Study: Patients don't like decision-making software

Increased use of computerized clinical decision-support (CDS) systems in conjunction with electronic health records leads to greater patient dissatisfaction and could increase noncompliance with preventive care and treatment recommendations, according to a study in Medical Decision Making (January 2013, Vol. 33:1, pp. 108-118).

Victoria Shaffer, PhD, an assistant professor of health sciences and psychological sciences at the University of Missouri, explained that CDS systems offer several types of decision aids, including alerts about medication errors, suggestions for alternative prescriptions or courses of treatment, ideas for managing chronic diseases, and reminders to discuss vaccinations, screenings, or other preventive care services.

Shaffer found that patients view physicians who use decision aids as less capable than practitioners who make judgments unaided or consult their colleagues. However, patients were less likely to assign physicians responsibility for negative health outcomes when they used CDS systems; therefore, the aids may serve protective functions in litigation, she said.

Physicians concerned about whether using CDS systems will negatively affect their relationships with clients could incorporate the tools to engage patients and help them understand diagnoses and recommendations, she noted.

In particular, patients may be concerned about the impact on their face-to-face time with their physician, Shaffer added. However, practitioners can use the aids as teaching tools to explain their diagnoses using pictures or graphs, which can make the patients' experiences much more interactive and educational.

The researchers' next step is to identify whether educating patients about the benefits of decision aids alleviates their concerns and leads to greater compliance with practitioners' medical advice, Shaffer noted.