Online Program

285564
Dental provider experiences using a web-based clinical decision support system for tobacco use treatment


Monday, November 4, 2013 : 10:50 a.m. - 11:10 a.m.

Donna Shelley, MD, MPH, Department of Population Health, NYU Medical Center, New York, NY
Deanna Jannat-Khah, MSPH, Department of Population Health, NYU Medical Center, New York, NY
Hieu Pham, MSPH, Department of Population Health, NYU Medical Center, New York, NY
Marcy Hager, MA, Department of Population Health, NYU School of Medicine, New York, NY
Tuo-Yen Tseng, MA, Department of Population Health, NYU Medical Center, New York, NY
Elise Eisenberg, DDS, MA, Informatics and Epidemiology and Health Promotion, NYU College of Dentistry, New York, NY
Matt McGuirk, Informatics and Epidemiology and Health Promotion, NYU College of Dentistry, New York, NY
Background: Dental providers have a credible role in treating tobacco use, yet their adherence to guideline recommended care is poor. Clinical Decision Support Systems (CDSS) are promising strategies for improving adoption of guideline recommended care. We developed a CDSS tool, based on the Public Health Services Guideline on Treating Tobacco Use and Dependence that offers dentists a simple algorithm for assessing smokers' readiness to quit and for prescribing appropriate cessation medication.

Methods: After implementing CDSS in six clinics in the NYU College of Dentistry, we conducted 25 semi-structured interviews with dental students and faculty members regarding their experience in using CDSS. Venkatesh's Technology Acceptance Model (TAM2) provided a framework for the coding process.

Results: We identified two main domains that influence the user's intention to use CDSS: perceived usefulness of CDSS and perception of CDSS's ease-of-use. Factors that contributed to one's perception of usefulness included a) social influence processes, b) cognitive instrumental processes, and c) the extent to which dental students perceive the “mandatoriness” of use. The perceived ease-of-use of the CDSS was dictated by the perception of a) how easy CDSS is to use, b) duration of use, and c) cognitive process that goes into usage. In our interviews we also elucidated other factors that were not in the TAM2 model, including incentives (financial or educational), the types of patient, the types of dental student, and the extent to which smoking screening is part of the normal clinic routine.

Conclusion: This web-based tool has the potential to enhance the quality and consistency of tobacco use treatment in dental health care settings. Qualitative interviews suggest that providers believe the CDSS is an easy-to-use system that saves time and improves their confidence in addressing tobacco use. We plan to disseminate and adapt CDSS for use more broadly in the dental community.

Learning Areas:

Implementation of health education strategies, interventions and programs
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the Technology Acceptance Model for understanding adoption of technology among health care providers List the pros and cons of using a CDSS in a dental setting

Keyword(s): Tobacco, Information Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of multiple federally funded grants focusing on smoking cessation in underserved populations and health care system changes to improve the quality of tobacco use treatment in the health care setting. My research has been funded by AHRQ, NIH, CDC, and the New York State Department of Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.