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Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Related Experiment Video

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Developing a User-Centered Digital Clinical Decision Support App for Evidence-Based Medication Recommendations for

Kevin Larsen1, Bilikis Akindele2, Henry Head3

  • 1Center for Advanced Clinical Solution, OptumHealth, Optum, Washington, DC, United States.

JMIR Human Factors
|November 16, 2021
PubMed
Summary

A user-centered design process created a medication recommender app that significantly improved adherence to type 2 diabetes mellitus guidelines. The app demonstrated potential for increased provider efficiency and satisfaction in medication ordering.

Keywords:
clinical decision supportdecision supportdesigndiabeteselectronic health recordevidence-based guidelinestype 2 diabetes mellitususer testinguser-centered designvalidationworkflows

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Area of Science:

  • Health Informatics
  • Clinical Decision Support
  • Human-Computer Interaction

Background:

  • Bridging the gap between evidence-based guidelines and clinical practice remains a challenge.
  • Clinical decision support systems (CDSSs) aim to aid clinicians but often suffer from poor usability, leading to workflow issues and alert fatigue.

Purpose of the Study:

  • To validate a user-centered design (UCD) process for developing a standards-based medication recommender for type 2 diabetes mellitus (T2DM).
  • To evaluate the prototype app's effectiveness, efficiency, and user satisfaction in a simulated clinical setting.

Main Methods:

  • Iterative user testing with 8 clinical leaders and 2-8 prescribers per round informed app development.
  • A validation study with 43 participants compared a prototype app against a traditional electronic health record (EHR).
  • Measures included adherence to guidelines, task completion time, perceived cognitive load (NASA-TLX), and usability (SUS).

Main Results:

  • The prototype app significantly increased adherence to evidence-based guidelines compared to the EHR (96.2% vs. 72.0%).
  • Medication ordering time decreased with the app in the second period (107.7s vs. 130.7s).
  • System Usability Scale (SUS) scores indicated good usability, ranging from 68-86, suggesting provider satisfaction.

Conclusions:

  • A UCD process can yield a point-of-care medication recommender app that enhances adherence to guidelines, such as those from the American Diabetes Association.
  • The T2DM app shows potential for improving provider efficiency in medication ordering with practice.
  • The app achieved good usability and provider satisfaction scores.