title: Health information technology: use it well, or don't! Findings from the use of a decision support system for breast cancer management.
abstract: The potential of health information technology is hampered by new types of errors which impact is not totally assessed. OncoDoc2 is a decision support system designed to support treatment decisions of multidisciplinary meetings (MDMs) for breast cancer patients. We evaluated how the way the system was used had an impact on MDM decision compliance with clinical practice guidelines. We distinguished "correct navigations" (N+), "incorrect navigations" (N-), and "missing navigations" (N0), according to the quality of data entry when using OncoDoc2. We collected 557 MDM decisions from three hospitals of Paris area (France) where OncoDoc2 was routinely used. We observed 33.9% N+, 36.8% N-, and 29.3% N0. The compliance rate was significantly different according to the quality of navigations, 94.2%, 80.0%, and 90.2% for N+, N-, and N0 respectively. Surprinsingly, it was better not to use the system (N0) than to use it improperly (N-).
authors.affiliation: AP-HP, DRCD, Paris, France ; INSERM, U1142, LIMICS, Paris, France ; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1142, LIMICS, Paris, France ; Université Paris 13, Sorbonne Paris Cité, LIMICS, (UMR_S 1142), Bobigny, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Bouaud
authors.affiliation: CH Lagny Marne la Vallée, Service de radiothérapie-oncologie, Lagny, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Blaszka-Jaulerry
authors.affiliation: Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France; AP-HP, Hôpital Avicenne, Service d'oncologie médicale, Bobigny, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Zelek
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UFR de médecine, Paris, France ; AP-HP, Hôpital Pitié-Salpétrière, Service d'oncologie médicale, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Spano
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UFR de médecine, Paris, France ; AP-HP, Hôpital Pitié-Salpétrière, Service de chirurgie et cancérologie gynécologique et mammaire, Paris, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lefranc
authors.affiliation: Hôpital des Diaconesses, Pôle oncologie médicale, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Cojean-Zelek
authors.affiliation: Institut de Cancérologie des Peupliers, Paris, France.
authors.forename: Axel
authors.initials: A
authors.lastname: Durieux
authors.affiliation: AP-HP, Hôpital St-Antoine, Service d'oncologie médicale, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tournigand
authors.affiliation: AP-HP, Hôpital St-Antoine, URC-EST, Paris, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Rousseau
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1142, LIMICS, Paris, France ; INSERM, U1142, LIMICS, Paris, France ; Université Paris 13, Sorbonne Paris Cité, LIMICS, (UMR_S 1142), Bobigny, France ; AP-HP, Hôpital Tenon, Département de santé publique, Paris, France; APREC, Paris, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Séroussi
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D003627:Data Interpretation, Statistical; D020000:Decision Support Systems, Clinical; D019468:Disease Management; D005103:Expert Systems; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D010297:Paris; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D013813:Therapy, Computer-Assisted