Clinical Decision Support Systems and Trust in Automation: Case of a Clinical Reminder for Titration of Beta Blockers

Abstract

Trust in automation depends on more than just the automation itself, but the larger context in which the automation and the human operator are collaborating. This study takes a naturalistic approach to explore providers' trust in a Clinical Decision Support System. Primary Care Providers were shown simulated medical records and a prototype Clinical Reminder indicating that the patient should be titrated with recommended Beta Blockers to address the patient's Heart Failure with reduced ejection fraction. Analysis of responses showed three main themes: Concerns about the medical documentation used to generate the recommendation; Complexity of the patient condition and care delivery context (and how such factors limit possible courses of action); and Concerns about the Clinical Reminder and clinical guideline it is instantiating. These results align with the macrocognitive model of trust and reliance based on sensemaking and flexecution.

Keywords

decision support health information technology trust

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