{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:27:05Z","timestamp":1768397225810,"version":"3.49.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2006,2,1]],"date-time":"2006-02-01T00:00:00Z","timestamp":1138752000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Real-time clinical decision support (CDS) integrated into clinicians' workflow has the potential to profoundly affect the cost, quality, and safety of health care delivery. Recent reports have identified a surprisingly low acceptance rate for different types of CDS. We hypothesized that factors affecting CDS system acceptance could be categorized as relating to differences in patients, physicians, CDS-type, or environmental characteristics.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a survey of all adult primary care physicians (PCPs, n = 225) within our group model Health Maintenance Organization (HMO) to identify factors that affect their acceptance of CDS. We defined clinical decision support broadly as \"clinical information\" that is either provided to you or accessible by you, from the clinical workstation (e.g., enhanced flow sheet displays, health maintenance reminders, alternative medication suggestions, order sets, alerts, and access to any internet-based information resources).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>110 surveys were returned (49%). There were no differences in the age, gender, or years of service between those who returned the survey and the entire adult PCP population. Overall, clinicians stated that the CDS provided \"helps them take better care of their patients\" (3.6 on scale of 1:Never \u2013 5:Always), \"is worth the time it takes\" (3.5), and \"reminds them of something they've forgotten\" (3.2). There was no difference in the perceived acceptance rate of alerts based on their type (i.e., cost, safety, health maintenance). When asked about specific patient characteristics that would make the clinicians \"more\", \"equally\" or \"less\" likely to accept alerts: 41% stated that they were more (8% stated \"less\") likely to accept alerts on elderly patients (&gt; 65 yrs); 38% were more (14% stated less) likely to accept alerts on patients with more than 5 current medications; and 38% were more (20% stated less) likely to accept alerts on patients with more than 5 chronic clinical conditions. Interestingly, 80% said they were less likely to accept alerts when they were behind schedule and 84% of clinicians admitted to being at least 20 minutes behind schedule \"some\", \"most\", or \"all of the time\".<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Even though a majority of our clinical decision support suggestions are not explicitly followed, clinicians feel they are of benefit and would be even more beneficial if they had more time available to address them.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1472-6947-6-6","type":"journal-article","created":{"date-parts":[[2006,2,4]],"date-time":"2006-02-04T19:16:50Z","timestamp":1139080610000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":96,"title":["A survey of factors affecting clinician acceptance of clinical decision support"],"prefix":"10.1186","volume":"6","author":[{"given":"Dean F","family":"Sittig","sequence":"first","affiliation":[]},{"given":"Michael A","family":"Krall","sequence":"additional","affiliation":[]},{"given":"Richard H","family":"Dykstra","sequence":"additional","affiliation":[]},{"given":"Allen","family":"Russell","sequence":"additional","affiliation":[]},{"given":"Homer L","family":"Chin","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2006,2,1]]},"reference":[{"key":"95_CR1","volume-title":"Crossing the quality chasm: a new health system for the 21st Century","author":"Institute of Medicine Committee on Quality of Health Care in America","year":"2001","unstructured":"Institute of Medicine Committee on Quality of Health Care in America: Crossing the quality chasm: a new health system for the 21st Century. 2001, Washington (DC): National Academy Press"},{"key":"95_CR2","volume-title":"To Err Is Human: Building a Safer Health System","author":"Institute of Medicine","year":"1999","unstructured":"Institute of Medicine: To Err Is Human: Building a Safer Health System. 1999, Washington, DC: National Academy Press"},{"key":"95_CR3","doi-asserted-by":"crossref","unstructured":"Teich JM, Osheroff JA, Pifer EA, Sittig DF, Jenders RA: Clinical Decision Support in Electronic Prescribing: Recommendations and an Action Plan. 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Agency for Healthcare Research and Quality, Rockville, MD. 2005, 1\u20134: [http:\/\/www.ahrq.gov\/downloads\/pub\/advances\/vol3\/Feldstein.pdf]"},{"issue":"11","key":"95_CR8","first-page":"602","volume":"30","author":"A Feldstein","year":"2004","unstructured":"Feldstein A, Simon SR, Schneider J, Krall M, Laferriere D, Smith DH, Sittig DF, Soumerai SB: How to design computerized alerts to safe prescribing practices. Jt Comm J Qual Saf. 2004, 30 (11): 602-13.","journal-title":"Jt Comm J Qual Saf"},{"key":"95_CR9","doi-asserted-by":"crossref","unstructured":"Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR: Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA. 282 (15): 1458-65. 10.1001\/jama.282.15.1458. 1999, Oct 20","DOI":"10.1001\/jama.282.15.1458"},{"key":"95_CR10","doi-asserted-by":"crossref","unstructured":"Subramanian U, Fihn SD, Weinberger M, Plue L, Smith FE, Udris EM, McDonell MB, Eckert GJ, Temkit M, Zhou XH, Chen L, Tierney WM: A controlled trial of including symptom data in computer-based care suggestions for managing patients with chronic heart failure. Am J Med. 116 (6): 375-84. 10.1016\/j.amjmed.2003.11.021. 2004 Mar 15","DOI":"10.1016\/j.amjmed.2003.11.021"},{"key":"95_CR11","doi-asserted-by":"crossref","unstructured":"Dexter PR, Perkins S, Overhage JM, Maharry K, Kohler RB, McDonald CJ: A computerized reminder system to increase the use of preventive care for hospitalized patients. 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