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Another important group of barriers concerns the current guidelines.
Environmental barriers, particularly organizational constraints, are another often-perceived group of barriers to implementation.
From the group of barriers related to the evaluation of the features of the CDSS, particularly the subgroup functionality was considered relevant.
For the second and third group of barriers (attitude-related and external barriers) the barrier statements that were stated positively rather than negatively, were first recoded, so that a higher score indicated a higher level of perceived barriers.
Furthermore, the second group of barriers referring to rigid bureaucracy and funding might also be reinforced by the ideological barriers and exacerbated by the social and financial crisis and subsequent austerity measures.
Within the group of barriers related to the evaluation of the features of the CDSS itself, we found that a high intensity of alerts, irrelevant alerts and a lack of flexibility and learning capacity of the CDSS were commonly reported.
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It is shown that under appropriate conditions the discharge of hydrogen at mercury and silver, the chlorine discharge at graphite, the oxidation of azide at platinum anodes and evidently some other cases belong to the group of barrier free processes.
To measure the perceived barriers three groups of barriers were included, based on the framework that emerged from the focus group study [ 15].
We found that three groups of barriers may hinder implementation: knowledge-related barriers, barriers related to the evaluation of the features of the CDSS and external barriers interacting with the CDSS.
These findings are consistent with our focus group study and confirm that barriers to using NHGDoc were found within all three main groups of barriers in our previously developed framework of barriers to using CDSSs [ 15].
Table 3 presents the three groups of barriers as reported by the respondents of the questionnaire.> As can be seen in Table 3 2%% of the GPs and 18%% of the PNs were not aware of the existence of NHGDoc at all.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com