ArticleBMC medical informatics and decision making2009
Barriers to implementation of a computerized decision support system for depression: an observational report on lessons learned in "real world" clinical settings.
Article in BMC medical informatics and decision making, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Implementation costs of hospital-based computerised decision support systems: a systematic review.Implementation science : IS · 2023Pooled it
- Factors influencing the implementation of decision support systems for antibiotic prescription in hospitals: a systematic review.BMC medical informatics and decision making · 2023Pooled it
- Using an Integrated Framework to Investigate the Facilitators and Barriers of Health Information Technology Implementation in Noncommunicable Disease Management: Systematic Review.Journal of medical Internet research · 2022Pooled it
- Clinical decision support systems in child and adolescent psychiatry: a systematic review.European child & adolescent psychiatry · 2017Pooled it
- Systematic review of factors influencing the adoption of information and communication technologies by healthcare professionals.Journal of medical systems · 2012Pooled it
- A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review.BMC medical informatics and decision making · 2010Pooled it
- A Systematic Review of Factors Affecting Utilization of Decision Support Systems: The Interplay Between Technology, Users, and the Healthcare Environment.Health science reports · 2026Review
- Mixed-methods evaluation of clinician experiences and adoption patterns of an EHR-integrated generative AI-based clinical decision support uptake by clinicians in Kenya.BMJ digital health & AI · 2026Article
- Primary care online training on multifactorial breast cancer risk: pre-post evaluation study.BJGP open · 2025Article
- Facilitators, barriers, and insights using an HFA-PEFF-based clinical decision support system: A proof-of-concept study.ESC heart failure · 2025Article
- Implementation of artificial intelligence-based decision support systems for antibiotic prescribing in hospitals: a Delphi study.Frontiers in digital health · 2025Article
- A scoping review, novel taxonomy and catalogue of implementation frameworks for clinical decision support systems.BMC medical informatics and decision making · 2024Article
- Barriers to and Facilitators of Key Stakeholders Influencing Successful Digital Implementation of Remote Monitoring Solutions: Mixed Methods Analysis.JMIR human factors · 2024Article
- Facilitators and Barriers in the Implementation of a Digital Surveillance and Outbreak Response System in Ghana Before and During the COVID-19 Pandemic: Qualitative Analysis of Stakeholder Interviews.JMIR formative research · 2023Article
- Article
- Clinical decision support systems-based interventions to improve medication outcomes: A systematic literature review on features and effects.Medical journal of the Islamic Republic of Iran · 2021Review
- An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia.Journal of personalized medicine · 2020Article
- Article
- Identifying undetected dementia in UK primary care patients: a retrospective case-control study comparing machine-learning and standard epidemiological approaches.BMC medical informatics and decision making · 2019Article
- The development and evaluation of a computerized decision aid for the treatment of psychotic disorders.BMC psychiatry · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundDespite wide promotion, clinical practice guidelines have had limited effect in changing physician behavior. Effective implementation strategies to date have included: multifaceted interventions involving audit and feedback, local consensus processes, marketing; reminder systems, either manual or computerized; and interactive educational meetings. In addition, there is now growing evidence that contextual factors affecting implementation must be addressed such as organizational support (leadership procedures and resources) for the change and strategies to implement and maintain new systems.
methodsTo examine the feasibility and effectiveness of implementation of a computerized decision support system for depression (CDSS-D) in routine public mental health care in Texas, fifteen study clinicians (thirteen physicians and two advanced nurse practitioners) participated across five sites, accruing over 300 outpatient visits on 168 patients.
resultsIssues regarding computer literacy and hardware/software requirements were identified as initial barriers. Clinicians also reported concerns about negative impact on workflow and the potential need for duplication during the transition from paper to electronic systems of medical record keeping.
conclusionThe following narrative report based on observations obtained during the initial testing and use of a CDSS-D in clinical settings further emphasizes the importance of taking into account organizational factors when planning implementation of evidence-based guidelines or decision support within a system.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.