Identifying barriers to implementing a cardiovascular computerised decision support system (CDSS): a Delphi survey.

Abstract

PURPOSE: This paper reports an evaluation of stakeholders' perspectives and recommendations for the dissemination of a cardiovascular computerised decision support system (CDSS) program. METHODS: A literature review of dissemination models for health information and decision support aids was undertaken to develop a semi-structured interview protocol outlining a range of dissemination models for distribution. A cross section of eight health professionals and three corporate managers were interviewed to provide as broad a view as possible of eight dissemination models. Data were collected via two questionnaires incorporating the Delphi technique. Perspectives from the corporate managers were collected by telephone interview. RESULTS: Financial incentive was the most highly rated dissemination method, followed by joint promotion with a professional body and undergraduate medical education. The lowest average rating was for dividing the program into separate components. Participants provided five other suggestions for dissemination. Suggestions for further exploration include the development of a multi-professional model comprising two or more approaches that is piloted and evaluated. CONCLUSION: Our results provide beneficial information on the potential dissemination of computer decision support systems to health professionals whose uptake of CDSS has not previously been explored. Whether use of a shared decision aid impacts on the decisions made by health professionals working in a team is, however, less evident.