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Interruptive Versus Noninterruptive Clinical Decision Support: Usability Study.

Saul Blecker1,2, Rishi Pandya2, Susan Stork1

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|April 18, 2019
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Summary
This summary is machine-generated.

This study compared interruptive and noninterruptive clinical decision support (CDS) alerts for heart failure care. While interruptive alerts were noticed, they disrupted workflow; noninterruptive alerts were less intrusive but less visible, impacting engagement.

Keywords:
clinical decision supportelectronic health recordshospital

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Area of Science:

  • Health Informatics
  • Medical Decision Making
  • Human-Computer Interaction

Background:

  • Clinical decision support (CDS) improves care but faces challenges like alert fatigue and poor usability.
  • Noninterruptive CDS may reduce alert fatigue, but its usability needs assessment.

Purpose of the Study:

  • To evaluate the usability of interruptive versus noninterruptive clinical decision support (CDS) alerts.
  • To understand provider preferences and workflow impacts of different CDS alert types.

Main Methods:

  • A usability study comparing two versions of a CDS tool for prescribing ACE inhibitors in heart failure patients.
  • Inpatient providers used both interruptive (order entry) and noninterruptive (sidebar) alerts in a lab setting.
  • Think-aloud protocols and semistructured interviews analyzed usability using the CDS Five Rights framework.

Main Results:

  • Interruptive alerts were easily noticed but hindered workflow; noninterruptive alerts were less annoying but had lower visibility.
  • Provider role influenced preferences: those with global patient responsibility favored noninterruptive alerts, while task-oriented providers preferred interruptive ones.
  • A trade-off exists between workflow impedance and alert visibility.

Conclusions:

  • Provider preferences for CDS alerts vary, influenced by workflow and responsibility.
  • Strategies for effective CDS include tailoring alerts by provider role or combining noninterruptive alerts with occasional interruptive ones.