How Implementation Context Shapes Clinician Acceptance and Engagement with Guideline-Based Clinical Decision Support Systems in Primary Care: A Qualitative Study

Background

Guideline-based clinical decision support (CDS) tools have become central to promoting evidence-based, high-quality primary care. Despite widespread implementation, clinician adoption and sustained use remain inconsistent. Existing research has typically examined technological usability or organizational implementation factors separately, providing limited understanding of how these influences interact in real-world primary care settings. This study examined how organizational implementation context and clinician technology acceptance jointly shape adoption and sustained use of guideline-based CDS tools in US primary care using an integrated Consolidated Framework for Implementation Research (CFIR) and Technology Acceptance Model (TAM) perspective.