P58– Active implementation is required even with fully automatic decision support service

Abstract

PRIMARY TRACK: Guideline implementation SECONDARY TRACK: Computer-based decision support BACKGROUND (INTRODUCTION): The Evidence-Based Medicine electronic Decision Support service (EBMeDS) integrated within the Electronic Health Record (EHR) was introduced into clinical practice in one primary care health center in June 2009. Patient-specific automatic reminders and diagnosis-based guideline links are shown on computer screen to physicians, nurses, and physiotherapists (45 in total), when they use the EHR. The aim was to find out what the professionals think helps or hinders the implementation and use of automatic reminders after six months use. LEARNING OBJECTIVES (TRAINING GOALS): 1. Identify health care professionals’ opinions of use of an automatic decision support service. 2. Find out potential barriers and facilitators for the implementation of automatic reminders. METHODS: We convened three focus groups of 12 professionals: six physicians, five nurses, and one physiotherapist. A broad discussion theme was used, and the group discussion was audio-taped and transcribed. The data were analyzed using a content analysis. RESULTS: The majority of the participants reported only limited usage of the EBMeDS service. The guideline links were used most, regardless of the professional background. Physicians discussed practical problems at the time of introduction of the system, though not related to the system. In particular, slowness of the EHR was considered a major problem. A significant issue was the clear delay (3 months) from learning about the system to starting to use it. More education and a local opinion leader were desired to help uptake in the future. DISCUSSION (CONCLUSION): The study indicates that active and maybe even repeated implementation efforts should be used on uptake of even an automatic decision support service. TARGET AUDIENCE(S): 1. Guideline implementer 2. Developer of guideline-based products 3. Quality improvement manager/facilitator 4. Medical providers and executives 5. Allied health professionals 6. Nurses P59– Clinical guidelines from PDF-format to modern computer-based decision support Anne Hilde Rosv Rosvik, MDS (Presenter) (The Norwegian Electronic Library of Health, Oslo, Norway); Thomas Gauperaa (The National Knowledge Centre for Health, Oslo, Norway); Runar Eggen (The Norwegian Electronic Library of Health, Oslo, Norway); Reidun Kvaernbraaten (The National Knowledge Centre for Health, Oslo, Norway)