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Table 4 Barriers in using CDSSs as experienced by physicians and nurses

From: User perspectives on an electronic decision-support tool performing comprehensive medication reviews - a focus group study with 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