title: Understanding the acceptability of a computer decision support system in pediatric primary care.
abstract: OBJECTIVE
  Individual users' attitudes and opinions help predict successful adoption of health information technology (HIT) into practice; however, little is known about pediatric users' acceptance of HIT for medical decision-making at the point of care.
  
  
  METHODS
  We wished to examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. Surveys were administered in 2011 and 2012 to all users to measure CHICA's acceptability and users' satisfaction with it. Free text comments were analyzed for themes to understand areas of potential technical refinement.
  
  
  RESULTS
  70 participants completed the survey in 2011 (100% response rate) and 64 of 66 (97% response rate) in 2012. Initially, satisfaction with CHICA was mixed. In general, users felt the system held promise; however various critiques reflected difficulties understanding integrated technical aspects of how CHICA worked, as well as concern with the format and wording on generated forms for families and users. In the subsequent year, users' ratings reflected improved satisfaction and acceptance. Comments also reflected a deeper understanding of the system's logic, often accompanied by suggestions on potential refinements to make CHICA more useful at the point of care.
  
  
  CONCLUSIONS
  Pediatric users appreciate the system's automation and enhancements that allow relevant and meaningful clinical data to be accessible at point of care. Understanding users' acceptability and satisfaction is critical for ongoing refinement of HIT to ensure successful adoption into practice.
authors.affiliation: Department of Pediatrics, Section of Children's Health Services Research, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Nerissa S
authors.initials: NS
authors.lastname: Bauer
authors.forename: Aaron E
authors.initials: AE
authors.lastname: Carroll
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Downs
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003625:Data Collection; D020000:Decision Support Systems, Clinical; D057286:Electronic Health Records; D006801:Humans; D010372:Pediatrics; D011320:Primary Health Care; D014584:User-Computer Interface
keywords: Clinical guidelines; Computer-based decision support; Pediatrics; Primary care