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Evaluating provider experience with clinic decision support to improve HIV testing recommendations implementation
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Tailor, Amrita. Evaluating provider experience with clinic decision support to improve HIV testing recommendations implementation. Retrieved from https://doi.org/doi:10.7282/t3-b7fk-tt46

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TitleEvaluating provider experience with clinic decision support to improve HIV testing recommendations implementation
NameTailor, Amrita (author); Parrott, James (chair); Rothpletz-Puglia, Pamela (member); Mishra, Ninad (member); Nelson, John (member); Rutgers University; School of Health Professions
Date Created2023
Other Date2023-08 (degree)
SubjectHealth sciences, Clinic decision support, Clinical informatics, Electronic medical record, Evaluation, Guidelines implementation, HIV testing
Extent239 pages : illustrations
DescriptionBackground: Centers for Disease Control and Prevention (CDC) estimated that almost one-third of human immunodeficiency virus (HIV) transmissions stem from people who were unaware of their HIV infection. However, HIV testing as recommended has been sub-optimal. Clinic decision support systems (CDSS) can integrate testing into routine care and improve HIV testing rates, however its implementation is less understood. This project aims to identify factors influencing HIV testing CDSS use and implementation. Methods: An explanatory sequential mixed methods design that integrated the Human-Organization-Technology fit (HOT-fit) framework within a 21-question survey and interview methods. Descriptive statistics, chi square test, fishers exact test, and direct content analysis methods were used to analyze data. Participants of the survey and interview were recruited from multiple networks with access to providers in located in high HIV burden areas.
Results: There were 36 survey respondents and 10 interview participants. Respondents reported an overall positive response bias towards using CDSS. Survey analysis identified type of CDSS (stepwise protocol, clinical encounter documentation forms, general link to current testing recommendations) was significantly associated with provider perceptions about CDSS. Interview analysis reflected organizational factors had the largest role in CDSS implementation, followed by human then technology factors. Theoretical propositions to characterize complex relationships between the human, organization, and technology were identified, including new relationships absent from the HOT-fit framework.
Discussion: Developing, implementing, or using an HIV testing CDSS is not a straightforward process. The findings revealed that before engaging in the CDSS implementation, it is important to assess the need for the CDSS, available financial and human resources, the organizational environment, type of interorganizational relationship, and suitable CDSS format(s). During the implementation, it is important to diagnose problem areas (e.g., provider lack of knowledge about HIV) and identify appropriate treatment options (e.g., training). It is important to monitor and evaluate the progress of normalizing the HIV testing CDSS usage in that organization and its clinical impact (e.g., high clinical efficiency).
Conclusion: By understanding the existing system and mapping the desired system, organizations can outline a thoughtful plan using the findings from this research.
NotePh.D.
NoteIncludes bibliographical references
Genretheses
Persistent URLhttps://doi.org/doi:10.7282/t3-b7fk-tt46
LanguageEnglish
CollectionSchool of Health Professions ETD Collection
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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