Abstract
BackgroundRecently, attention has shifted to improving the design of computerized alerts via the incorporation of human factors design principles. The Instrument for Evaluating Human Factors Principles in Medication-Related Decision Support Alerts (I-MeDeSA) is a tool developed in the United States to guide improvements to alert design and facilitate selection of electronic systems with superior design. In this study, we aimed to determine the reliability, ease of use and usefulness of I-MeDeSA for assessing drug-drug interaction (DDI) alerts in an Australian context.MethodsUsing the I-MeDeSA, three reviewers independently evaluated DDI alert interfaces of seven electronic systems used in Australia. Inter-rater reliability was assessed and reviewers met to discuss difficulties in using I-MeDeSA and the tool’s usefulness.ResultsInter-rater reliability was high (Krippendorff’s alpha = 0.76), however, ambiguous wording and the inclusion of conditional items impacted ease of use. A number of items were not relevant to Australian implementations and as a result, most systems achieved an I-MeDeSA score of less than 50%.ConclusionsThe I-MeDeSA proved to be reliable, but item wording and structure made application difficult. Future studies should investigate potential modifications to the I-MeDeSA to improve ease of use and increase applicability to a variety of system configurations.
Highlights
Attention has shifted to improving the design of computerized alerts via the incorporation of human factors design principles
As was the case in previous studies utilising I-MeDeSA, [18,19,20] inter-rater reliability was high in our application, this was likely to be due to the in-depth discussions held during piloting
Overall, our results indicate that computerised alerts in use in Australian healthcare settings require significant redesign to incorporate human factors principles of good warning design
Summary
Attention has shifted to improving the design of computerized alerts via the incorporation of human factors design principles. The Instrument for Evaluating Human Factors Principles in Medication-Related Decision Support Alerts (I-MeDeSA) is a tool developed in the United States to guide improvements to alert design and facilitate selection of electronic systems with superior design. Drug-drug interactions (DDIs) occur when two or more drugs are taken concurrently and the result is a change in the effect of one or more of the drugs. DDIs can result in adverse effects (e.g. bleeding) or to one or both of the drugs not achieving their therapeutic effect [1]. The sheer volume of known drug interactions is likely to contribute to poor DDI detection. Electronic systems are increasingly being adopted by hospitals all over the
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