Human-centered design of clinical decision support for management of hypertension with chronic kidney disease.
Human-centered design of clinical decision support for management of hypertension with chronic kidney disease.
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DOI：
10.1186/s12911-022-01962-y
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发表时间：
2022-08-13
影响因子：
3.5
通讯作者：
Samal, Lipika
中科院分区：
文献类型：
--
作者：
Garabedian, Pamela M.;Gannon, Michael P.;Aaron, Skye;Wu, Edward;Burns, Zoe;Samal, Lipika
初级保健提供者在识别和控制慢性肾脏病（CKD）患者的高血压方面面临挑战。临床决策支持（CDS）有可能帮助临床医生识别可能从药物变化中受益的患者。本研究使用迭代的以人为本的设计过程设计了一种警报，以控制CKD患者的高血压。在这项研究中，我们提出了一个以人为本的设计过程，采用多种方法收集用户的需求和反馈的设计和可用性。最初，我们进行了上下文查询会话，以收集CDS的用户需求。随后是小组设计会议和一对一的形成性思维会议，以验证需求，获得对设计和布局的反馈，发现可用性问题，并验证更改。这项研究包括20名参与者。情境调查产生了10个用户需求，影响了最初的警报设计。小组设计会议揭示了与几个主题相关的问题，包括不符合提供者期望的建议和临床内容以及关于警报的无关信息，这些信息没有提供价值。个人有声思维会议的结果显示，参与者不同意一些推荐的临床行动，要求提供更多信息，并对工作流程中的位置表示担忧。在每个步骤之后，对警报内容和设计进行迭代更改。这项研究表明，在整个设计过程中，用户的参与可以导致更好地了解用户的需求和最佳的设计，即使在EHR报警系统的约束。在提高对设计需求的认识的同时，它也揭示了与工作流程、可理解性和相关性有关的问题。以人为本的设计框架使用多种方法进行CDS开发，为创建警报提供了信息，以帮助治疗和识别CKD患者的高血压。在线版本包含补充材料，可通过10.1186/s12911-022-01962-y获得。
Primary care providers face challenges in recognizing and controlling hypertension in patients with chronic kidney disease (CKD). Clinical decision support (CDS) has the potential to aid clinicians in identifying patients who could benefit from medication changes. This study designed an alert to control hypertension in CKD patients using an iterative human-centered design process. In this study, we present a human-centered design process employing multiple methods for gathering user requirements and feedback on design and usability. Initially, we conducted contextual inquiry sessions to gather user requirements for the CDS. This was followed by group design sessions and one-on-one formative think-aloud sessions to validate requirements, obtain feedback on the design and layout, uncover usability issues, and validate changes. This study included 20 participants. The contextual inquiry produced 10 user requirements which influenced the initial alert design. The group design sessions revealed issues related to several themes, including recommendations and clinical content that did not match providers' expectations and extraneous information on the alerts that did not provide value. Findings from the individual think-aloud sessions revealed that participants disagreed with some recommended clinical actions, requested additional information, and had concerns about the placement in their workflow. Following each step, iterative changes were made to the alert content and design. This study showed that participation from users throughout the design process can lead to a better understanding of user requirements and optimal design, even within the constraints of an EHR alerting system. While raising awareness of design needs, it also revealed concerns related to workflow, understandability, and relevance. The human-centered design framework using multiple methods for CDS development informed the creation of an alert to assist in the treatment and recognition of hypertension in patients with CKD. The online version contains supplementary material available at 10.1186/s12911-022-01962-y.
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DOI：
10.3122/jabfm.2016.05.160020
发表时间：
2016-09-01
影响因子：
2.9
作者：
Litvin, Cara B.;Hyer, J. Madison;Ornstein, Steven M.
通讯作者：
Ornstein, Steven M.
影响因子：
3.5
作者：
Ancker JS;Edwards A;Nosal S;Hauser D;Mauer E;Kaushal R;with the HITEC Investigators
通讯作者：
with the HITEC Investigators
DOI：
10.1016/j.ijmedinf.2017.05.004
发表时间：
2017-08-01
影响因子：
4.9
作者：
Brunner, Julian;Chuang, Emmeline;Yano, Elizabeth M.
通讯作者：
Yano, Elizabeth M.
影响因子：
2.2
作者：
Kunstler, Breanne E.;Furler, John;Manski-Nankervis, Jo-Anne
通讯作者：
Manski-Nankervis, Jo-Anne
DOI：
10.1161/hypertensionaha.110.150722
发表时间：
2010-05
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Crews DC;Plantinga LC;Miller ER 3rd;Saran R;Hedgeman E;Saydah SH;Williams DE;Powe NR;Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team
通讯作者：
Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team