MP13-11 EHR-BASED CLINICAL DECISION SUPPORT FOR UROLOGIC SURGERY: USER PERSPECTIVES AND NEEDS

You have accessJournal of UrologyCME1 May 2022MP13-11 EHR-BASED CLINICAL DECISION SUPPORT FOR UROLOGIC SURGERY: USER PERSPECTIVES AND NEEDS Hung-Jui Tan, Brooke Spratte, Allison Deal, Antonia Bennett, Susan Blalock, Arlene Chung, David Gotz, Matthew Nielsen, Dan Reuland, Alex Sox-Harris, and Ethan Basch Hung-Jui TanHung-Jui Tan More articles by this author , Brooke SpratteBrooke Spratte More articles by this author , Allison DealAllison Deal More articles by this author , Antonia BennettAntonia Bennett More articles by this author , Susan BlalockSusan Blalock More articles by this author , Arlene ChungArlene Chung More articles by this author , David GotzDavid Gotz More articles by this author , Matthew NielsenMatthew Nielsen More articles by this author , Dan ReulandDan Reuland More articles by this author , Alex Sox-HarrisAlex Sox-Harris More articles by this author , and Ethan BaschEthan Basch More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002542.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Surgeon decision-making is a key driver of care variation and quality. Despite prior work developing and validating risk prediction tools, uptake in clinical practice remains limited. With broad adoption of electronic health records (EHRs), EHR-based clinical decision support (CDS) offers a potential path forward towards broader uptake. In this context, we assessed urologist attitudes toward EHR-based CDS and explored user preferences and needs. METHODS: We performed an exploratory sequential mixed methods study. Through the 2019 AUA Census survey, we elicited urologist perspectives on the automated calculation and display of validated information on surgical risk and benefits within the EHR at the point-of-care. Next, we interviewed 25 respondents on the potential impact, design preferences, and implementation needs. Bivariable, multivariable, and coding-based thematic analyses were applied, and findings were integrated. RESULTS: Among a weighted sample of 12,366 urologists, 8,767 (70.9%, CI 68.7-73.2%) agreed that the proposed CDS would help decision-making, 78.5% (CI 76.5-80.5%) agreed it would aid patient counseling, 58.1% (CI 55.7-60.5%) agreed it would save time, and 42.9% (CI 40.5-45.4%) agreed it would improve patient outcomes (Figure). In a multivariable analysis, experience level emerged as the key determinant across all four survey items, with more clinical experience associated with less positive attitudes (p<0.001). Qualitatively, urologists described multiple ways CDS could help across each domain (Figure). Urologists also offered design features to facilitate ease of use (e.g, automation, prominent location in the EHR, interoperability, familiarity) and usefulness (e.g., customization, patient-facing options, ability to adjust and see outcomes of different choices) as well as implementation strategies to promote uptake (e.g., physician champion, minimal cost, technical support). CONCLUSIONS: Despite the limited impact of risk prediction tools in current practice, urologists expressed favorable attitudes toward the prospect of automating and embedding these tools in the EHR, particularly for supporting decision-making and patient counseling. Based on urologist preferences and needs, user-centered design may increase CDS viability and impact. Models will be developed and tested based on this feedback. Source of Funding: This work is funded by the Mentored Research Scholar Grant in Applied and Clinical Research, MRSG-18-193-01-CPPB, from the American Cancer Society © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e225 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hung-Jui Tan More articles by this author Brooke Spratte More articles by this author Allison Deal More articles by this author Antonia Bennett More articles by this author Susan Blalock More articles by this author Arlene Chung More articles by this author David Gotz More articles by this author Matthew Nielsen More articles by this author Dan Reuland More articles by this author Alex Sox-Harris More articles by this author Ethan Basch More articles by this author Expand All Advertisement PDF downloadLoading ...