Human Factors Barriers to the Effective Use of Ten HIV Clinical Reminders
Open accessAbstract
OBJECTIVE: Substantial variations in adherence to guidelines for human immunodeficiency virus (HIV) care have been documented. To evaluate their effectiveness in improving quality of care, ten computerized clinical reminders (CRs) were implemented at two pilot and eight study sites. The aim of this study was to identify human factors barriers to the use of these CRs. DESIGN: Observational study was conducted of CRs in use at eight outpatient clinics for one day each and semistructured interviews were conducted with physicians, pharmacists, nurses, and case managers. MEASUREMENTS: Detailed handwritten field notes of interpretations and actions using the CRs and responses to interview questions were used for measurement. RESULTS: Barriers present at more than one site were (1) workload during patient visits (8 of 8 sites), (2) time to document when a CR was not clinically relevant (8 of 8 sites), (3) inapplicability of the CR due to context-specific reasons (9 of 26 patients), (4) limited training on how to use the CR software for rotating staff (5 of 8 sites) and permanent staff (3 of 8 sites), (5) perceived reduction of quality of provider-patient interaction (3 of 23 permanent staff), and (6) the decision to use paper forms to enable review of resident physician orders prior to order entry (2 of 8 sites). CONCLUSION: Six human factors barriers to the use of HIV CRs were identified. Reducing these barriers has the potential to increase use of the CRs and thereby improve the quality of HIV care.
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Seventeen prioritized short- and long-term recommendations were produced to improve the usefulness and usability of the nine reminders.
“Seventeen prioritized short-and long-term recommendations were generated to improve the usefulness and usability of the 9 reminders.59”
From The role of formative evaluation in implementation research and the QUERI experience (2006) · cites this paper as [59]
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References 22 · Cited by 115
Research works printed but not linked: 4
- Asch S, McCutchan A, Gifford A, et al. Underuse of primary prophylaxis for mycobacterium avium complex (MAC) in a representative sample of HIV-infected patients in care in the U.S.A: who is missing out? Presented at the World AIDS Conference, June 1998.
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- Sarter N, Woods DD, Billings CE. Automation Surprises. In: Salvendy G, (ed). Human Factors/Ergonomics (ed 2). New York: Wiley; 1997.
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- Authors
- Patterson, E. S., Nguyen, A. D., Halloran, J. P., & Asch, S. M.
- Affiliations
- VA West Los Angeles Medical Center (US)
- Corresponding author
- Patterson, Emily S.
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-01
- Volume
- 11
- Issue
- 1
- Pages
- 50-59
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC305458
- OpenAlex
- W1597117152
- Cited by
- 115
- References
- 22
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 1 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 7 · 2014: 3 · 2013: 6 · 2012: 4
- FWCI
- 19.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs (HIS 99-042)
- Health Services Research and Development (HIS 99-042)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- HIV care, clinical decision support, guideline adherence, quality of care, physician workload, employee training, provider-patient interaction, outpatient clinics
- MeSH terms
- Attitude of Health Personnel, Computer User Training, Humans, Professional-Patient Relations, Psychology, Applied, Software, HIV Infections, Medical Records Systems, Computerized, Workload, Reminder Systems, Practice Guidelines as Topic, Guideline Adherence
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