Involving users in the design and usability evaluation of a clinical decision support system

To design and evaluate a clinical decision support system (CDSS) to support cardiovascular risk prevention in type 2 diabetes.

A preliminary requirements specification and three prototype CDSS interface designs were developed. Seven patients and seven clinicians conducted 'usability tests' on five different task scenarios with the CDSS prototypes to test its effectiveness, efficiency and 'user-friendliness'. Structured, qualitative questions explored their preferences for the different designs and overall impressions of clinical usefulness.

Patients and clinicians were enthusiastic about the CDSS and used it confidently after a short learning period. Some patients had difficulty interpreting clinical data, but most were keen to see the CDSS used to help them understand their diabetes, provided a clinician explained their results. Clinicians' main concern was that the CDSS would increase consultation times. Changes suggested by users were incorporated into the final interface design.

We have successfully incorporated patients' and clinicians' views into the design of a CDSS, but it was an arduous process.