Hospital Pharmacists' Perspectives on Clinical Decision Support Systems: Perceived Usefulness, Barriers, and Willingness to Adopt in Non-Implementing Hospitals in Rizal Province, Philippines
Research Article  ·  Published: 04 October 2026
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Biomedical Informatics and Smart Healthcare
Volume 2, Issue 4, 2026: 166-190
Research Article Open Access

Hospital Pharmacists' Perspectives on Clinical Decision Support Systems: Perceived Usefulness, Barriers, and Willingness to Adopt in Non-Implementing Hospitals in Rizal Province, Philippines

1 School of Pharmacy, Philippine Women's University, Manila 1004, Philippines
* Corresponding Author: Hassan Hussein Mohamed Elhagali, [email protected]
Volume 2, Issue 4
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Article Information

Abstract

Clinical decision support systems (CDSS) can improve medication safety, yet implementation remains limited in some Philippine hospitals. This study examined hospital pharmacists' perceived usefulness of CDSS, willingness to adopt, trust requirements, and anticipated barriers in non-implementing hospitals in Rizal Province, Philippines. A convergent mixed-methods, cross-sectional survey was conducted among 84 licensed hospital pharmacists using a content-validated 15-item Likert questionnaire and six open-ended questions, analysed descriptively and thematically. Across perceived-usefulness items, 88.10%–92.86% agreed that CDSS could improve medication safety, risk detection, and efficiency. Trust was conditional on transparency: 82.14%–85.71% reported greater trust or willingness when systems provided clinical rationales, evidence links or grading, and auditable calculation pathways. Although no respondent's hospital had a CDSS, 78.57% reported a general tendency to override electronic alerts from other tools to maintain clinical speed; this is not a CDSS override rate but signals a risk if future notifications are poorly stratified. Self-reported CDSS knowledge was not associated with age (Fisher-Freeman-Halton exact test, $p = 0.389$). The main barriers were software and infrastructure costs (86.90%) and insufficient IT support (82.14%); qualitative findings added paper-based infrastructure, budget constraints, understaffing, and demands for low-friction interfaces, tiered alerting, and preserved professional judgment. Pharmacists viewed CDSS as useful and were conditionally willing to adopt it. Implementation should prioritize technical support, transparent recommendations, and workflow-compatible alert design.

Graphical Abstract

Hospital Pharmacists' Perspectives on Clinical Decision Support Systems: Perceived Usefulness, Barriers, and Willingness to Adopt in Non-Implementing Hospitals in Rizal Province, Philippines

Keywords

clinical decision support systems hospital pharmacists technology acceptance implementation barriers medication safety Philippines

Data Availability Statement

Data will be made available on request.

Funding

This work was supported without any funding.

Conflicts of Interest

The author declares no conflicts of interest.

AI Use Statement

The author declares that ChatGPT-5 was used for language editing, and Perplexity AI was used to assist in formatting bibliographic information; all references were independently verified by the author against the original sources. The author has carefully reviewed, revised, and verified the AI-assisted output and takes full responsibility for the content of the manuscript.

Ethical Approval and Consent to Participate

The study protocol was reviewed and approved by the Philippine Women's University Ethics Review Board (ERB Protocol No. ERB 2020_008; Certificate of Approval dated 12 March 2026). Written informed consent was obtained from all participants before participation. Participation was voluntary, and study data were handled in accordance with applicable Philippine ethical requirements and Republic Act No. 10173 (Data Privacy Act of 2012).

