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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Clinical decision support must be useful, functional is not enough: a qualitative study of computer-based clinical decision support in primary care

BMC Health Services Research > Ausgabe 1/2012
Tiina Kortteisto, Jorma Komulainen, Marjukka Mäkelä, Ilkka Kunnamo, Minna Kaila
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-349) contains supplementary material, which is available to authorized users.

Competing interests

Authors TK and MM declare that they have no competing interests. JK is Editor-in-chief of Current Care Guidelines, Finnish Medical Society Duodecim, and a member of the editorial board for EBMeDS, Duodecim Medical Publications Ltd. IK is a salaried employee of Duodecim Medical Publications Ltd, the company that develops and licenses the EBMeDS decision support service. MK chairs the Current Care Guidelines board at Finnish Medical Society Duodecim.

Authors’ contributions

All authors were involved in conceiving the study and designing the questionnaire and interview forms. TK was responsible for data collection and analysis. TK led the writing process, supervised by MK, and all authors commented on sequential drafts and approved the final version of the manuscript.



Health information technology, particularly electronic decision support systems, can reduce the existing gap between evidence-based knowledge and health care practice but professionals have to accept and use this information. Evidence is scant on which features influence the use of computer-based clinical decision support (eCDS) in primary care and how different professional groups experience it. Our aim was to describe specific reasons for using or not using eCDS among primary care professionals.


The setting was a Finnish primary health care organization with 48 professionals receiving patient-specific guidance at the point of care. Multiple data (focus groups, questionnaire and spontaneous feedback) were analyzed using deductive content analysis and descriptive statistics.


The content of the guidance is a significant feature of the primary care professional’s intention to use eCDS. The decisive reason for using or not using the eCDS is its perceived usefulness. Functional characteristics such as speed and ease of use are important but alone these are not enough. Specific information technology, professional, patient and environment features can help or hinder the use.


Primary care professionals have to perceive eCDS guidance useful for their work before they use it.
Additional file 1: Patient specific automatic reminders and guideline links on the electronic patient record screen: a patient with diabetes as an example.(PDF 83 KB)
Additional file 2: Patient specific drug interaction alert function on the electronic patient record screen.(PDF 40 KB)
Additional file 3: Virtual health check results within the physician’s appointment schedule.(PDF 121 KB)
Additional file 4: Computer-based Clinical Decision Support: An overview of the Evidence-Based Medicine electronic Decision Support (EBMeDS) architecture and decision support rules (= scripts).(PDF 43 KB)
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