Table 6 Examples of perceived barriers related to the functionality of the CDSS

     -     Responsiveness of the system (loading of an alert takes too long)

          •     “I gave up rather quickly because the loading of an alert took way too long”.

     -     Intensity of alerts (low threshold for triggering)

          •     “So it shouldn't be too much, not like ten alerts per patient right? Then you’ll get a little over-alerted right? Enough is as good as a feast!”.

          •     “… did you check kidney function, liver function…? At a certain point you’ll get overloaded with information that is actually quite straightforward…. 25 yellow [an alert] out of the last 50 patients....”.

     -     Lack of adjustability to personal preferences

          •     “The customization options are still rather limited. You should be able to turn off specific types of advices, for instance the ‘give up-smoking-alerts’ rather than all life style advices at ones”.

          •     “I wanna be able to set the threshold myself, so not all at 40 for blood pressure, for example”.

     -     Lack of learning capacity of the system

          •     “This almost asks for a system that can be overruled. You don’t want the computer stupidly, not intuitively, to state the same thing over and over again. In practice, that will result in overriding alerts. The system should cooperate with how people think”.