Designing for implementation: user-centered development and pilot testing of a behavioral economic-inspired electronic health record clinical decision support module

Pilot and Feasibility Studies
Sara ChokshiDevin Mann

Abstract

Current guidelines recommend less aggressive target hemoglobin A1c (HbA1c) levels based on older age and lower life expectancy for older adults with diabetes. The effectiveness of electronic health record (EHR) clinical decision support (CDS) in promoting guideline adherence is undermined by alert fatigue and poor workflow integration. Integrating behavioral economics (BE) and CDS tools is a novel approach to improving adherence to guidelines while minimizing clinician burden. We will apply a systematic, user-centered design approach to incorporate BE "nudges" into a CDS module and will perform user testing in two "vanguard" sites. To accomplish this, we will conduct (1) semi-structured interviews with key informants (n = 8), (2) a 2-h, design-thinking workshop to derive and refine initial module ideas, and (3) semi-structured group interviews at each site with clinic leaders and clinicians to elicit feedback on three proposed nudge module components (navigator section, inbasket refill protocol, medication preference list). Detailed field notes will be summarized by module idea and usability theme for rapid iteration. Frequency of firing and user action taken will be assessed in the first month of implementation via EHR reporti...Continue Reading

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Citations

Aug 22, 2020·Yearbook of Medical Informatics·Ivana Jankovic, Jonathan H Chen
Sep 26, 2020·Orphanet Journal of Rare Diseases·Jannik SchaafHolger Storf
Sep 17, 2019·Joint Commission Journal on Quality and Patient Safety·David W Bates
Apr 10, 2021·Journal of Medical Internet Research·Jonathan AustrianDevin M Mann

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