Barriers to Using Clinical Decision Support in Ambulatory Care: Do Clinics in Health Systems Fare Better?

Authors: Yunfeng Shi, Alejandro Amill-Rosario, Robert S. Rudin, Shira H. Fischer, Paul Shekelle, Dennis P. Scanlon, Cheryl L. Damberg

The existing literature provides little empirical understanding of barriers to using clinical decision support (CDS) in the ambulatory care setting. Using data from 821 clinics in 117 medical groups, based on Minnesota Community Measurement’s annual Health Information Technology Survey (2014-2016), the authors examined 7 CDS tools and 7 barriers in 3 areas (resource, user acceptance, and technology).

The study found that health system affiliated clinics used more CDS tools than those not in systems, but they also reported more barriers related to resources and user acceptance. The results indicated that health systems, while being effective in promoting CDS tools, may need to provide more assistance to their affiliated ambulatory clinics to overcome barriers, especially for the requirement to redesign workflow and more resources for training in rural clinics.

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