Pragmatic Integration of User-Centered Design and Implementation Science: A New Methodological Approach for Clinical...

Area of Science:

• Health Informatics
• Implementation Science
• Human-Computer Interaction

Background:

• Clinical decision support (CDS) tools improve care but can cause burnout if poorly designed.
• User-centered design (UCD) and implementation science (IS) methods enhance CDS but are underutilized in resource-limited settings.
• Guidance is needed for applying UCD and IS within operational constraints.

Purpose of the Study:

• To demonstrate the pragmatic application of an integrated UCD-IS approach for optimizing CDS tools.
• To adapt UCD-IS methods to meet operational constraints in real-world health systems.
• To provide practical guidance for designing and evaluating CDS in resource-constrained environments.

Main Methods:

• Applied an integrated UCD-IS approach guided by the Practical Robust Implementation and Sustainability Model (PRISM).
• Utilized iterative phases: partner engagement, design, prototyping, deployment, and evaluation.
• Employed methods including interviews, focus groups, surveys, and usability testing across two CDS projects.

Main Results:

• Multilevel partner engagement informed design adaptations for both heart failure and naloxone CDS tools.
• The approach balanced rigor with pragmatism, enabling timely implementation and evaluation.
• Iterative evaluations are ongoing to refine CDS for improved outcomes.

Conclusions:

• An integrated UCD-IS approach can be flexibly adapted for CDS design and evaluation in resource-constrained health systems.
• This approach addresses partner needs, ensures contextual relevance, and supports sustained adoption.
• Health systems can leverage this guidance to optimize CDS tools and mitigate clinician burnout.