Concordance, decision impact, and satisfaction for a computerized clinical decision support system in treatment of lung cancer patients

Abstract

Background: Treatment options for lung cancer patients are progressing rapidly. A clinical decision support system(CDSS) which affords first-line treatment recommendations for cancer patients was implemented at Jupiter Medical Center, on March 1, 2017. This pilot analysis studied system performance and its impact on patients and providers. Method(s): Lung cancer cases managed in the CDSS between October 2017 and November 2018 were incorporated. CDSS results were viewed by providers, discussed in tumor board, and shared with the patients. Navigators directed a survey about CDS impact and user satisfaction to clinician and patients at conclusion of visits. Summary responses were calculated. Result(s): Thirty cases were processed by the CDSS; 23 surveys were completed. The treatment team agreed completely with CDSS recommendations for 18 cases (78.3%) and partly for 4 (17.4%). Clinicians reported that the CDSS impacted the treatment decision 9 (39.1%) cases and saved time in treatment design for 17 (73.9%). The CDSS confirmed the treatment plan for 16 cases (69.6%), recommended an option that was designated for 5 (21.7%), and offered a useful option not chosen for 1 (4.3%). For most cases, clinicians conveyed they were pleased with the CDSS results (n=22; 95.7%), realized 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 answered 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%). Conclusion(s): This study provides initial 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 conclusions. Providers and patients were pleased with the CDSS and reported being willing to use it again.