Table 2.
Taxonomy of variances between computerized clinical decision-support system (CDSS) and clinicians
| Reason for variance | N (%)* |
| Asthma severity | N=63 |
| Guideline-driven | |
| Guideline-deficient area | 6 (10) |
| CDSS-driven | |
| Patient already receiving asthma treatment | 14 (22) |
| Free-text documentation not recognized | 6 (10) |
| Incorrect attribution of symptoms or actions to asthma | 8 (13) |
| CDSS algorithm error | 8 (13) |
| Provider-driven | |
| Failure to comply with guidelines | 14 (22) |
| Provider disagreed with guidelines | 4 (6) |
| Provider documentation error | 3 (5) |
| Asthma step choice | N=47 |
| Guideline-driven | |
| Guideline-deficient area | 2 (4) |
| CDSS-driven | |
| Patient already receiving asthma treatment | 18 (38) |
| Incorrect attribution of symptoms or actions to asthma | 11 (23) |
| Free-text documentation not recognized | 2 (4) |
| CDSS algorithm error | 5 (11) |
| Provider-driven | |
| Failure to comply with guidelines | 5 (11) |
| Provider disagreed with guidelines | 2 (4) |
| Provider documentation error | 2 (4) |
| Asthma control | N=119 |
| CDSS-driven | |
| Symptoms not attributed to asthma | 66 (55) |
| Free-text documentation | 15 (13) |
| Inadequate adherence to existing therapy or improper technique | 5 (4) |
| Provider-driven | |
| Failure to comply with guidelines | 33 (28) |
*
These represent 100% of variances for asthma severity and step choice, and 53% of variances for asthma control between January 6, 2009 and December 31, 2009.