Redesign of a computerized clinical reminder for colorectal cancer screening: a human-computer interaction evaluation

Saleem, Jason J.; Haggstrom, David A.; Militello, Laura G.; Flanagan, Mindy E.; Kiess, Chris; Arbuckle, Nicole; Doebbeling, Bradley N.

doi:10.1186/1472-6947-11-74

Cited by 20 publications

(11 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Findings from this study guided the design of a notional visualisation that would integrate all the information relevant to a patient's colorectal cancer screening into one screen. A simulation study was conducted to evaluate the potential value of the visualisation concept (Saleem et al 2011 ).…”

Section: Sts Methods In Action: Six Case Study Examplesmentioning

confidence: 99%

Defining the methodological challenges and opportunities for an effective science of sociotechnical systems and safety

et al. 2015

View full text Add to dashboard Cite

An important part of the application of sociotechnical systems theory (STS) is the development of methods, tools and techniques to assess human factors and ergonomics workplace requirements. We focus in this paper on describing and evaluating current STS methods for workplace safety, as well as outlining a set of six case studies covering the application of these methods to a range of safety contexts. We also describe an evaluation of the methods in terms of ratings of their ability to address a set of theoretical and practical questions (e.g. the degree to which methods capture static/dynamic aspects of tasks and interactions between system levels). The outcomes from the evaluation highlight a set of gaps relating to the coverage and applicability of current methods for STS and safety (e.g. coverage of external influences on system functioning; method usability). The final sections of the paper describe a set of future challenges, as well as some practical suggestions for tackling these. Practitioner Summary: We provide an up-to-date review of STS methods, a set of case studies illustrating their use and an evaluation of their strengths and weaknesses. The paper concludes with a ‘roadmap’ for future work.

show abstract

Section: Sts Methods In Action: Six Case Study Examplesmentioning

confidence: 99%

Defining the methodological challenges and opportunities for an effective science of sociotechnical systems and safety

et al. 2015

View full text Add to dashboard Cite

show abstract

“…[21][22][23][28][29][30][31] Observation and interview data were collected from 2004 to 2008. Both studies used a combination of key informant interviews, direct observations, and opportunistic interviews.…”

Section: Methodsmentioning

confidence: 99%

“…More concrete recommendations for improving specific CDS tools have been published elsewhere. [21][22][23] Approach Cognitive field research, including methods such as ethnographic observation and interviews, are used increasingly across disciplines to integrate information technology (IT) into complex work settings. 24 This approach is especially useful with respect to HIT because of the ability to discover and understand the impact of new technologies on workflow early.…”

Section: Introductionmentioning

confidence: 99%

Sources of variation in primary care clinical workflow: Implications for the design of cognitive support

Militello

Arbuckle

Saleem

et al. 2013

Health Informatics J

Self Cite

View full text Add to dashboard Cite

This article identifies sources of variation in clinical workflow and implications for the design and implementation of electronic clinical decision support. Sources of variation in workflow were identified via rapid ethnographic observation, focus groups, and interviews across a total of eight medical centers in both the Veterans Health Administration and academic medical centers nationally regarded as leaders in developing and using clinical decision support. Data were reviewed for types of variability within the social and technical subsystems and the external environment as described in the sociotechnical systems theory. Two researchers independently identified examples of variation and their sources, and then met with each other to discuss them until consensus was reached. Sources of variation were categorized as environmental (clinic staffing and clinic pace), social (perception of health information technology and real-time use with patients), or technical (computer access and information access). Examples of sources of variation within each of the categories are described and discussed in terms of impact on clinical workflow. As technologies are implemented, barriers to use become visible over time as users struggle to adapt workflow and work practices to accommodate new technologies. Each source of variability identified has implications for the effective design and implementation of useful health information technology. Accommodating moderate variability in workflow is anticipated to avoid brittle and inflexible workflow designs, while also avoiding unnecessary complexity for implementers and users.

show abstract

“…Last, we wanted to explore the efficacy of just-in-time educational materials to facilitate a streamlined discussion to support provider–patient collaborative decision making. Mock-ups of these early design ideas were tested in a laboratory simulation study to facilitate and refine the concept development (Saleem et al, 2011). …”

Section: Methods For Design and Developmentmentioning

confidence: 99%

Designing Colorectal Cancer Screening Decision Support

Militello

Saleem

Borders

et al. 2016

Journal of Cognitive Engineering and Decision Making

View full text Add to dashboard Cite

Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration’s EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability.

show abstract

Redesign of a computerized clinical reminder for colorectal cancer screening: a human-computer interaction evaluation

Cited by 20 publications

References 19 publications

Defining the methodological challenges and opportunities for an effective science of sociotechnical systems and safety

Defining the methodological challenges and opportunities for an effective science of sociotechnical systems and safety

Sources of variation in primary care clinical workflow: Implications for the design of cognitive support

Designing Colorectal Cancer Screening Decision Support

Contact Info

Product

Resources

About