Digital clinical decision support to save costs: a qualitative evaluation of the views of frontline healthcare professionals

BACKGROUND: Digital clinical decision support (CDS) can improve clinical decision-making, prescribing, diagnostic accuracy, and guideline adherence. Its potential to reduce healthcare costs has received less attention, and the mechanisms by which cost savings might occur remain poorly understood. This study explored resident doctors' experiences of using CDS to improve care and reduce costs. METHODS: A qualitative study was carried out. Individual semi-structured interviews were conducted by videoconference with resident doctors who were users of a digital CDS resource. Interviews explored experiences of CDS use, perceptions of cost implications, and barriers and enablers to cost-conscious care. Transcripts were analyzed using constant comparative analysis with open, axial, and selective coding. RESULTS: Twenty-two resident doctors participated. Four main themes emerged. First, cost savings occurred indirectly through improved clinical decisions, including avoidance of unnecessary investigations, referrals, overtreatment, and inappropriate admissions. Second, workflow integration was central to achieving these outcomes; participants emphasized accessibility and integration with electronic systems. Third, CDS complemented rather than replaced clinical expertise, acting as an adjunct to decision-making. Fourth, organizational culture shaped adoption. DISCUSSION: Resident doctors viewed CDS primarily as a means of improving care rather than reducing costs. Cost savings were perceived as secondary benefits arising from better clinical decisions.