Evidence map›Paper›PMID 42129832›Full record

SynthesisSystematic reviews2026

Barriers and facilitators to the implementation and adoption of computerised clinical decision support systems: an overview of reviews.

Anna Katharina Böhm-Hustede, Johanna Sophie Lubasch, Anna Thalea Hoogestraat, Eike Buhr, Antje Wulff

Abstract readSystematic Review
In one paragraph

Synthesis in Systematic reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anna Katharina Böhm-HustedeBig Data in Medicine, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Germany. anna.katharina.boehm-hustede@uni-oldenburg.de.ORCID 0009-0003-5929-7419
Johanna Sophie LubaschOldenburg Research Network Emergency- and Intensive Care Medicine (OFNI), Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Germany.
Anna Thalea HoogestraatBig Data in Medicine, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Germany.
Eike BuhrEthics in Medicine, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Germany.
Antje WulffBig Data in Medicine, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of computerised clinical decision support systems (CDSSs) holds considerable potential in enhancing healthcare delivery by improving patient safety, practitioner performance, and patient outcomes. However, despite the numerous reported advantages of CDSSs, their adoption remains restricted, thereby compromising the full realisation of their potential. To enable a profound evaluation and successful implementation of these systems, it is imperative to identify the reasons for their limited uptake. The objective of this study is to provide a comprehensive overview of the barriers and facilitators to the implementation and adoption of decision support systems across healthcare settings.

methodsThis study was reported in accordance with the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement. A systematic search was conducted in the databases PubMed, IEEE Xplore, Scopus, and Web of Science from inception to 15 October 2024, targeting at review articles of primary studies focusing on the identification and reporting of barriers and facilitators to the implementation and adoption of CDSSs across healthcare settings. The risk of bias of the included reviews was assessed with the Risk of Bias in Systematic Reviews (ROBIS) tool, and the primary study overlap was calculated using the corrected covered area method. All data on barriers and facilitators to the implementation and adoption of CDSSs were extracted from the included reviews, synthesised through a mapping of identical factors, and ranked according to their frequency of occurrence.

resultsOf the 1640 records retrieved through database searches, 30 reviews were included in this overview, which summarised the findings of 721 unique primary studies. A total of 101 distinct factors influencing the implementation and adoption of CDSSs were identified and could be categorised into the overarching categories of human, technology-related, and contextual factors. The following six factors were reported most frequently: usability, usefulness/perceived benefits, organisational readiness, training, trust, and workflow integration.

conclusionsThe findings of this study highlight the diversity of factors that influence a successful implementation of CDSSs and emphasise the need for their comprehensive evaluation that goes beyond the assessment of general performance aspects but takes into account human and contextual factors. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024507614.

Indexed as

Decision Support Systems, ClinicalDelivery of Health CareHumansBarriersClinical decision support systemsContextual factorsEvaluationFacilitatorsHuman factorsImplementationOverview of reviewsSystematic reviewUmbrella review

Identifiers

PMID42129832
PMCPMC13173960

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.