Are clinical decision support systems seen as helpful to First Contact Practitioners (FCPs) working in musculoskeletal health?

Salt, Emma; Khalid, Mo; Van Der Windt, Danielle; Hill, Jonathan

Abstract

Background There is increasing burden on musculoskeletal (MSK) First Contact Practitioners (FCPs) working in primary care. One possible solution is to use digital technologies such as clinical decision support systems (CDSS). The primary objective of this study was to understand the potential for MSK FCPs to use a CDSS to support their practice in the United Kingdom. Design An exploratory sequential mixed methods design, using a cross sectional survey questionnaire and a subsequent focus group. Following ethical approval responders were recruited via professional networks to complete an online survey. A subsequent focus group enabled an in-depth exploration of survey results. Descriptive statistics were used to summarise survey data and thematic analysis with normalisation process theory used to describe findings. Methods A snowball sampling method was used to invite MSK FCPs to complete the survey, using email, adverts and social media. The questionnaire captured responders’ demographic and professional practice characteristics, their knowledge and use of CDSS and their views and experiences regarding CDSS in MSK practice. Results There were 75 responders to the survey and six participants in the focus group. The majority of responders 67% (n = 50/75) reported to be in favour of integrating a CDSS into their practice. Three themes were: 1) ensuring CDSS address efficiency concerns, 2) using CDSS to reduce unwarranted variation in practice, and 3) ensuring CDSS sustainability. Conclusions CDSSs have potential value for FCPs working in MSK primary care settings. Eight summary recommendations advise future developments of CDSS for FCPs working in MSK primary care practice. Contribution of the Paper • This is the first known study evaluating the usefulness of clinical decision support systems (CDSS) for musculoskeletal (MSK) First Contact Practitioners (FCPs). • CDSS have potential value for MSK FCPs providing they are integrated into existing digital note systems and save clinic consultation time. • Eight recommendations advise future integration of CDSS into MSK FCP practice.

Citation

Salt, E., Khalid, M., Van Der Windt, D., & Hill, J. (2025). Are clinical decision support systems seen as helpful to First Contact Practitioners (FCPs) working in musculoskeletal health?. Physiotherapy (Elsevier), 126, Article 101445. https://doi.org/10.1016/j.physio.2024.101445

• Journal Article Type: Article
• Acceptance Date: Oct 29, 2024
• Online Publication Date: Dec 16, 2024
• Publication Date: 2025-03
• Deposit Date: Dec 17, 2024
• Publicly Available Date: Dec 17, 2024
• Journal: Physiotherapy
• Print ISSN: 0031-9406
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 126
• Article Number: 101445
• DOI: https://doi.org/10.1016/j.physio.2024.101445
• Public URL: https://keele-repository.worktribe.com/output/1019063
• Additional Information: This article is maintained by: Elsevier; Article Title: Are clinical decision support systems seen as helpful to First Contact Practitioners (FCPs) working in musculoskeletal health?; Journal Title: Physiotherapy; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.physio.2024.101445; Content Type: article; Copyright: Crown Copyright © 2024 Published by Elsevier Ltd on behalf of Chartered Society of Physiotherapy. All rights are reserved, including those for text and data mining, AI training, and similar technologies.