Table 1 Description of 21 CCG's features in five categories and proportion^# of study containing each feature

General system features

Presence of networks *

User has access to recommendation in computer terminals, available at several workstations in the hospital.

0.20

Type of suggestion *

Recommendation is provided in different ways including reminders of overdue health care tasks, alerts of critical values, prompts for various active care issues.

0.78

Conflict of interest *

Software designer or producer is involved in the design of study.

0.38

Degree of automation *

User automatically receives prompts (complete automation) instead of active initiation of the system by user (incomplete automation).

0.80

Clinician-system interaction feature

Automatic provision of recommendation in paper version as part of clinician workflow **

Recommendations printed on paper forms and attached to patient charts by clinical support staff, so that clinicians do not need to look for the computer advice.

0.29

Automatic provision of recommendation in electronic version as part of clinician workflow **

Electronic recommendations linked to patient charts display automatically to clinicians when a clinician accesses the database.

0.82

Data updating via network *

Data of patient are updated via network link to servers storing information about all contacts of patient with the hospital.

0.33

Request documentation of the reason for not following recommendation **

The user is asked to justify the decision of disagreement with a reason such as "the patient refused" or "I disagree with the recommendation".

0.56

Provision of recommendation at time and location of decision making **

Recommendations provided as chart reminders during an encounter, rather than as monthly reports listing all the patients in need of services.

0.13

Recommendation executed by noting agreement **

Computerised system provides recommendations in response to an order and the user simply clicks "OK" to order the recommended tests.

0.11

Communication content features

Provision of a recommendation, not just an assessment **

Systems show better actions to perform, rather than simply providing a diagnosis.

0.11

Promotion of action rather than inaction **

Systems recommend an alternative view, rather than simply recommending the order to be cancelled.

0.11

Justification of recommendation via provision of reasoning **

Recommendation for a check justified by noting date of last exam and recommended frequency of testing.

0.18

Auxiliary features

Local user involvement in development process **

Recommendation design finalised after testing preliminary versions of software (beta version) with representatives from targeted user group.

0.09

Provision of recommendations to patients as well as providers **

As well as providing chart reminders for clinicians, system generates postcards that are sent to patients to inform them of existing recommendation.

0.18

Recommendation accompanied by periodic performance feedback **

Users are sent e-mails periodically that summarise users compliance with recommendations.

0.02

Recommendation accompanied by conventional education **

Implementation of a recommendation is accompanied by a presentation or an appropriate explanation for following such suggestion.

0.27

User training *

A training period is provided for users to experience the basic features of the software.

0.22

Guidelines features

Type of guideline*

Recommendations are focused on preventive or treatment issues or both options.

0.31

0.62

0.07

Type of condition*

Recommendations are oriented towards acute or chronic patients or both options.

0.16

0.60

0.24

Type of intervention*

Recommendations suggest to administrate tests or/and drugs to patients or to perform other type of intervention on them or both options.

0.53

0.16

0.31