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Real-Time User Feedback to Support Clinical Decision Support System Improvement.

David Rubins1,2, Allison B McCoy3, Sayon Dutta1,2,4

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Applied Clinical Informatics
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Summary
This summary is machine-generated.

Real-time user feedback on clinical decision support (CDS) tools improves electronic health record (EHR) systems. Incorporating end-user input enhances CDS alert accuracy and usability.

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Area of Science:

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

Background:

  • Clinical decision support (CDS) tools are integral to modern electronic health records (EHRs).
  • Improving the effectiveness of CDS requires understanding user interaction and feedback.
  • Lack of structured feedback mechanisms can limit CDS optimization.

Purpose of the Study:

  • To enhance clinical decision support (CDS) by enabling real-time user feedback.
  • To establish processes for acting upon user feedback to improve CDS tools.
  • To investigate the value and actionability of end-user feedback in EHR systems.

Main Methods:

  • Two organizations implemented real-time feedback tools within their EHR systems over 30 months.
  • Users provided feedback via Likert links on alerts and comments during alert overrides.
  • Clinical informatics teams monitored feedback systems daily.

Main Results:

  • Over 2,639 Likert feedback comments and 623,270 override comments were collected.
  • End-user feedback identified build errors, knowledge management issues, and user-interface problems.
  • Case studies demonstrated rapid responses to feedback, improving system functionality.

Conclusions:

  • Soliciting feedback through multiple channels yields valuable, actionable suggestions for CDS alerts.
  • End users value acknowledgment of their feedback and may offer broader EHR improvement ideas.
  • Integrating end-user feedback into CDS monitoring and remediation significantly enhances CDS effectiveness.