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Medical Decision Making
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Patterns of Use of Handheld Clinical Decision Support Tools in the Clinical Setting

Feliciano Yu, MD, MSHI, MSPH

UAB Center for Outcomes and Effectiveness Research and Education (COERE), Birmingham, Alabama, Department of Pediatrics, UAB Health Services and Outcomes Research Training Program, Birmingham, Alabama, fyu{at}peds.uab.edu

Thomas K. Houston, MD, MPH

UAB Center for Outcomes and Effectiveness Research and Education (COERE), Birmingham, Alabama, Department of Medicine, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, Deep South Center on Effectiveness Research, Birmingham, Alabama

Midge N. Ray, RN, MSN

UAB Center for Outcomes and Effectiveness Research and Education (COERE), Birmingham, Alabama, Department of Health Services Administration University of Alabama at Birmingham

Duriel Q. Garner

Department of Health Services Administration University of Alabama at Birmingham

Eta S. Berner, EdD

UAB Center for Outcomes and Effectiveness Research and Education (COERE), Birmingham, Alabama, Department of Health Services Administration University of Alabama at Birmingham

Objectives. To assess the patterns of use of handheld clinical decision support tools by internal medicine residents in clinical settings. Methods. Eighty-two internal medicine residents were given personal digital assistants (PDAs) containing a suite of clinical decision support (CDS) programs. A tracking program was used to prospectively track program use during the study period, and a follow-up survey regarding self-reported program use was administered after the study period. Patterns of program use from the tracking data were compared to the data from the self-report survey. Results. Sixty-eight residents were followed using the tracking data. Residents used an average of 1.81 CDS programs (SD: 1.57; range, 0—5) per month. Forty-nine residents completed the self-report survey. Residents reported using an average of 3.15 (SD: 1.61) and 3.92 (SD: 1.40) CDS programs during a typical clinic session and inpatient day, respectively. In both inpatient and outpatient settings and for both methods of assessing program use, 2 programs (Epocrates and MedCalc) were used more often than the other programs. No association was observed between age, gender, race, and PGY level with the use of handheld clinical decision support tools for either tracked or self-report data. The self-report data show higher estimates of CDS program use than the tracking data in the clinical setting. Conclusions. The data show that physicians prefer to use certain handheld CDS tools in clinical settings. Drug references and medical calculators have been consistently used more than clinical prediction rules and diagnostic systems. Self-report survey instruments may overestimate recorded use of CDS programs.

Key Words: decision support systems • clinical • computers • handheld • decision making • computer assisted • internal medicine.

References

This version was published on December 1, 2007

Medical Decision Making, Vol. 27, No. 6, 744-753 (2007)
DOI: 10.1177/0272989X07305321
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This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Yu, F.
Right arrow Articles by Berner, E. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Yu, F.
Right arrow Articles by Berner, E. S.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?