
  
  
  METHODS
  To gain insight into community-based physicians' goals, environments, tasks, and desired support tools, we used a human-computer interaction model that was based in grounded theory. We conducted 30 recorded interviews with, and 25 observations of, primary care providers within 15 urban and rural community-based clinics across Oregon. Participants were members of three healthcare organizations with different commercial electronic health record systems. We used a grounded theory approach to analyze data and develop a user-centered definition of CDS and themes related to desired CDS functionalities.
  
  
  RESULTS
  Physicians viewed CDS as a set of software tools that provide alerts, prompts, and reference tools, but not tools to support patient management, clinical operations, or workflow, which they would like. They want CDS to enhance physician-patient relationships, redirect work among staff, and provide time-saving tools. Participants were generally dissatisfied with current CDS capabilities and overall electronic health record usability.
  
  
  CONCLUSIONS
  Physicians identified different aspects of decision-making in need of support: clinical decision-making such as medication administration and treatment, and cognitive decision-making that enhances relationships and interactions with patients and staff.
  
  
  CONCLUSIONS
  Physicians expressed a need for decision support that extended beyond their own current definitions. To meet this requirement, decision support tools must integrate functions that align time and resources in ways that assist providers in a broad range of decisions.
authors: Department of Public Health, Weill Cornell Medical College, New York City, New York 10065, USA. jor2032@med.cornell.edu
authors: Joshua E
authors: JE
authors: Richardson
authors: Joan S
authors: JS
authors: Ash
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003154:Community Medicine; D003657:Decision Making; D020000:Decision Support Systems, Clinical; D003661:Decision Support Techniques; D057286:Electronic Health Records; D006040:Goals; D006801:Humans; D007407:Interviews as Topic; D020380:Needs Assessment; D010820:Physicians / Q000523:psychology; D012984:Software; D014584:User-Computer Interface