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Adoption of Clinical Decision Support Systems (CDSS) is a crucial step towards the digital transition of the healthcare sector. This review aims to determine and synthesise the influential factors in CDSS adoption in inpatient healthcare settings in order to grasp an understanding of the phenomenon and identify future research gaps.

A systematic literature search of five databases (Medline, EMBASE, PsycINFO, Web of Science and Scopus) was conducted between January 2010 and June 2023. The search strategy was a combination of the following keywords and their synonyms: clinical decision support, hospital or secondary care and influential factors. The quality of studies was evaluated against a 40-point rating scale.

Thirteen papers were systematically reviewed and synthesised and deductively classified into three main constructs of the Technology–Organisation–Environment theory. Scarcity of papers investigating CDSS adoption and its challenges, especially in developing countries, was evident.

This study offers a summative account of challenges in the CDSS procurement process. Strategies to help adopters proactively address the challenges are: (1) Hospital leaders need a clear digital strategy aligned with stakeholders' consensus; (2) Developing modular IT solutions and conducting situational analysis to achieve IT goals; and (3) Government policies, accreditation standards and procurement guidelines play a crucial role in navigating the complex CDSS market.

To the best of the authors’ knowledge, this is the first review to address the adoption and procurement of CDSS. Previous literature only addressed challenges and facilitators within the implementation and post-implementation stages. This study focuses on the firm-level adoption phase of CDSS technology with a theory refining lens.

This paper investigates the dynamics between state affect and trusting cognitive beliefs on post-adoptive information technology (IT) use behaviors in the form of intention to explore and deep structure usage. That state affect can influence behaviors is recognized in practice. In fact, some studies examine the impact of affective constructs, but the way state affect impacts how individuals use IT remains largely unexplored. The authors theorize that state affect, in the form of positive and negative affect, will influence trusting cognitive beliefs regarding an IT artifact (in terms of perceived helpfulness, capability and reliability) and, more importantly, directly influence intention to explore and deep structure usage.

The authors test the model using a sample of 357 IT users. Survey items were derived from established measures, and the data were analyzed using structural equation modeling.

Results of this study suggest that positive affect and negative affect impact trusting cognitive beliefs. Trusting cognitive beliefs positively impact intention to explore with an IT and deep structure usage of an IT. Even in the presence of trusting beliefs, though, positive affect directly impacts intention to explore. Positive affect and negative affect both also have various indirect, mediated effects on intention to explore and deep structure usage.

In order to maximize value from workplace IT, the results suggest managers foster an authentic, positive work environment in order to harness or redirect employees' emotional energies.