A CRITICAL REVIEW OF THE THEORETICAL FRAMEWORKS AND THE CONCEPTUAL FACTORS IN THE ADOPTION OF CLINICAL DECISION SUPPORT SYSTEM (CDSS)

Introduction The clinical decision support system (CDSS) is utilized to translate evidence- based knowledge into evidence-based practice in clinical settings. (Moore & Fisher, 2012) Many studies have been conducted to understand the users’ adoption of the CDSS. (Kawamoto, Houlihan, Balas, & Lobach, 2005; Moore & Fisher, 2012) Method A critical review was conducted to understand the theoretical or conceptual frameworks used to inform the studies on the adoption of the CDSS. The review identified 15 theoretical and conceptual frameworks embedded using multiple hybrids of theories and concepts. The Technology Acceptance Model was the most frequently used baseline framework combined with frameworks such as the diffusion of innovation, social theory, longitudinal theory, etc. Results The results from these articles yielded multiple concepts influencing the adoption of the CDSS. These concepts can be re-categorized into nine major concepts, namely, the information system, person (user or patient), social, organization, perceived benefits, emotions, trust ability, relevance (fitness) and professionalism. Conclusion None of the studies found all the nine concepts. That said, most of them have identified the information system, organization and person concepts as one of its concepts affecting the use of the CDSS. Within each of the concepts, its sub concepts were noted to be very varied. Yet each of these sub concepts has significantly contributed to painting the different facets of the concepts. A pluralistic framework was built using the concepts and sub concepts to provide an overall framework for future study on the adoption of the CDSS.