Barriere e facilitatori all'implementazione dei sistemi di supporto decisionale computerizzati in ospedale: Uno studio "grounded theory"

Translated title of the contribution: Barriers and facilitators to the implementation of computerized decision support systems in italian hospitals: A grounded theory study

Elisa Giulia Liberati, Laura Galuppo, Mara Gorli, Marco Maraldi, Francesca Ruggiero, Matteo Capobussi, Rita Banzi, Koren Kwag, Giuseppe Scaratti, Oriana Nanni, Pietro Ruggieri, Hernan Polo Friz, Claudio Cimminiello, Marco Bosio, Massimo Mangia, Lorenzo Moja

Research output: Contribution to journalArticle

Abstract

Introduction: Computerized Decision Support Systems (CDSSs) connect health care professionals with high-quality, evidence-based information at the point-ofcare to guide clinical decision-making. Current research shows the potential of CDSSs to improve the efficiency and quality of patient care. The mere provision of the technology, however, does not guarantee its uptake.This qualitative study aims to explore the barriers and facilitators to the use of CDSSs as identified by health providers. Methods: The study was performed in three Italian hospitals, each characterized by a different level of familiarity with the CDSS technology. We interviewed frontline physicians, nurses, information technology staff, and members of the hospital board of directors (n=24). A grounded theory approach informed our sampling criteria as well as the data collection and analysis. Results: The adoption of CDSSs by health care professionals can be represented as a process that consists of six "positionings," each corresponding to an individual's use and perceived mastery of the technology. In conditions of low mastery, the CDSS is perceived as an object of threat, an unfamiliar tool that is difficult to control. On the other hand, individuals in conditions of high mastery view the CDSS as a helpful tool that can be locally adapted and integrated with clinicians' competences to fulfil their needs. In the frst positionings, the uptake of CDSSs is hindered by representational obstacles. The last positionings, alternatively, featured technical obstacles to CDSS uptake. Discussion: Our model of CDSS adoption can guide hospital administrators interested in the future integration of CDSSs to evaluate their organizational contexts, identify potential challenges to the implementation of the technology, and develop an effective strategy to address them. Our findings also allow reflections concerning the misalignment between most Italian hospitals and the current innovation trends toward the uptake of computerized decision support technologies.

Translated title of the contributionBarriers and facilitators to the implementation of computerized decision support systems in italian hospitals: A grounded theory study
Original languageItalian
Pages (from-to)180-191
Number of pages12
JournalRecenti Progressi in Medicina
Volume106
Issue number4
Publication statusPublished - Apr 1 2015

ASJC Scopus subject areas

  • Medicine(all)

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    Liberati, E. G., Galuppo, L., Gorli, M., Maraldi, M., Ruggiero, F., Capobussi, M., Banzi, R., Kwag, K., Scaratti, G., Nanni, O., Ruggieri, P., Friz, H. P., Cimminiello, C., Bosio, M., Mangia, M., & Moja, L. (2015). Barriere e facilitatori all'implementazione dei sistemi di supporto decisionale computerizzati in ospedale: Uno studio "grounded theory". Recenti Progressi in Medicina, 106(4), 180-191.