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Table 3 Number and percentage of GPs and PNs that perceive barriers to using NHGDoc

From: Exposure to and experiences with a computerized decision support intervention in primary care: results from a process evaluation

 

GPs (N = 112) N (%)

N of valid responses

PN (n = 52) N (%)

N of valid responses

Knowledge-related barriers

 Knowledge of existence of NHGDoc

2 (2 %)

111

9 (18 %)

50

  Knowledge of basic functions

   Alerts

1 (1 %)

109

0 (0 %)

40

   Feedback

45 (41 %)

109

22 (55 %)

40

  Knowledge of personalization functions

   My NHGDoc

34 (31 %)

109

16 (40 %)

40

   Alerts settings

50 (46 %)

109

26 (65 %)

40

   Reporting settings

56 (51 %)

109

28 (70 %)

40

Barriers related to the evaluation of the features of the CDSS

 Source and content of the CDSS

  Reliability of the source of the content

4 (4 %)

104

0 (0 %)

37

  Currentness of the content

11 (11 %)

101

6 (16 %)

37

  Relevance of the alert content for individual users, with varying needs across time

57 (58 %)

98

24 (62 %)

39

  Relevance of the alert content for different user groups

13 (13 %)

99

4 (11 %)

38

 Format/lay out of the CDSS content

    

  Notification method of alerts (too intrusive)

7 (7 %)

105

1 (3 %)

38

  Notification method of alerts (uninformative)

17 (17 %)

100

4 (11 %)

37

  Readability of the alert text (too wordy/verbose)

15 (15 %)

98

2 (5 %)

38

 Functionality of the CDSS

  Responsiveness of the system (retrieval of an alert takes too long)

32 (33 %)

98

14 (38 %)

37

  Intensity of alerts (low threshold for triggering alerts)

39 (40 %)

98

12 (32 %)

38

  Flexibility (lack of adjustability to personal preferences)

16 (18 %)

90

7 (23 %)

30

  Learning capacity of the system (only fixed rules are used)

84 (80 %)

105

27 (75 %)

36

External barriers interacting with the CDSS

 Patient-related factors

  Doctor-patient communication (too much time spent on the computer during consultation)

26 (26 %)

101

8 (22 %)

37

  Relevance of alert content for patient (discrepancy between patient’s reason for visit and alert content)

5 (5 %)

100

3 (8 %)

37

 Environmental factors

  Limited time available (during and after consultation)

61 (60 %)

101

6 (16 %)

37

  Too much additional work required (during and after consultation)

61 (60 %)

100

10 (27 %)

37

  Lack of integration with other systems (no direct links to follow-up actions)

25 (27 %)

93

7 (21 %)

34

  Fear for misuse of data (patient data and medical practice) by third parties (i.e. health insurers)

11 (11 %)

104

3 (8 %)

36