Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Physician Perceptions of Clinical Reminders

Valenta AL, Stevenson G, Browning M, Boyd AD, Weddle TE, Hynes DM. Physician Perceptions of Clinical Reminders. Presented at: Association for Computing Machinery International Health Informatics Symposium; 2010 Nov 12; Arlington, VA.

Related HSR&D Project(s)


Objective: To measure differences in physician perception of clinical decision reminders. Design: Residents and attending physicians in a VA General Medicine Clinic participated in the study. They were asked to rank order (Q-sort) 44 opinion statements from those most important, those about which they were ambivalent, to those most unimportant, answering the question: "Which issues would be important or not so important to you in affecting your behavior following the appearance of a computer-generated decision support alert?" Measurements: 21 Q-sorts were performed by 12 attending physicians (attendings) and 9 residents. The data were analyzed using PQ-Method 2.11 for statistical analysis. The output of analysis, the factors, represents groups who share an opinion set. Results: From the combined results, three factors (stories) emerged: A1, Medicine cannot be reduced to rules; A2, Alerts undermine patient and provider autonomy; and A3, Alerts raise issues of authority. When analyzing the residents' results alone, two factors emerged: B1, Information provided in a non-clinical way; and B2, Legal ramifications are unknown. Conclusion: Clearly, within and outside the VA, the goal is to understand the barriers to the effectiveness of clinical reminders. Among the many barriers surrounding use of alerts, participants identified alerts (p < 0.01) that were inappropriate to context, reduced patient's contact time, that intruded on professional autonomy, and were presented in a non-clinical way. They also identified alert fatigue and the sense of big brother watching. Limitations: As a qualitative method, Q is not intended to describe all possible opinions, but uniquely tries to capture opinion sets.

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.