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  • Retrospective analysis of the human-centered design process used to develop a clinical decision support in the emergency department: PE Dx Study Part 2

Retrospective analysis of the human-centered design process used to develop a clinical decision support in the emergency department: PE Dx Study Part 2

Publication Year: 2023
Contributing Organisation: Vanderbilt University Medical Center
Authors: Megan E. Salwei, Peter L.T. Hoonakker, and Michael Pulia
Learning Themes: Global Health

With the growing implementation and use of health IT such as Clinical Decision Support (CDS), there is
increasing attention on the potential negative impact of these technologies on patients (e.g., medication errors)
and clinicians (e.g., increased workload, decreased job satisfaction, burnout). Human-Centered Design (HCD)
and Human Factors (HF) principles are recommended to improve the usability of health IT and reduce its
negative impact on patients and clinicians; however, challenges persist. The objective of this study is to understand how an HCD process influences the usability of health IT. We conducted a systematic retrospective
analysis of the HCD process used in the design of a CDS for pulmonary embolism diagnosis in the emergency
department (ED). Guided by the usability outcomes (e.g., barriers and facilitators) of the CDS use “in the wild”
(see Part 1 of this research in the accompanying manuscript), we performed deductive content analysis of 17
documents (e.g., design session transcripts) produced during the HCD process. We describe if and how the design team considered the barriers and facilitators during the HCD process. We identified 7 design outcomes of the HCD process, for instance designing a workaround and making a design change to the CDS. We identify gaps in the current HCD process and demonstrate the need for a continuous health IT design process.

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