Usability of a Human Factors-based Clinical Decision Support in the Emergency Department: Lessons Learned for Design and Implementation.
Health information technology
implementation
sociotechnical systems
usability
workflow integration
Journal
Human factors
ISSN: 1547-8181
Titre abrégé: Hum Factors
Pays: United States
ID NLM: 0374660
Informations de publication
Date de publication:
Mar 2024
Mar 2024
Historique:
medline:
9
2
2024
pubmed:
15
4
2022
entrez:
14
4
2022
Statut:
ppublish
Résumé
To evaluate the usability and use of human factors (HF)-based clinical decision support (CDS) implemented in the emergency department (ED). Clinical decision support can improve patient safety; however, the acceptance and use of CDS has faced challenges. Following a human-centered design process, we designed a CDS to support pulmonary embolism (PE) diagnosis in the ED. We demonstrated high usability of the CDS during scenario-based usability testing. We implemented the HF-based CDS in one ED in December 2018. We conducted a survey of ED physicians to evaluate the usability and use of the HF-based CDS. We distributed the survey via Qualtrics, a web-based survey platform. We compared the computer system usability questionnaire scores of the CDS between those collected in the usability testing to use of the CDS in the real environment. We asked physicians about their acceptance and use of the CDS, barriers to using the CDS, and areas for improvement. Forty-seven physicians (56%) completed the survey. Physicians agreed that diagnosing PE is a major problem and risk scores can support the PE diagnostic process. Usability of the CDS was reported as high, both in the experimental setting and the real clinical setting. However, use of the CDS was low. We identified several barriers to the CDS use in the clinical environment, in particular a lack of workflow integration. Design of CDS should be a continuous process and focus on the technology's usability in the context of the broad work system and clinician workflow.
Sections du résumé
OBJECTIVE
OBJECTIVE
To evaluate the usability and use of human factors (HF)-based clinical decision support (CDS) implemented in the emergency department (ED).
BACKGROUND
BACKGROUND
Clinical decision support can improve patient safety; however, the acceptance and use of CDS has faced challenges. Following a human-centered design process, we designed a CDS to support pulmonary embolism (PE) diagnosis in the ED. We demonstrated high usability of the CDS during scenario-based usability testing. We implemented the HF-based CDS in one ED in December 2018.
METHOD
METHODS
We conducted a survey of ED physicians to evaluate the usability and use of the HF-based CDS. We distributed the survey via Qualtrics, a web-based survey platform. We compared the computer system usability questionnaire scores of the CDS between those collected in the usability testing to use of the CDS in the real environment. We asked physicians about their acceptance and use of the CDS, barriers to using the CDS, and areas for improvement.
RESULTS
RESULTS
Forty-seven physicians (56%) completed the survey. Physicians agreed that diagnosing PE is a major problem and risk scores can support the PE diagnostic process. Usability of the CDS was reported as high, both in the experimental setting and the real clinical setting. However, use of the CDS was low. We identified several barriers to the CDS use in the clinical environment, in particular a lack of workflow integration.
CONCLUSION
CONCLUSIONS
Design of CDS should be a continuous process and focus on the technology's usability in the context of the broad work system and clinician workflow.
Identifiants
pubmed: 35420923
doi: 10.1177/00187208221078625
pmc: PMC9581441
mid: NIHMS1815839
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
647-657Subventions
Organisme : AHRQ HHS
ID : K12 HS026395
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000427
Pays : United States
Organisme : NLM NIH HHS
ID : T15 LM007450
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002373
Pays : United States
Organisme : AHRQ HHS
ID : K08 HS024558
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS022086
Pays : United States
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