Understanding primary care providers’ perceptions of cancer prevention and screening in a predominantly rural healthcare system in the upper Midwest

Saman, Daniel M.; Walton, Kayla M.; Harry, Melissa L.; Asche, Stephen E.; Truitt, Anjali R.; Henzler-Buckingham, Hillary A.; Allen, Clayton I.; Ekström, Heidi; O’Connor, Patrick J.; Sperl-Hillen, JoAnn M.; Ziegenfuss, Jeanette Y.; Bianco, Joseph A.; Elliott, Thomas E.

doi:10.1186/s12913-019-4872-9

Cited by 15 publications

(43 citation statements)

References 24 publications

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“…The 75 non-review, non-opinion articles used a variety of metrics to evaluate the usability and acceptability of their CDS tools, with many using more than one metric. The most common evaluation was via interviews (n=29) 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 , followed by surveys or questionnaires (n=16) 27 29 50 53 55 56 57 58 59 60 61 62 63 64 65 66 . Other qualitative feedback responses were obtained by focus groups or workshops (n=5) 43 57 61 67 68 .…”

Section: Resultsmentioning

confidence: 99%

“…A strength of this study is that it included a wide array of healthcare professionals’ experiences including physicians 37 62 , advanced practice providers 17 18 63 , nurses 90 92 , pharmacists 29 33 , midwives 38 , and paramedics 59 . We also surveyed a heterogenous mix of publication types including systematic reviews, randomized trials, quality improvement initiatives, and opinion pieces.…”

Section: Discussionmentioning

confidence: 99%

“…Usability was measured directly in several studies, including by observation or tracking of eye movements, click counts, and use errors. Interestingly, users sometimes had differing opinions on design elements [63,64].…”

Section: Make It Easy -Workflow Efficiency and Integrationmentioning

confidence: 99%

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Clinical Decision Support and Implications for the Clinician Burnout Crisis

Janković

Chen

2020

Yearb Med Inform

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Objectives: This survey aimed to review aspects of clinical decision support (CDS) that contribute to burnout and identify key themes for improving the acceptability of CDS to clinicians, with the goal of decreasing said burnout. Methods: We performed a survey of relevant articles from 2018-2019 addressing CDS and aspects of clinician burnout from PubMed and Web of Science™. Themes were manually extracted from publications that met inclusion criteria. Results: Eighty-nine articles met inclusion criteria, including 12 review articles. Review articles were either prescriptive, describing how CDS should work, or analytic, describing how current CDS tools are deployed. The non-review articles largely demonstrated poor relevance and acceptability of current tools, and few studies showed benefits in terms of efficiency or patient outcomes from implemented CDS. Encouragingly, multiple studies highlighted steps that succeeded in improving both acceptability and relevance of CDS. Conclusions: CDS can contribute to clinician frustration and burnout. Using the techniques of improving relevance, soliciting feedback, customization, measurement of outcomes and metrics, and iteration, the effects of CDS on burnout can be ameliorated.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical Decision Support and Implications for the Clinician Burnout Crisis

Janković

Chen

2020

Yearb Med Inform

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“…CDSS tools provide a layer of patient safety to reduce medical errors and improve patient outcomes. 30,[34][35][36] Previous studies have presented benefits of CDSS alerts within the EMR to facilitate ordering of preventive care, including cancer screening procedures. 37,38 Benefits of CDSS include workflow efficiency, patient safety, cost effectiveness, and system replication.…”

Section: Clinical Decision Support Systemsmentioning

confidence: 99%

“…[41][42][43] There is little known about provider perspective or user acceptance in relationship to CDSS use in primary care. 33,36,44,45 The objective of this study was to investigate PCP perceptions of utilizing CDSS alerts in the EMR to promote increasing screening rates for breast cancer, cervical cancer, and colorectal cancer.…”

Section: Clinical Decision Support Systemsmentioning

confidence: 99%

Understanding User Acceptance of Clinical Decision Support Systems to Promote Increased Cancer Screening Rates in a Primary Care Practice

Kelsey

Njeru

Chaudhry

et al. 2020

J Prim Care Community Health

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Objective: Clinical decision support systems (CDDSs) in the electronic medical record (EMR) have been implemented in primary care settings to identify patients due for cancer screening tests, while functioning as a real time reminder system. There is little known about primary care providers (PCPs) perspective or user acceptance of CDSS. The purpose of this study was to investigate primary care provider perceptions of utilizing CDSS alerts in the EMR to promote increased screening rates for breast cancer, cervical cancer, and colorectal cancer. Methods: An electronic survey was administered to PCPs in a Midwest Health Institution community internal medicine practice from September 25, 2019 through November 27, 2019. Results: Among 37 participants (9 NP/Pas and 28 MD/DOs), the NP/PA group was more likely to agree that alerts were helpful (50%; P-value = .0335) and the number of alerts (89%; P = .0227) in the EMR was appropriate. The NP/PA group also was more likely to find alerts straightforward to use (78%, P = .0239). Both groups agreed about feeling comfortable using the health maintenance alerts ( MD/DO = 79%; NP/PA = 100%). Conclusion: CDSSs can promote and facilitate ordering of cancer screening tests. The use of technology can promptly identify patients due for a test and act as a reminder to the PCP. PCPs identify these alerts to be a beneficial tool in the EMR when they do not interrupt workflow and provide value to patient care. More work is needed to identify factors that could optimize alerts to be even more helpful, particularly to MD/DO groups.

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Implementation strategies preferred by primary care clinicians to facilitate cancer prevention and control activities

et al. 2023

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Key clinical and community members need to be involved in the identification of feasible and impactful implementation strategies for translation of evidence-based interventions into practice. While a wide range of implementation strategies has been developed, there is little research on their applicability for cancer prevention and control (CPC) efforts in primary care. We conducted a survey of primary care physicians to identify implementation strategies they perceive as most feasible and impactful. The survey included both primary prevention behavior change counseling and cancer screening issues. Analyses contrasted ratings of feasibility and impact of nine implementation strategies, and among clinicians in different settings with a focus on comparisons between clinicians in rural vs. non-rural settings. We recruited a convenience sample of 326 respondents from a wide range of practice types from four practice-based research networks in 49 states and including 177 clinicians in rural settings. Ratings of impact were somewhat higher than those for feasibility. Few of the nine implementation strategies were high on both impact and feasibility. Only ‘adapting to my practice’ was rated higher than a 4 (“moderate”) on both impact and feasibility. There were relatively few differences between rural and non-rural clinicians or associated with other clinician or setting characteristics. There is considerable variability in perceived impact and feasibility of implementation strategies for CPC activities among family medicine clinicians. It is important to assess both feasibility and impact of implementation strategies as well as their generalizability across settings. Our results suggest that optimal strategies to implement evidence-based CPC activities will likely need to be adapted for primary care settings. Future research is needed to replicate these findings and identify practical, implementation partner informed implementation strategies.

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Understanding primary care providers’ perceptions of cancer prevention and screening in a predominantly rural healthcare system in the upper Midwest

Cited by 15 publications

References 24 publications

Clinical Decision Support and Implications for the Clinician Burnout Crisis

Clinical Decision Support and Implications for the Clinician Burnout Crisis

Understanding User Acceptance of Clinical Decision Support Systems to Promote Increased Cancer Screening Rates in a Primary Care Practice

Implementation strategies preferred by primary care clinicians to facilitate cancer prevention and control activities

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