Knowledge-based clinical decision support systems continuance: An integration of physicians' identity and system attributes

Despite the importance of sustained use of healthcare information systems, research on the continuous use of these systems is scanty, especially for clinical decision support systems. Moreover, there is an apparent gap between information systems and healthcare research approaches in studying use. We address these gaps by creating a comprehensive model based on the composite attitude-behavior model that integrates system related constructs with physicians' professional identity constructs to explain and model physicians' continuous use of a pain management clinical decision support system theoretically. Using a mixed methods longitudinal study design, we investigate factors influencing continuous use of automated clinical guidelines. The potential contributions of this study include enhancing our understanding of factors influencing physicians' continuance behavior, and providing guidance on developing effective automated knowledge-based clinical decision support.