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Cite This Article

APA Style
Elhagali, H. H. M. (2026). Hospital Pharmacists’ Perspectives on Clinical Decision Support Systems: Perceived Usefulness, Barriers, and Willingness to Adopt in Non-Implementing Hospitals in Rizal Province, Philippines. Biomedical Informatics and Smart Healthcare, 2(4), 166-190. https://doi.org/10.62762/BISH.2026.200896
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TY  - JOUR
AU  - Elhagali, Hassan Hussein Mohamed
PY  - 2026
DA  - 2026/10/04
TI  - Hospital Pharmacists' Perspectives on Clinical Decision Support Systems: Perceived Usefulness, Barriers, and Willingness to Adopt in Non-Implementing Hospitals in Rizal Province, Philippines
JO  - Biomedical Informatics and Smart Healthcare
T2  - Biomedical Informatics and Smart Healthcare
JF  - Biomedical Informatics and Smart Healthcare
VL  - 2
IS  - 4
SP  - 166
EP  - 190
DO  - 10.62762/BISH.2026.200896
UR  - https://www.icck.org/article/abs/BISH.2026.200896
KW  - clinical decision support systems
KW  - hospital pharmacists
KW  - technology acceptance
KW  - implementation barriers
KW  - medication safety
KW  - Philippines
AB  - Clinical decision support systems (CDSS) can improve medication safety, yet implementation remains limited in some Philippine hospitals. This study examined hospital pharmacists' perceived usefulness of CDSS, willingness to adopt, trust requirements, and anticipated barriers in non-implementing hospitals in Rizal Province, Philippines. A convergent mixed-methods, cross-sectional survey was conducted among 84 licensed hospital pharmacists using a content-validated 15-item Likert questionnaire and six open-ended questions, analysed descriptively and thematically. Across perceived-usefulness items, 88.10%–92.86% agreed that CDSS could improve medication safety, risk detection, and efficiency. Trust was conditional on transparency: 82.14%–85.71% reported greater trust or willingness when systems provided clinical rationales, evidence links or grading, and auditable calculation pathways. Although no respondent's hospital had a CDSS, 78.57% reported a general tendency to override electronic alerts from other tools to maintain clinical speed; this is not a CDSS override rate but signals a risk if future notifications are poorly stratified. Self-reported CDSS knowledge was not associated with age (Fisher-Freeman-Halton exact test, $p = 0.389$). The main barriers were software and infrastructure costs (86.90%) and insufficient IT support (82.14%); qualitative findings added paper-based infrastructure, budget constraints, understaffing, and demands for low-friction interfaces, tiered alerting, and preserved professional judgment. Pharmacists viewed CDSS as useful and were conditionally willing to adopt it. Implementation should prioritize technical support, transparent recommendations, and workflow-compatible alert design.
SN  - 3068-5524
PB  - Institute of Central Computation and Knowledge
LA  - English
ER  - 
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@article{Elhagali2026Hospital,
  author = {Hassan Hussein Mohamed Elhagali},
  title = {Hospital Pharmacists' Perspectives on Clinical Decision Support Systems: Perceived Usefulness, Barriers, and Willingness to Adopt in Non-Implementing Hospitals in Rizal Province, Philippines},
  journal = {Biomedical Informatics and Smart Healthcare},
  year = {2026},
  volume = {2},
  number = {4},
  pages = {166-190},
  doi = {10.62762/BISH.2026.200896},
  url = {https://www.icck.org/article/abs/BISH.2026.200896},
  abstract = {Clinical decision support systems (CDSS) can improve medication safety, yet implementation remains limited in some Philippine hospitals. This study examined hospital pharmacists' perceived usefulness of CDSS, willingness to adopt, trust requirements, and anticipated barriers in non-implementing hospitals in Rizal Province, Philippines. A convergent mixed-methods, cross-sectional survey was conducted among 84 licensed hospital pharmacists using a content-validated 15-item Likert questionnaire and six open-ended questions, analysed descriptively and thematically. Across perceived-usefulness items, 88.10\%–92.86\% agreed that CDSS could improve medication safety, risk detection, and efficiency. Trust was conditional on transparency: 82.14\%–85.71\% reported greater trust or willingness when systems provided clinical rationales, evidence links or grading, and auditable calculation pathways. Although no respondent's hospital had a CDSS, 78.57\% reported a general tendency to override electronic alerts from other tools to maintain clinical speed; this is not a CDSS override rate but signals a risk if future notifications are poorly stratified. Self-reported CDSS knowledge was not associated with age (Fisher-Freeman-Halton exact test, \$p = 0.389\$). The main barriers were software and infrastructure costs (86.90\%) and insufficient IT support (82.14\%); qualitative findings added paper-based infrastructure, budget constraints, understaffing, and demands for low-friction interfaces, tiered alerting, and preserved professional judgment. Pharmacists viewed CDSS as useful and were conditionally willing to adopt it. Implementation should prioritize technical support, transparent recommendations, and workflow-compatible alert design.},
  keywords = {clinical decision support systems, hospital pharmacists, technology acceptance, implementation barriers, medication safety, Philippines},
  issn = {3068-5524},
  publisher = {Institute of Central Computation and Knowledge}
}

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