Table 4 Barriers in using CDSSs as experienced by physicians and nurses
Original text fragment | Code |
|---|---|
Physicians | |
‘I get too many reminders for some of my patients…some of them have to be eliminated’ | too many reminders |
‘The EHR allows me to exit the system without documenting a diagnosis for an encounter’ | lack of diagnoses |
‘At the hospital they don’t record diagnoses in the structured way into (our common) EHR’ | lack of common practice in documentation in different sectors of the health care system |
‘I have noticed that medication is not up to date in the EHR. Patients get prescriptions also from the private sector…it’s difficult to know the real medication…’ | medication not updated |
‘the CDSS reminded me to drop the dosing of metformin (renal insufficiency) by 25 %, but I had reduced the dose already to the minimum…’ | wrong reminders |
Nurses | |
‘We are not allowed to put diagnoses in the EHR…it’s doctor’s job…’ | rules preventing effective documentation |
‘It takes 15-20 minutes for a doctor to go through the diagnoses of one patient…who makes it and when?’ | checking up of diagnoses is time-consuming |
‘I saw medication that was paused medication yet triggered reminders…’ | reminders launched by paused medication |
‘Self-monitoring values were documented in the free text…’ ‘We wondered why we got a reminder to measure blood pressure…’ | lack of practice in documenting within the structured form in the EHR |