TY - JOUR
T1 - Designing Colorectal Cancer Screening Decision Support
T2 - A Cognitive Engineering Enterprise
AU - Militello, Laura G.
AU - Saleem, Jason J.
AU - Borders, Morgan R.
AU - Sushereba, Christen E.
AU - Haverkamp, Donald
AU - Wolf, Steven P.
AU - Doebbeling, Bradley
N1 - Funding Information:
This research was funded by the Small Business Innovation Research program, through a contract with the Centers for Disease Control and Prevention (Contract No. 200- 2012-52902), and also by the Agency for Healthcare Research and Quality (Contract HSA2902006000131). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, the Department of Veterans Affairs, or the U.S. government.
Publisher Copyright:
© 2016, Human Factors and Ergonomics Society.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - 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.
AB - 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.
KW - agile software development
KW - cancer prevention
KW - cognitive task analysis
KW - ethnographic observation
KW - health promotion
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U2 - 10.1177/1555343416630875
DO - 10.1177/1555343416630875
M3 - Article
AN - SCOPUS:84960112303
SN - 1555-3434
VL - 10
SP - 74
EP - 90
JO - Journal of Cognitive Engineering and Decision Making
JF - Journal of Cognitive Engineering and Decision Making
IS - 1
ER -