Patient’s views on a computer decision support for diagnosing asthma: a qualitative study

Abstract

Background: A clinical decision support system (CDSS) in primary care could address the substantial over/under-diagnosis of asthma in routine clinical practice. Including a patient-facing mode could involve patients in the diagnostic process

Aims: We explored patient perspectives on the use of a CDSS within consultations to support primary care clinicians to diagnose asthma.

Methods: In-depth Interviews explored patient views on how a CDSS could affect the diagnostic process; understand existing approaches and the potential for integrating a CDSS into current approaches. We explored advantages/challenges of using a patient-facing CDSS, including the potential impact on the professional/patient relationship. Interviews were recorded, transcribed verbatim and analysed thematically.

Results: We recruited five Scottish and three English socioeconomically varied practices. Preliminary findings suggested that an asthma CDSS with screen-sharing potential could improve patient understanding of the process of confirming/refuting a diagnosis and their perceptions of asthma. Patients suggested that an indication of asthma severity by the CDSS would encourage them to take their condition more seriously if diagnosed. The CDSS was viewed as a useful adjunct to clinician opinion; clinician’s interpretation was key to trusting the outcome of the CDSS. Patients noted the potential of the CDSS to provide trusted information, enabling them come to terms with and manage their condition.

Conclusions: An asthma diagnosis CDSS could encourage better communication between clinicians and patients in primary care, inviting patients to become more engaged in their diagnosis.