International Journal of Medical Informatics (2004) 73, 433—441 Clinicians’ perceptions of clinical decision support integrated into computerized provider order entry  S. Trent Rosenbloom a,b, * , Doug Talbert c , Dominik Aronsky a,d a Department of Biomedical Informatics, Vanderbilt University Medical Center, Eskind Biomedical Library, Room 440, 2209 Garland Avenue, Nashville, TN 37232-8340, USA b School of Nursing, Vanderbilt University Medical Center, Nashville, TN, USA c Tennessee Technological Institute, Cookeville, TN, USA d Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA Received 11 February 2004 ; received in revised form 2 March 2004; accepted 2 April 2004 KEYWORDS Attitude to computers; Comparative study; Internship and residency; Medical records systems; Computerized; Questionnaires; User-computer interface Summary Computerized provider order entry systems can improve patient care by integrating clinical decision support. Decision support is most effective when its con- tent and delivery are acceptable. The authors report the results of a multifaceted survey of the attitudes of housestaff and medical student users of a provider order entry system with integrated decision support at an academic medical center. The survey contained 16 items covering four themes: efficiency, quality of care, results re- porting and embedded guidelines. Responses were captured using a five point Likert scale, and were compared using ANOVA and Bartlett’s testing. Out of 491 houses- taff and 128 medical students, response rates were 47 and 29%, respectively. Among respondents, 72% agreed or strongly agreed that the provider order entry system im- proves the quality of care that they provide, 54% that the decision support usually help them to provide quality patient care, and 62% that it improves the efficiency of order entry. Respondents were least likely to agree that the display of prior laboratory results influenced their decision to order a subsequent test. There were no significant differences between subspecialties and by advancing years of training among houses- taff. Respondents agreed that the integrated clinical decision support enhanced their medical training. © 2004 Elsevier Ireland Ltd. All rights reserved.  Poster Presentated by S.T. Rosenbloom, R.A. Miller, Ameri- can Medical Informatics Association 2002 Symposium, Surveying Housestaff Opinions Regarding Clinical Decision Support, Proc. AMIA Symp. (2002) 1145. *Corresponding author. Tel.: +1-615-936-1556; fax: +1-615-936-1427. E-mail address: trent.rosenbloom@vanderbilt.edu (S.T. Rosenbloom). 1. Background Computerized care provider order entry (CPOE) systems with integrated clinical decision support systems (CDSS) are designed to capture structured clinical orders for patient testing and treatments while simultaneously reducing errors [1—3], fa- cilitating conformity with care guidelines [4—7], and enhancing efficiency of entry. CPOE systems enhance clarity of communication, accuracy of content, ease of dissemination, and legibility of 1386-5056/$ — see front matter © 2004 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijmedinf.2004.04.001