Open Access Research article

Clinical decision support must be useful, functional is not enough: a qualitative study of computer-based clinical decision support in primary care

Tiina Kortteisto1*, Jorma Komulainen2, Marjukka Mäkelä3, Ilkka Kunnamo4 and Minna Kaila5

Author affiliations

1 School of Health Sciences, University of Tampere, Tampere, 33014, Finland

2 The Finnish Medical Society Duodecim, PO Box 713, Helsinki, 00101, Finland

3 Finnish Office for Health Technology Assessment at National Institute for Health and Welfare, PO Box 30, Helsinki, 00271, Finland

4 Duodecim Medical Publications Ltd, PO Box 713, Helsinki, 00101, Finland

5 The Hjelt Institute, University of Helsinki, PO Box 41, Helsinki, 00014, Finland

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Citation and License

BMC Health Services Research 2012, 12:349  doi:10.1186/1472-6963-12-349

Published: 8 October 2012



Health information technology, particularly electronic decision support systems, can reduce the existing gap between evidence-based knowledge and health care practice but professionals have to accept and use this information. Evidence is scant on which features influence the use of computer-based clinical decision support (eCDS) in primary care and how different professional groups experience it. Our aim was to describe specific reasons for using or not using eCDS among primary care professionals.


The setting was a Finnish primary health care organization with 48 professionals receiving patient-specific guidance at the point of care. Multiple data (focus groups, questionnaire and spontaneous feedback) were analyzed using deductive content analysis and descriptive statistics.


The content of the guidance is a significant feature of the primary care professional’s intention to use eCDS. The decisive reason for using or not using the eCDS is its perceived usefulness. Functional characteristics such as speed and ease of use are important but alone these are not enough. Specific information technology, professional, patient and environment features can help or hinder the use.


Primary care professionals have to perceive eCDS guidance useful for their work before they use it.