Table 2 Clinical barriers and enablers

Clinical context barriers

Interfered with communication (n = 3)

Interference with communication, priorities, and clinical relationship during the consult

Providers experienced clinical context barriers with the interference to clinician-patient communication, lack of CDS applicability, particularly with regard to inappropriate application of guidelines

Distorted priorities (n = 2)

Patient’s own agenda

Lack of applicability

Lack of applicability due to limited number of conditions addressed or patient factors

Information not included

[Limited] number of conditions

Health literacy [of patient]

Cookbook medicine

Guidelines applied indiscriminately to patients

Blanket recommendations

Conflicting guidelines

Clinical context enablers

Systematic consistent care (n = 3)

Support systematic and structured processes, improving quality of care

Providers experienced clinical context enablers where CDS supported structured quality care, facilitated discussions with patients, improved clinical judgment, and presented useful clinical knowledge

Improved quality of care (n = 2)

Support referral

Care coordination

Trigger further discussion (n = 3)

Facilitates clinical discussions, particularly in opportunities for shared decision making with patients

Supported shared decision making (n = 2)

Communicating with patients

Patient satisfaction

Facilitate own judgment

Reminders improved clinician judgment and motivation, to provide recommended care and avoid dangerous situations

Remembering recommended orders

Good reminder

Increased motivation

Avoid dangerous situations

New knowledge (n = 2)

Useful sources of knowledge and advice during the consult

Useful sources of advice

Influenced treatment