Are clinical decision support systems seen as helpful to First Contact Practitioners (FCPs) working in musculoskeletal health?

Abstract

BackgroundThere is increasing burden on musculoskeletal (MSK) First Contact Practitioners (FCPs) working in primary care. One possible solution is to use digital technologies such as clinical decision support systems (CDSS). The primary objective of this study was to understand the potential for MSK FCPs to use a CDSS to support their practice in the United Kingdom. DesignAn exploratory sequential mixed methods design, using a cross sectional survey questionnaire and a subsequent focus group.Following ethical approval responders were recruited via professional networks to complete an online survey. A subsequent focus group enabled an in-depth exploration of survey results. Descriptive statistics were used to summarise survey data and thematic analysis with normalisation process theory used to describe findings. MethodsA snowball sampling method was used to invite MSK FCPs to complete the survey, using email, adverts and social media. The questionnaire captured responders’ demographic and professional practice characteristics, their knowledge and use of CDSS and their views and experiences regarding CDSS in MSK practice. ResultsThere were 75 responders to the survey and six participants in the focus group. The majority of responders 67% (n = 50/75) reported to be in favour of integrating a CDSS into their practice. Three themes were: 1) ensuring CDSS address efficiency concerns, 2) using CDSS to reduce unwarranted variation in practice, and 3) ensuring CDSS sustainability. ConclusionsCDSSs have potential value for FCPs working in MSK primary care settings. Eight summary recommendations advise future developments of CDSS for FCPs working in MSK primary care practice. Contribution of the Paper•This is the first known study evaluating the usefulness of clinical decision support systems (CDSS) for musculoskeletal (MSK) First Contact Practitioners (FCPs).•CDSS have potential value for MSK FCPs providing they are integrated into existing digital note systems and save clinic consultation time.•Eight recommendations advise future integration of CDSS into MSK FCP practice.