Human-computer interaction evaluation can inform the redesign of computerized clinical reminders
Research Activities, December 2012, No. 388
Clinicians continue to report barriers to using computerized clinical decision support (CDS) as part of electronic health records. Earlier, researchers had identified several barriers related to the use of CDS for colorectal cancer screening. In a new study, they use human-computer interaction evaluations to redesign this CDS to make it more user-friendly and effective.
The researchers recruited 12 primary care providers from 5 outpatient clinics that were part of a Veterans Affairs medical center. Evaluations took place in a simulation laboratory where participants were videotaped to include their facial expressions and interactions with the clinical information system. Participating providers tested both the current and redesigned prototype by completing a simple and complex scenario involving colorectal screening. Following this, participants received a workflow integration survey.
The redesigned prototype scored significantly higher than the current prototype on the workflow integration survey. Providers gave high marks for the redesigned colorectal cancer screening reminder and the timeline visual of a patient's history for screening. The redesign enhancements had a positive impact on the providers' workflow integration and the ability to find a patient's relevant data. No differences were observed between the two prototypes in terms of perceived workload, simplicity, efficiency, and overall satisfaction.
The researchers conclude that using these and other human-computer interaction methods can benefit not only clinical software development, but its integration into clinical practice as well. Human factors input must be adopted early in the process if user performance is to be improved. The study was supported in part by the Agency for Healthcare Research and Quality (Contract No. 290-06-00013).
See "Redesign of a computerized clinical reminder for colorectal cancer screening: A human-computer interaction evaluation," by Jason J. Saleem, Ph.D., M.S., David A. Haggstrom, M.D., M.A.S., Laura G. Militello, M.A., and others in the BMC Medical Informatics and Decision Making, 2011.