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Design of decision support interventions for medication prescribing
Jan Horsky1, Shobha Phansalkar, Amrita Desai
1Clinical Informatics Research and Development, Partners HealthCare, Boston, United States. jhorsky@partners.org
International Journal of Medical Informatics
|March 16, 2013
Summary
Optimizing clinical decision support (CDS) design enhances human-computer interaction (HCI) and patient safety. Implementing user-centered design principles for CDS alerts improves clinician efficiency and reduces errors in medication prescribing.
Area of Science:
- Health Informatics
- Human-Computer Interaction
- Medical Informatics
Background:
- Clinical decision support (CDS) systems are integral to electronic health records (EHRs).
- Current CDS interventions often present suboptimal human-computer interaction (HCI) and usability.
- Poorly designed CDS can lead to alert fatigue and reduced patient safety.
Purpose of the Study:
- To define optimal design attributes for medication prescribing CDS interventions.
- To enhance HCI and patient safety through improved perceptual, cognitive, and functional characteristics.
- To provide evidence-based design recommendations for effective CDS alerts.
Main Methods:
- Review and interpretation of published reports on CDS implementation successes and failures.
- Application of HCI and software usability principles to analyze CDS alert design.
- Formulation of design recommendations to minimize workflow interruptions and cognitive load.
Main Results:
- Reducing excessive alerting by differentiating interruptive alerts from non-interruptive warnings.
- Curating knowledge bases to suppress low-utility warnings and integrating contextual patient data.
- Recommending minimalist design, parsimonious use of color/language, and clear visual hierarchy for alerts.
Conclusions:
- Existing CDS and EHR interfaces frequently deviate from established HCI and usability best practices.
- CDS interventions require ongoing monitoring, research, and analysis for maturation.
- Clarity, specificity, and optimal perceptual/cognitive attributes are crucial for effective CDS.
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