Enhancing Usefulness and Usability of a Clinical Decision Support Prototype for Antibiotic Stewardship

Abstract

Human factors engineering can enhance software usefulness and usability. We describe a multi-method approach to improve clinical decision support (CDS) for antibiotic stewardship. We employed a heuristic review to generate recommendations to improve the usability of a prototype CDS to support empiric antibiotic prescribing in the hospital setting. We then engaged in a design improvement cycle in collaboration with software programmers, which resulted in additional enhancements to our prototype. Finally, we used the revised prototype during three walkthrough demonstration interviews with physician and pharmacist subject matter experts. These walkthrough interviews generated recommendations to improve the interface, functionality, and tailoring for groups of users. We discuss common elements of the recommendations for models for using clinical decision support in general.

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

“…Many technologies focused on the creation and evaluation of customized clinical decision support tools. The application of these customized clinical decision support tools varied widely in context, including diagnostic support [ 17 , 132 ], antibiotic stewardship [ 36 , 70 ], screening for and management of chronic conditions [ 53 , 91 , 119 ], identifying individuals at risk for varied clinical outcomes [ 50 , 69 , 87 , 118 ].…”

Usability and Utility of Human Immunodeficiency Virus Pre-exposure Prophylaxis Clinical Decision Support to Increase Knowledge and Pre-exposure Prophylaxis Initiations among Pediatric Providers

“…One potential consideration is whether the CDSS alert should be interruptive-which forces provider response in the middle of a workflow and may increase alert fatigue-or non-interruptive-which does not force immediate response but has been shown to be less successful at changing provider behavior. 25,[50][51][52] This provider's feedback also suggests that the CDSS could potentially improve its sensitivity by utilizing available patient data to better predict if a patient would benefit from PrEP at that visit. A hybrid design to consider may be a non-interruptive PrEP CDSS that is available on-demand throughout the visit workflow paired with well-timed and highly applicable interruptive alerts for patients who would most benefit.…”