Clinical decision support systems for multidisciplinary team decision-making in patients with solid cancer: Composition of an implementation model based on a scoping review
Mathijs P. Hendriks, Agnes Jager, Kees C.W.J. Ebben, Janine A. van Til, Sabine Siesling
Abstract
Generating guideline-based recommendations during multidisciplinary team (MDT) meetings in solid cancers is getting more complex due to increasing amount of information needed to follow the guidelines. Usage of clinical decision support systems (CDSSs) can simplify and optimize decision-making. However, CDSS implementation is lagging behind. Therefore, we aim to compose a CDSS implementation model. By performing a scoping review of the currently reported CDSSs for MDT decision-making we determined 102 barriers and 86 facilitators for CDSS implementation out of 44 papers describing 20 different CDSSs. The most frequently reported barriers and facilitators for CDSS implementation supporting MDT decision-making concerned CDSS maintenance (e.g. incorporating guideline updates), validity of recommendations and interoperability with electronic health records. Based on the identified barriers and facilitators, we composed a CDSS implementation model describing clinical utility, analytic validity and clinical validity to guide CDSS integration more successfully in the clinical workflow to support MDTs in the future. • MDT clinical decision-making to reach a personalized advice becomes more complex as scientific knowledge is increasing rapidly • Usage of CDSSs can simplify and optimize decision-making, however implementation in the clinical workflow remains far behind • This review identified the currently reported CDSSs for MDTs and determined the barriers and facilitators for implementation • Based on the barriers and facilitators found, a CDSS implementation model was composed aiming to support CDSS implementation