An Exploratory Study of Evidence-Based Clinical Decision Support Systems

Cheerkoot-Jalim, Sudha; Khedo, Kavi Kumar; Jodheea-Jutton, Abha

doi:10.1007/978-981-13-3338-5_20

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…GlycASSIST was considered to make treatment intensification easier for both experienced GPs and registrars. This was based on the functionality of GlycASSIST (eg, using evidence-based algorithms to inform the presentation of appropriate medication classes and prescribing rules [ 45 ]) and its content (eg, including all T2D medication classes). Both clinicians and people with diabetes also felt that GlycASSIST has the potential to facilitate SDM, prompting discussion around medication side effects and outcome preferences.…”

Section: Discussionmentioning

confidence: 99%

“…The evidence-based nature of recommendations generated by GlycASSIST was mentioned frequently as beneficial and necessary to facilitate treatment intensification, assuming that GlycASSIST remains up-to-date. The features that allow GlycASSIST to make treatment intensification easier are time, funding, and resource intensive [ 45 ]. A tool such as GlycASSIST needs continual updating as new evidence and clinical guidelines become available.…”

Section: Discussionmentioning

confidence: 99%

“…Co-design was used to enhance the design of GlycASSIST, ensuring that it met the needs of end users: both clinicians and people with diabetes. This process enabled the testing of GlycASSIST with end users to explore their interest in and interaction with GlycASSIST, which is critical for identifying both barriers to and enablers of adoption in real-world clinical settings [ 38 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

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Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record

Kunstler¹,

Furler²,

Holmes‐Truscott³

et al. 2020

JMIR Form Res

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Background Managing type 2 diabetes (T2D) requires progressive lifestyle changes and, sometimes, pharmacological treatment intensification. General practitioners (GPs) are integral to this process but can find pharmacological treatment intensification challenging because of the complexity of continually emerging treatment options. Objective This study aimed to use a co-design method to develop and pretest a clinical decision support (CDS) tool prototype (GlycASSIST) embedded within an electronic medical record, which uses evidence-based guidelines to provide GPs and people with T2D with recommendations for setting glycated hemoglobin (HbA1c) targets and intensifying treatment together in real time in consultations. Methods The literature on T2D-related CDS tools informed the initial GlycASSIST design. A two-part co-design method was then used. Initial feedback was sought via interviews and focus groups with clinicians (4 GPs, 5 endocrinologists, and 3 diabetes educators) and 6 people with T2D. Following refinements, 8 GPs participated in mock consultations in which they had access to GlycASSIST. Six people with T2D viewed a similar mock consultation. Participants provided feedback on the functionality of GlycASSIST and its role in supporting shared decision making (SDM) and treatment intensification. Results Clinicians and people with T2D believed that GlycASSIST could support SDM (although this was not always observed in the mock consultations) and individualized treatment intensification. They recommended that GlycASSIST includes less information while maintaining relevance and credibility and using graphs and colors to enhance visual appeal. Maintaining clinical autonomy was important to GPs, as they wanted the capacity to override GlycASSIST’s recommendations when appropriate. Clinicians requested easier screen navigation and greater prescribing guidance and capabilities. Conclusions GlycASSIST was perceived to achieve its purpose of facilitating treatment intensification and was acceptable to people with T2D and GPs. The GlycASSIST prototype is being refined based on these findings to prepare for quantitative evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record

Kunstler¹,

Furler²,

Holmes‐Truscott³

et al. 2020

JMIR Form Res

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Exploring physicians’ continuous use of clinical decision support systems

Abouzahra

Guenter

Tan

2022

European Journal of Information Systems

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Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record (Preprint)

Kunstler¹,

Furler²,

Holmes‐Truscott³

et al. 2020

Preprint

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BACKGROUND Managing type 2 diabetes (T2D) requires progressive lifestyle change and pharmacological treatment intensification. General practitioners (GPs) are integral to this process but can find it challenging due to the complexity of continually emerging treatment options. OBJECTIVE We aimed to use co-design to develop and pretest a prototype clinical decision support tool (Glyc-assist), embedded within the electronic medical record, that uses evidence-based guidelines to provide GPs and people with T2D with recommendations for setting HbA1c targets and intensifying treatment together in real-time in the consultation. METHODS Literature on T2D-related clinical decision support tools informed the initial Glyc-Assist design. A two-part co-design method was then used. Initial feedback was sought via interviews and focus groups with clinicians (four GPs, five endocrinologists, three diabetes educators) and six people with T2D. Following refinements, 8 GPs participated in mock consultations in which they had access to Glyc-Assist. Six people with T2D viewed a similar mock consultation. Participants provided feedback on the functionality of Glyc-Assist, and its role in supporting shared decision making and treatment intensification. RESULTS Clinicians and people with T2D believed Glyc-Assist could support shared decision making, although this was not always observed in the mock consultations, and individualised treatment intensification. They recommended that Glyc-Assist include less information, while keeping relevance and credibility, and use graphs and colours to enhance visual appeal. Maintaining autonomy was important to GPs, so they wanted the capacity to override Glyc-Assist’s recommendations when appropriate. Clinicians requested easier screen navigation, and greater prescribing guidance and capabilities. CONCLUSIONS Glyc-Assist was perceived to achieve its purpose of facilitating treatment intensification and was acceptable to people with T2D and GPs. The Glyc-Assist prototype is being refined based on these findings to prepare for quantitative evaluation. CLINICALTRIAL N/A

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An Exploratory Study of Evidence-Based Clinical Decision Support Systems

Cited by 3 publications

References 16 publications

Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record

Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record

Exploring physicians’ continuous use of clinical decision support systems

Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record (Preprint)

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