Health information technology: use it well, or don't! Findings from the use of a decision support system for breast cancer management

Jacques Bouaud; Brigitte Blaszka-Jaulerry; Laurent Zelek; Jean-Philippe Spano; Jean-Pierre Lefranc; Isabelle Cojean-Zelek; Axel Durieux; Christophe Tournigand; Alexandra Rousseau; Brigitte Séroussi

Health information technology: use it well, or don't! Findings from the use of a decision support system for breast cancer management

AMIA Annu Symp Proc. 2014 Nov 14:2014:315-24. eCollection 2014.

Affiliations

¹ AP-HP, DRCD, Paris, France ; INSERM, U1142, LIMICS, Paris, France ; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1142, LIMICS, Paris, France ; Université Paris 13, Sorbonne Paris Cité, LIMICS, (UMR_S 1142), Bobigny, France.
² CH Lagny Marne la Vallée, Service de radiothérapie-oncologie, Lagny, France.
³ Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France; AP-HP, Hôpital Avicenne, Service d'oncologie médicale, Bobigny, France.
⁴ Sorbonne Universités, UPMC Univ Paris 06, UFR de médecine, Paris, France ; AP-HP, Hôpital Pitié-Salpétrière, Service d'oncologie médicale, Paris, France.
⁵ Sorbonne Universités, UPMC Univ Paris 06, UFR de médecine, Paris, France ; AP-HP, Hôpital Pitié-Salpétrière, Service de chirurgie et cancérologie gynécologique et mammaire, Paris, France.
⁶ Hôpital des Diaconesses, Pôle oncologie médicale, Paris, France.
⁷ Institut de Cancérologie des Peupliers, Paris, France.
⁸ AP-HP, Hôpital St-Antoine, Service d'oncologie médicale, Paris, France.
⁹ AP-HP, Hôpital St-Antoine, URC-EST, Paris, France.
¹⁰ Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1142, LIMICS, Paris, France ; INSERM, U1142, LIMICS, Paris, France ; Université Paris 13, Sorbonne Paris Cité, LIMICS, (UMR_S 1142), Bobigny, France ; AP-HP, Hôpital Tenon, Département de santé publique, Paris, France; APREC, Paris, France.

PMID: 25954334
PMCID: PMC4419891

Abstract

The potential of health information technology is hampered by new types of errors which impact is not totally assessed. OncoDoc2 is a decision support system designed to support treatment decisions of multidisciplinary meetings (MDMs) for breast cancer patients. We evaluated how the way the system was used had an impact on MDM decision compliance with clinical practice guidelines. We distinguished "correct navigations" (N+), "incorrect navigations" (N-), and "missing navigations" (N0), according to the quality of data entry when using OncoDoc2. We collected 557 MDM decisions from three hospitals of Paris area (France) where OncoDoc2 was routinely used. We observed 33.9% N+, 36.8% N-, and 29.3% N0. The compliance rate was significantly different according to the quality of navigations, 94.2%, 80.0%, and 90.2% for N+, N-, and N0 respectively. Surprinsingly, it was better not to use the system (N0) than to use it improperly (N-).

MeSH terms

Breast Neoplasms / therapy*
Data Interpretation, Statistical
Decision Support Systems, Clinical*
Disease Management
Expert Systems*
Female
Guideline Adherence*
Humans
Paris
Patient Care Team
Practice Guidelines as Topic
Therapy, Computer-Assisted