Barriers and Facilitators to Adoption of a Web-based Antibiotic Decision Support System

OBJECTIVE To measure clinicians' perceptions of barriers and facilitators to the adoption of a Computerised Decision Support System (CDSS) for antibiotic approval, and to examine the correlation between these perceptions and actual usage of the system by clinicians. METHODS This study was conducted in a tertiary care university hospital of Melbourne, Australia. A survey tool comprising of demographic items and newly developed scales to measure clinicians' perceptions of barriers and facilitators to use of an CDSS was developed. Cross-sectional mail surveys were sent to 250 Junior and Senior Medical Staff and Pharmacists in a tertiary care hospital. Cronbach's alpha was used to measure the reliability of the perceptions scales. One way ANOVA was used to assess the differences between participants' responses; Tamhane's test was used for post-hoc analysis. Pearson correlations were used to measure the relationship between the participants' scores on the scales and their actual use of the CDSS under study. RESULTS The overall survey response rate was 54%. Cronbach's alpha for the perceived barrier and facilitator scales were 0.80 and 0.88, respectively. Senior medical staff perceived significantly more barriers than junior medical staff and pharmacists. Statistically significant differences were observed between the scores of the participants on a number of items on the perceived barriers and facilitators scales. Negative correlations were observed between the participants' scores on the perceived barriers scale and their use of the system. (r= -0.415, p= 0.001). CONCLUSIONS The scales to measure perceived barriers and facilitators to adopt antibiotic CDSS have shown acceptable reliability and validity measures. Important differences exist between senior and junior medical staff about the barriers and facilitators to adopting the CDSS which may influence future use by clinicians.