Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support...

Area of Science:

• Emergency Medical Services
• Clinical Decision Support Systems
• Human-Computer Interaction

Background:

• Prehospital providers face decision-making challenges due to limited cognitive support and high-stress environments.
• Clinical Decision Support Systems (CDSS) can improve prehospital care but face adoption barriers like workflow disruption.
• Designing effective CDSS requires understanding prehospital provider needs and workflow specificities.

Purpose of the Study:

• To investigate prehospital providers' decision-making challenges and technological needs.
• To identify key considerations for designing and implementing CDSS in prehospital settings.
• To inform the development of user-centered CDSS for emergency medical services (EMS).

Main Methods:

• Conducted semi-structured interviews with 20 prehospital providers from four urban EMS agencies.
• Focused interviews on decision-making challenges, technology needs, and CDSS design/implementation.
• Analyzed interview data using content analysis to identify common themes.

Main Results:

• Identified decision-making challenges: limited diagnostics, lack of experience, and insufficient cognitive support.
• Highlighted desired CDSS features: automatic prompts, AI medication ID, hands-free protocol retrieval, and critical alerts.
• Emphasized need for balanced alerts, real-time data, and clear accountability to ensure CDSS adoption.

Conclusions:

• Study offers empirical insights into prehospital decision-making challenges and user needs.
• Provides practical implications for designing user-centered CDSS for prehospital environments.
• Suggests strategies for successful CDSS integration into emergency medical services workflows.