ArticleApplied clinical informatics2025
"I worry we'll blow right by it:" Barriers to Uptake of the STRATIFY-CDS for Acute Heart Failure.
Article in Applied clinical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
Clinical decision support (CDS) tools in electronic health records (EHRs) often face low uptake due to limited usability, workflow integration, and other implementation issues. We recently designed and implemented the STRATIFY-CDS tool, which calculates a validated risk-prediction model and recommends disposition for emergency department (ED) patients with acute heart failure. Despite applying human-centered design and implementation science strategies, initial utilization in the first 3 months of the STRATIFY-CDS tool was just 3%.To identify usability issues and contextual barriers to uptake of STRATIFY-CDS tool among ED clinicians.We performed an exploratory qualitative and simulation study with ED clinicians at Vanderbilt University Medical Center who had used the STRATIFY-CDS tool at least once. Semi-structured interviews with interactive simulation (summative usability) were conducted via videoconference. Two authors performed thematic analysis informed by the Technology Acceptance Model.Of 13 invited ED clinicians, 10 participated (7 attending and 3 resident physicians) with 1 to 11 prior tool uses. Although the main user interface had high perceived usability, participants struggled to find the launch button. The
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