Int J Med Inform - Design of decision support interventions for medication prescribing.

Tópicos

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Resumo

JECTIVE: Describe optimal design attributes of clinical decision support (CDS) interventions for medication prescribing, emphasizing perceptual, cognitive and functional characteristics that improve human-computer interaction (HCI) and patient safety.METHODS: Findings from published reports on success, failures and lessons learned during implementation of CDS systems were reviewed and interpreted with regard to HCI and software usability principles. We then formulated design recommendations for CDS alerts that would reduce unnecessary workflow interruptions and allow clinicians to make informed decisions quickly, accurately and without extraneous cognitive and interactive effort.RESULTS: Excessive alerting that tends to distract clinicians rather than provide effective CDS can be reduced by designing only high severity alerts as interruptive dialog boxes and less severe warnings without explicit response requirement, by curating system knowledge bases to suppress warnings with low clinical utility and by integrating contextual patient data into the decision logic. Recommended design principles include parsimonious and consistent use of color and language, minimalist approach to the layout of information and controls, the use of font attributes to convey hierarchy and visual prominence of important data over supporting information, the inclusion of relevant patient data in the context of the alert and allowing clinicians to respond with one or two clicks.CONCLUSION: Although HCI and usability principles are well established and robust, CDS and EHR system interfaces rarely conform to the best known design conventions and are seldom conceived and designed well enough to be truly versatile and dependable tools. These relatively novel interventions still require careful monitoring, research and analysis of its track record to mature. Clarity and specificity of alert content and optimal perceptual and cognitive attributes, for example, are essential for providing effective decision support to clinicians.

Resumo Limpo

jectiv describ optim design attribut clinic decis support cds intervent medic prescrib emphas perceptu cognit function characterist improv humancomput interact hci patient safetymethod find publish report success failur lesson learn implement cds system review interpret regard hci softwar usabl principl formul design recommend cds alert reduc unnecessari workflow interrupt allow clinician make inform decis quick accur without extran cognit interact effortresult excess alert tend distract clinician rather provid effect cds can reduc design high sever alert interrupt dialog box less sever warn without explicit respons requir curat system knowledg base suppress warn low clinic util integr contextu patient data decis logic recommend design principl includ parsimoni consist use color languag minimalist approach layout inform control use font attribut convey hierarchi visual promin import data support inform inclus relev patient data context alert allow clinician respond one two clicksconclus although hci usabl principl well establish robust cds ehr system interfac rare conform best known design convent seldom conceiv design well enough truli versatil depend tool relat novel intervent still requir care monitor research analysi track record matur clariti specif alert content optim perceptu cognit attribut exampl essenti provid effect decis support clinician

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