Sittig et al surveyed clinicians about their acceptance of alerts from a clinical decision support system (CDSS). Clinicians may perceive the CDSS as beneficial even when the majority of suggestions made by the CDSS were not explicitly followed. The authors are from Northwest Permanente PC, Kaiser Permanente, and Oregon Health & Science University in Portland, Oregon.


A clinician was more likely to accept an alert if:

(1) the patient was older than 65 years of age

(2) the patient had 6 or more comorbid conditions

(3) the patient was receiving 6 or more medications

(4) the clinician had time available


A clinician was less likely to accept an alert if:

(1) the clinician was managing a patient with an acute problem or emergency

(2) the clinician was behind schedule

(3) the alert comes up at the wrong time in the work flow

(4) the alert was based on information that was not up to date (like current medications)


An alert needs to be perceived as:

(1) beneficial to patient care

(2) reliable

(3) appropriate (not excessive or trivial)

(4) nonintrusive (does not add to the clinician's cognitive load)


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