Patients view docs using CDS tools as less capable

Physicians who use their EHR's clinical decision support tools are viewed more negatively by patients, according to a study published January in Medical Decision Making.

Researchers from the University of Missouri in Columbia, Mo., conducted three separate tests to test patient perceptions of physician clinical decision support tool use. According to their findings, patients viewed physicians who used the tools as less capable than those who made judgments without the computerized tool or who chose to consult a colleague. The patients whose physicians used the tools were more dissatisfied and may be more likely not to comply with treatment recommendations.

Researchers attributed the findings to patients' objection to impersonal technology and loss of face-to-face time, or their generally distrust of computing systems in place of clinical judgment. 

Interestingly, patients also were less likely to hold physicians responsible for negative health outcomes when the physicians used a clinical decision support tool.

Studies have shown that well-designed, targeted clinical decision support can improve outcomes, but that the tools can be difficult to use and incorporate into providers' workflow.

"Given the effectiveness of [clinical decision support systems], it is important to improve patient attitudes toward their use in the hopes that the decision support features of EMRs will be used more frequently," the authors wrote.

“Patients who desire to control their health outcomes are much less comfortable with health care practitioners’ use of technology,” said the study's lead author Victoria A. Shaffer, PhD, assistant professor in the department of health sciences in the University of Missouri School of Health Professions. “Anything physicians or nurses can do to humanize the process may make patients more comfortable.”