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Human-Centered Design of a Clinical Decision Support for Anemia Screening in Children with Inflammatory Bowel Disease.

Publication ,  Journal Article
Miller, SD; Murphy, Z; Gray, JH; Marsteller, J; Oliva-Hemker, M; Maslen, A; Lehmann, HP; Nagy, P; Hutfless, S; Gurses, AP
Published in: Applied clinical informatics
March 2023

Inflammatory bowel disease (IBD) commonly leads to iron deficiency anemia (IDA). Rates of screening and treatment of IDA are often low. A clinical decision support system (CDSS) embedded in an electronic health record could improve adherence to evidence-based care. Rates of CDSS adoption are often low due to poor usability and fit with work processes. One solution is to use human-centered design (HCD), which designs CDSS based on identified user needs and context of use and evaluates prototypes for usefulness and usability.this study aimed to use HCD to design a CDSS tool called the IBD Anemia Diagnosis Tool, IADx.Interviews with IBD practitioners informed creation of a process map of anemia care that was used by an interdisciplinary team that used HCD principles to create a prototype CDSS. The prototype was iteratively tested with "Think Aloud" usability evaluation with clinicians as well as semi-structured interviews, a survey, and observations. Feedback was coded and informed redesign.Process mapping showed that IADx should function at in-person encounters and asynchronous laboratory review. Clinicians desired full automation of clinical information acquisition such as laboratory trends and analysis such as calculation of iron deficit, less automation of clinical decision selection such as laboratory ordering, and no automation of action implementation such as signing medication orders. Providers preferred an interruptive alert over a noninterruptive reminder.Providers preferred an interruptive alert, perhaps due to the low likelihood of noticing a noninterruptive advisory. High levels of desire for automation of information acquisition and analysis with less automation of decision selection and action may be generalizable to other CDSSs designed for chronic disease management. This underlines the ways in which CDSSs have the potential to augment rather than replace provider cognitive work.

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Published In

Applied clinical informatics

DOI

EISSN

1869-0327

ISSN

1869-0327

Publication Date

March 2023

Volume

14

Issue

2

Start / End Page

345 / 353

Related Subject Headings

  • Mass Screening
  • Inflammatory Bowel Diseases
  • Humans
  • Electronic Health Records
  • Decision Support Systems, Clinical
  • Chronic Disease
  • Child
  • Anemia
  • 4203 Health services and systems
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Miller, S. D., Murphy, Z., Gray, J. H., Marsteller, J., Oliva-Hemker, M., Maslen, A., … Gurses, A. P. (2023). Human-Centered Design of a Clinical Decision Support for Anemia Screening in Children with Inflammatory Bowel Disease. Applied Clinical Informatics, 14(2), 345–353. https://doi.org/10.1055/a-2040-0578
Miller, Steven D., Zachary Murphy, Joshua H. Gray, Jill Marsteller, Maria Oliva-Hemker, Andrew Maslen, Harold P. Lehmann, Paul Nagy, Susan Hutfless, and Ayse P. Gurses. “Human-Centered Design of a Clinical Decision Support for Anemia Screening in Children with Inflammatory Bowel Disease.Applied Clinical Informatics 14, no. 2 (March 2023): 345–53. https://doi.org/10.1055/a-2040-0578.
Miller SD, Murphy Z, Gray JH, Marsteller J, Oliva-Hemker M, Maslen A, et al. Human-Centered Design of a Clinical Decision Support for Anemia Screening in Children with Inflammatory Bowel Disease. Applied clinical informatics. 2023 Mar;14(2):345–53.
Miller, Steven D., et al. “Human-Centered Design of a Clinical Decision Support for Anemia Screening in Children with Inflammatory Bowel Disease.Applied Clinical Informatics, vol. 14, no. 2, Mar. 2023, pp. 345–53. Epmc, doi:10.1055/a-2040-0578.
Miller SD, Murphy Z, Gray JH, Marsteller J, Oliva-Hemker M, Maslen A, Lehmann HP, Nagy P, Hutfless S, Gurses AP. Human-Centered Design of a Clinical Decision Support for Anemia Screening in Children with Inflammatory Bowel Disease. Applied clinical informatics. 2023 Mar;14(2):345–353.
Journal cover image

Published In

Applied clinical informatics

DOI

EISSN

1869-0327

ISSN

1869-0327

Publication Date

March 2023

Volume

14

Issue

2

Start / End Page

345 / 353

Related Subject Headings

  • Mass Screening
  • Inflammatory Bowel Diseases
  • Humans
  • Electronic Health Records
  • Decision Support Systems, Clinical
  • Chronic Disease
  • Child
  • Anemia
  • 4203 Health services and systems
  • 1103 Clinical Sciences