Descriptive Usability Study of CirrODS: Clinical Decision and Workflow Support Tool for Management of Patients With Cirrhosis.
clinical decision support
human factors engineering
interview
liver cirrhosis
Journal
JMIR medical informatics
ISSN: 2291-9694
Titre abrégé: JMIR Med Inform
Pays: Canada
ID NLM: 101645109
Informations de publication
Date de publication:
03 Jul 2019
03 Jul 2019
Historique:
received:
07
02
2019
accepted:
15
05
2019
revised:
13
05
2019
entrez:
5
7
2019
pubmed:
5
7
2019
medline:
5
7
2019
Statut:
epublish
Résumé
There are gaps in delivering evidence-based care for patients with chronic liver disease and cirrhosis. Our objective was to use interactive user-centered design methods to develop the Cirrhosis Order Set and Clinical Decision Support (CirrODS) tool in order to improve clinical decision-making and workflow. Two work groups were convened with clinicians, user experience designers, human factors and health services researchers, and information technologists to create user interface designs. CirrODS prototypes underwent several rounds of formative design. Physicians (n=20) at three hospitals were provided with clinical scenarios of patients with cirrhosis, and the admission orders made with and without the CirrODS tool were compared. The physicians rated their experience using CirrODS and provided comments, which we coded into categories and themes. We assessed the safety, usability, and quality of CirrODS using qualitative and quantitative methods. We created an interactive CirrODS prototype that displays an alert when existing electronic data indicate a patient is at risk for cirrhosis. The tool consists of two primary frames, presenting relevant patient data and allowing recommended evidence-based tests and treatments to be ordered and categorized. Physicians viewed the tool positively and suggested that it would be most useful at the time of admission. When using the tool, the clinicians placed fewer orders than they placed when not using the tool, but more of the orders placed were considered to be high priority when the tool was used than when it was not used. The physicians' ratings of CirrODS indicated above average usability. We developed a novel Web-based combined clinical decision-making and workflow support tool to alert and assist clinicians caring for patients with cirrhosis. Further studies are underway to assess the impact on quality of care for patients with cirrhosis in actual practice.
Sections du résumé
BACKGROUND
BACKGROUND
There are gaps in delivering evidence-based care for patients with chronic liver disease and cirrhosis.
OBJECTIVE
OBJECTIVE
Our objective was to use interactive user-centered design methods to develop the Cirrhosis Order Set and Clinical Decision Support (CirrODS) tool in order to improve clinical decision-making and workflow.
METHODS
METHODS
Two work groups were convened with clinicians, user experience designers, human factors and health services researchers, and information technologists to create user interface designs. CirrODS prototypes underwent several rounds of formative design. Physicians (n=20) at three hospitals were provided with clinical scenarios of patients with cirrhosis, and the admission orders made with and without the CirrODS tool were compared. The physicians rated their experience using CirrODS and provided comments, which we coded into categories and themes. We assessed the safety, usability, and quality of CirrODS using qualitative and quantitative methods.
RESULTS
RESULTS
We created an interactive CirrODS prototype that displays an alert when existing electronic data indicate a patient is at risk for cirrhosis. The tool consists of two primary frames, presenting relevant patient data and allowing recommended evidence-based tests and treatments to be ordered and categorized. Physicians viewed the tool positively and suggested that it would be most useful at the time of admission. When using the tool, the clinicians placed fewer orders than they placed when not using the tool, but more of the orders placed were considered to be high priority when the tool was used than when it was not used. The physicians' ratings of CirrODS indicated above average usability.
CONCLUSIONS
CONCLUSIONS
We developed a novel Web-based combined clinical decision-making and workflow support tool to alert and assist clinicians caring for patients with cirrhosis. Further studies are underway to assess the impact on quality of care for patients with cirrhosis in actual practice.
Identifiants
pubmed: 31271153
pii: v7i3e13627
doi: 10.2196/13627
pmc: PMC6636234
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e13627Subventions
Organisme : EPA
ID : EP-D-13-052
Pays : United States
Organisme : HSRD VA
ID : I01 HX001284
Pays : United States
Informations de copyright
©Jennifer Hornung Garvin, Julie Ducom, Michael Matheny, Anne Miller, Dax Westerman, Carrie Reale, Jason Slagle, Natalie Kelly, Russ Beebe, Jejo Koola, Erik J Groessl, Emily S Patterson, Matthew Weinger, Amy M Perkins, Samuel B Ho. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 03.07.2019.
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