Abstract
BackgroundBased on barriers to the use of computerized clinical decision support (CDS) learned in an earlier field study, we prototyped design enhancements to the Veterans Health Administration's (VHA's) colorectal cancer (CRC) screening clinical reminder to compare against the VHA's current CRC reminder.MethodsIn a controlled simulation experiment, 12 primary care providers (PCPs) used prototypes of the current and redesigned CRC screening reminder in a within-subject comparison. Quantitative measurements were based on a usability survey, workload assessment instrument, and workflow integration survey. We also collected qualitative data on both designs.ResultsDesign enhancements to the VHA's existing CRC screening clinical reminder positively impacted aspects of usability and workflow integration but not workload. The qualitative analysis revealed broad support across participants for the design enhancements with specific suggestions for improving the reminder further.ConclusionsThis study demonstrates the value of a human-computer interaction evaluation in informing the redesign of information tools to foster uptake, integration into workflow, and use in clinical practice.
Highlights
Based on barriers to the use of computerized clinical decision support (CDS) learned in an earlier field study, we prototyped design enhancements to the Veterans Health Administration’s (VHA’s) colorectal cancer (CRC) screening clinical reminder to compare against the VHA’s current CRC reminder
We considered recruiting non-Veterans Affairs (VA) primary care providers (PCPs) to remove the potential bias of users having experience with the current design of the CRC clinical reminder being more
Study population Of the 12 PCPs who participated from the VA Medical Center study site, ten of the PCPs were physicians (9 MDs and 1 DO) and two were nurse practitioners (NPs)
Summary
Based on barriers to the use of computerized clinical decision support (CDS) learned in an earlier field study, we prototyped design enhancements to the Veterans Health Administration’s (VHA’s) colorectal cancer (CRC) screening clinical reminder to compare against the VHA’s current CRC reminder. The role of human factors and human-computer interaction (HCI) methods in the development of health information technology (IT), including electronic health records (EHRs) and computerized clinical decision support (CDS), is underutilized [1,2,3]. Incorporating these methods can improve usability of these tools, including reduced workload and increased user satisfaction [3,4,5,6,7]. Each approach has inherent advantages and disadvantages Field methods, such as rapid ethnography and interviews, can capture the complexity and preserve the context of the work environment within which health IT is implemented. Laboratory-based methods, on the other hand, allow for the manipulation of experimental
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