Goud R et al. 2008 "Subjective usability of the CARDSS guideline-based decision support system."
Reference
Goud R, Jaspers MW, Hasman A, et al. Subjective usability of the CARDSS guideline-based decision support system. Stud Health Technol Inform 2008;136:193-198.
Abstract
"Clinical decision support systems (CDSSs) differ from other health information systems in their aim to directly influence the decision-making behaviour of healthcare professionals. As a result, CDSSs face additional challenges with respect to user acceptance. The objective of this study was to investigate subjective usability of a guideline-based CDSS for outpatient cardiac rehabilitation. The system ... was previously found to be effective in improving guideline adherence of rehabilitation professionals in a cluster randomized trial. To assess [the system's] usability, a modified version of the IBM Computer System Usability Questionnaire was sent to all 68 professionals from the 28 outpatient clinics that participated in the trial. The questionnaire was returned by 63 respondents (93%) from 27 clinics. Factors that influenced [the system's] usability were identified using linear regression analysis. Analysis showed that professionals who managed to smoothly integrate the system with their daily routine were more satisfied with ease of system use. Furthermore, a positive attitude of respondents towards CDSSs in general and a better agreement with the content of the national guidelines were positively correlated to satisfaction with [the system's] overall usability and each of its sub-domains."
Objective
To investigate subjective usability of a guideline-based CDSS for outpatient cardiac rehabilitation.
Tools Used
Type Clinic
Specialty care
Type Specific
Cardiac rehabilitation
Size
Small and/or medium
Other Information
Clinics were located in the Netherlands.
Type of Health IT
Decision support system
Type of Health IT Functions
The system "proceeds through a structured dialogue, prompting the professional to enter the necessary patient information and proposing the rehabilitation therapies that are considered appropriate for the patient in question ... Following the recommendations in the literature, [the system] also provides various additional patient information management services and [the system's] design takes into account the working procedures specific to multidisciplinary outpatient care."
Workflow-Related Findings
"Rehabilitation professionals that use the ... system in their clinic are free to consult the system simultaneously with patient visits or to work on paper during visits and consult the system afterwards. Simultaneous consultation will often be more efficient as it avoids duplicate registration (on paper and electronically) ... It is not surprising, then, that simultaneous users found the system more easy to use, as this is known to be related to integration of a system with users' workflow patterns."
"We also found that ... users who held a positive attitude towards CDSSs in general, or better agreed with the content of the national guidelines, found the system more usable than others."
"Professionals who reported that using the system caused no time increase were more satisfied with [the system's] ease of use. In this case, however, it is unclear whether poor workflow integration caused extra time and therefore dissatisfaction with the system, [or] usability problems led to poor integration and time increase."
Study Design
Story
Study Participants
The study participants included 68 healthcare professionals -- "primarily nurses and other paramedics" -- that worked with the decision support system in 28 outpatient clinics.