Concordance, Decision Impact, And Satisfaction For A Computerized Clinical Decision Support System In The Treatment Of Lung Cancer Patients
K A. Lee1, Winnie A. Felix2, Gretchen P. Jackson3.
1Jupiter Medical Center, Jupiter, FL, USA, 2IBM Watson Health, Cambridge, MA, USA, 3Vanderbilt University Medical Center, nashville, TN, USA.
Background Treatment options for lung cancer patients are evolving rapidly. A clinical decision support system (CDSS) that provides first-line treatment recommendations for cancer patients was adopted at Jupiter Medical Center, a private, non-profit hospital in the southeastern United States on March 1, 2017. This pilot study examined system performance and its impact on patients and providers. Methods Lung cancer cases processed in the CDSS between October 2017 and November 2018 were included. CDSS results were viewed by providers, discussed in tumor board, and shared with the patients in clinic. Nurse navigators administered a survey about CDS impact and user satisfaction to clinician and patient users at completion of visits. Summary statistics of survey responses were calculated. Results Thirty cases were processed by the CDSS; 23 surveys were completed. Table 1 summarizes patient characteristics and survey results. The treatment team agreed completely with CDSS recommendations for 18 cases (78.3%) and partially for 4 (17.4%). Clinicians reported that the CDSS impacted the treatment decision in 9 (39.1%) cases and saved time in treatment planning for 17 (73.9%). The CDSS confirmed the treatment plan for 16 cases (69.6%), recommended an option that was selected for 5 (21.7%), and presented a useful option that was not chosen for 1 (4.3%). For most cases, clinicians reported they were pleased with the CDSS results (n=22; 95.7%), found the system easy to use (n=21; 91.3%), and would use it again (n=22; 95.7%). For most cases, clinicians responded that they strongly agreed or agreed that the CDSS provided information that was relevant (n=22, 95.7%), easy to understand (n=21, 95.6%), and actionable (n=21, 95.6%). Most patients responded that they were pleased with the CDSS analysis of their treatment plan (n=19; 82.6%) and would want their provider to use the system in the future (n=19; 82.6%). Conclusions This study provides preliminary evidence that a CDSS can positively support and influence the care of lung cancer patients. Treatment teams agreed with CDSS recommendations in most cases, and the CDSS impacted treatment decisions. Providers and patients were satisfied with the CDSS and reported being willing to use it again.
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