General practitioners’ needs and wishes for a clinical decision support system

Published on January 19, 2023 – A Clinical Decision Support System (CDSS) can be of great value for facilitating shared decision making in primary care. Our focus group study investigated the needs and wishes of general practitioners (GPs) for a CDSS in the context of fall prevention. The findings provide a useful overview of GPs’ needs and wishes for a CDSS used to diminish the medication-related fall risk. 

Shared decision making is valuable for the overall healthcare quality, but is often not applied optimally in practice. This has also been problematic in the context of older patients’ medication related fall risk. Within the NWO-funded project SNOWDROP, ACHC members Leonie Westerbeek, Annemiek Linn and Julia van Weert, together with their colleagues from the AmsterdamUMC, aim to develop a CDSS that facilitates shared decision making in the context of medication-related fall prevention in primary care.

Implementing decision support in primary care is challenging as there is a high variety in patients and workflows. Therefore, understanding user needs when developing the CDSS is of great importance. Within this project, a user-centered design approach is applied, meaning end users are involved in the design and development process of the system. For this study, focus groups with GPs were conducted to understand their needs, wishes and expectations for this CDSS. During the focus groups, important themes such as the GPs’ workflow were discussed. GPs highlighted that a big challenge is to develop the system in such a way that its usage can fit into the different workflows of different practices. GPs also articulated a strong preference of a visual presentation of the patient’s fall risk, and presentation of advice on request.

The findings of this study have been used to develop a first prototype of the SNOWDROP CDSS, and can also be used to support the development of medication-related CDSSs in a broader context. The needs and wishes of older patients with regard to this intervention, and an associated patient portal were assessed in a separate interview study.

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