User-Centered Design and Implementation of an Interoperable FHIR Application for Pediatric Pneumonia Prognostication...

Area of Science:

• Pediatric Emergency Medicine
• Health Informatics
• Clinical Decision Support

Background:

• Pneumonia prognosis in children requires effective risk communication.
• Electronic Health Record (EHR) integration is crucial for clinical trial support.
• User-centered design (UCD) principles enhance tool adoption in healthcare.

Purpose of the Study:

• To design, test, and deploy a prognostic tool for pediatric pneumonia in emergency departments (EDs).
• To support a pragmatic, EHR-based randomized controlled trial using UCD and interoperable software.
• To improve risk communication and data capture for clinical trial purposes.

Main Methods:

• Applied UCD principles and evidence-based risk communication strategies.
• Developed an integrated SMART on Fast Healthcare Interoperability Resources (FHIR) web application.
• Utilized a UCD framework including user research, prototyping, and evaluations across different EHR vendors (Epic, Cerner).

Main Results:

• User research identified preferences for risk aversion, accessibility, and timing of risk communication.
• Iterative design incorporated numeracy, risk framing, and visualization techniques.
• Successful deployment in two EDs facilitated trial enrollment, randomization, and data capture.

Conclusions:

• Successful implementation highlights the importance of UCD, modern clinical data standards (FHIR), and rigorous testing.
• Key lessons include understanding user needs, knowledge management, and careful FHIR application configuration for interoperability.
• This approach demonstrates a viable method for developing and deploying clinical trial support tools across diverse EHR systems.