ArticleJournal of the American Medical Informatics Association : JAMIA2021
Barriers to using clinical decision support in ambulatory care: Do clinics in health systems fare better?
Article in Journal of the American Medical Informatics Association : JAMIA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Exploring the role of professional identity in the implementation of clinical decision support systems-a narrative review.Implementation science : IS · 2024Pooled it
- Implementation of Electronic Clinical Decision Support for Radiology Referrals: The Role of Governance, Clinician Engagement and Education.Emergency medicine Australasia : EMA · 2026Article
- Pediatric clinician perspectives on clinical decision support tools for chronic kidney disease risk after preterm birth.Pediatric nephrology (Berlin, Germany) · 2026Article
- From Concept to Practice: Lessons From the Balanced Nursing Teams Decision-Support System.JMIR nursing · 2026Article
- Barriers and Enablers for Sustaining Nurse-Led Use of Clinical Decision Support Tools for Antibiotic Stewardship: Qualitative Study.JMIR nursing · 2026Article
- Article
- A Mixed-Method Case Study to Evaluate Adoption of Clinical Decision Support for Cancer Symptom Management.Applied clinical informatics · 2025Article
- Implementation of a Clinical Decision Support System for Antimicrobial Prescribing in Sub-Saharan Africa: Multisectoral Qualitative Study.Journal of medical Internet research · 2024Article
- Application of a user experience design approach for an EHR-based clinical decision support system.JAMIA open · 2024Article
- Overcoming Barriers to Discovery and Implementation of Equitable Pharmacogenomic Testing in Oncology.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Review
- Clinical Decision Support Tools in the Electronic Medical Record.Kidney international reports · 2024Review
- Examining primary care provider experiences with using a clinical decision support tool for pain management.JAMIA open · 2023Article
- Clinicians' Views on Using Artificial Intelligence in Healthcare: Opportunities, Challenges, and Beyond.Cureus · 2023Article
- Facilitators and Barriers to Interacting With Clinical Decision Support in the ICU: A Mixed-Methods Approach.Critical care explorations · 2023Article
- Lessons Learned from a National Initiative Promoting Publicly Available Standards-Based Clinical Decision Support.Applied clinical informatics · 2023Article
- User Experience Design for Adoption of Asthma Clinical Decision Support Tools.Applied clinical informatics · 2022Article
- Clinical decision support for tobacco screening and counseling parents of pediatric patients: A qualitative analysis of pediatric emergency department and urgent care professionals.Drug and alcohol dependence reports · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveWe quantify the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examine whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic. MATERIALS AND
methodsDespite much discussion at the theoretic level, the existing literature provides little empirical understanding of barriers to using CDS in ambulatory care. We analyze data from 821 clinics in 117 medical groups, based on in Minnesota Community Measurement's annual Health Information Technology Survey (2014-2016). We examine clinics' use of 7 CDS tools, along with 7 barriers in 3 areas (resource, user acceptance, and technology). Employing linear probability models, we examine factors associated with CDS barriers.
resultsClinics in health systems used more CDS tools than did clinics not in systems (24 percentage points higher in automated reminders), but they also reported more barriers related to resources and user acceptance (26 percentage points higher in barriers to implementation and 33 points higher in disruptive alarms). Barriers related to workflow redesign increased in clinics affiliated with health systems (33 points higher). Rural clinics were more likely to report barriers to training.
conclusionsCDS barriers related to resources and user acceptance remained substantial. Health systems, while being effective in promoting CDS tools, may need to provide further assistance to their affiliated ambulatory clinics to overcome barriers, especially the requirement to redesign workflow. Rural clinics may need more resources for training.
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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.