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From an expert-driven paper guideline to a user-centred decision support system: a usability comparison study
Ellen Kilsdonk1, Linda W Peute, Rinke J Riezebos
1Department of Medical Informatics, Centre for Human Factors Engineering of Interactive Health Information Technology, Academic Medical Center - University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
Artificial Intelligence in Medicine
|May 21, 2013
Summary
A user-centered clinical decision support system (CDSS) improved healthcare practitioners' ability to retrieve childhood cancer survivor screening information, overcoming usability issues found in paper guidelines. This system enhanced task completeness and efficiency for complex tasks.
Area of Science:
- Health Informatics
- Human-Computer Interaction
- Pediatric Oncology
Background:
- Paper-based clinical guidelines often present usability challenges for healthcare practitioners.
- Effective retrieval of follow-up screening procedures for childhood cancer survivors is critical for patient care.
- Clinical decision support systems (CDSS) offer potential solutions to improve guideline usability.
Purpose of the Study:
- To compare a user-centered prototype CDSS with a paper-based guideline for usability and information retrieval effectiveness.
- To assess the impact of a CDSS on detecting usability problems and retrieving childhood cancer survivor follow-up screening procedures.
- To evaluate the efficiency and effectiveness of information retrieval in a CDSS versus a traditional guideline.
Main Methods:
- A user-centered design (UCD) process was used to develop a prototype CDSS.
- Think-aloud analysis with 13 participants evaluated usability of both the paper guideline and the prototype CDSS.
- Efficiency (task completion time) and effectiveness (completeness of retrieved procedures) were measured for both systems.
Main Results:
- The prototype CDSS significantly reduced usability problems, particularly those incongruent with users' mental models (from 17 to 6).
- Task completeness improved by 58% for simple tasks and 17% for complex tasks with the CDSS, despite a slight increase in time for simple tasks.
- Complex scenario retrieval time decreased by 3 minutes and 50 seconds using the CDSS.
Conclusions:
- Implementing guidelines in a user-centered CDSS design can overcome usability issues faced by healthcare practitioners.
- While the CDSS presented different usability challenges, they did not impede effective and efficient task performance.
- Usability problem analysis was crucial for comparing information retrieval systems and informing the CDSS user-centered design process.
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