OP196 Clinical Decision Support Systems (CDSS) For Antibiotic Management: Factors Limiting Sustainable Digital Transformation

Introduction Clinical decision support systems (CDSS) are being developed to evidence-based antibiotic prescribing and reduce the risk of inappropriate or over-prescribing; however, adoption CDSS into health system is rarely sustained. We aimed understand implementation challenges at a macro (policymakers), meso (organizational) micro-level (individual practices) identify drivers non-adoption. Methods have adopted mixed-method study design which comprised of: (i) systematic review meta-analysis assess impact on appropriate prescribing, (ii) Online survey clinicians in Australia from hospitals primary care (iii) in-depth interviews with policymakers evaluate policy-level opportunities implementation. Results can improve compliance guidelines, relative decrease mortality, volume use length hospital stay. However, provision alone not enough achieve these benefits. Important predictors clinicians’ perception regarding include seniority clinical end-users (years), CDSS, setting. Clinicians those significant experience less likely due lack trust system, fear comprising professional autonomy, patients’ expectations. Lack important policy considerations for integration multi-stakeholder healthcare has limited organizational capacity foster change align processes innovation. Conclusions These results using multiple lines evidence highlight importance holistic approach when undertaking technology management. There needs be system-wide guidance that integrates individual, system-level factors implementing so effective stewardship facilitated.