What do healthcare professionals need to turn risk models for type 2 diabetes into usable computerized clinical decision support systems? Lessons learned from the MOSAIC project

Background To understand user needs, system requirements and organizational conditions towards successful design and adoption of Clinical Decision Support Systems for Type 2 Diabetes (T2D) care built on top of computerized risk models. Methods The holistic and evidence-based CEHRES Roadmap , used to...

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Published in:BMC medical informatics and decision making Vol. 19; no. 1; pp. 163 - 16
Main Authors: Fico, Giuseppe, Hernanzez, Liss, Cancela, Jorge, Dagliati, Arianna, Sacchi, Lucia, Martinez-Millana, Antonio, Posada, Jorge, Manero, Lidia, Verdú, Jose, Facchinetti, Andrea, Ottaviano, Manuel, Zarkogianni, Konstantia, Nikita, Konstantina, Groop, Leif, Gabriel-Sanchez, Rafael, Chiovato, Luca, Traver, Vicente, Merino-Torres, Juan Francisco, Cobelli, Claudio, Bellazzi, Riccardo, Arredondo, Maria Teresa
Format: Journal Article
Language:English
Published: London BioMed Central 16.08.2019
BioMed Central Ltd
BMC
Subjects:
Adult
Aged
Analysis
Care and treatment
Chronic diseases
Clinical decision-making
Clinical trials
Computer Simulation
Computerized decision support systems
Decision making
Decision support systems
Decision Support Systems, Clinical
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - etiology
Diabetes therapy
End users
Evidence-based medicine
Female
Health Informatics
Human centred design
Humans
Information Systems and Communication Service
Information Systems, Social aspects (including Human Aspects of ICT)
knowledge support systems
Male
Management of Computing and Information Systems
Mass Screening
Media and Communications
Medical personnel
Medical research
Medicine
Medicine & Public Health
Medie-, kommunikations-, och informationsvetenskaper
Middle Aged
Multi-disciplinary approach
Prevention
Research Article
Risk Assessment
Risk factors
Risk modelling
Samhällsvetenskap
Social Sciences
Software
Systemvetenskap, informationssystem och informatik med samhällsvetenskaplig inriktning
Telemedicine
theory
Type 2 diabetes
Type 2 diabetes
Risk modelling
Multi-disciplinary approach
Computerized decision support systems
Human centred design
ISSN:1472-6947, 1472-6947
Online Access:Get full text
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Summary:Background To understand user needs, system requirements and organizational conditions towards successful design and adoption of Clinical Decision Support Systems for Type 2 Diabetes (T2D) care built on top of computerized risk models. Methods The holistic and evidence-based CEHRES Roadmap , used to create eHealth solutions through participatory development approach, persuasive design techniques and business modelling, was adopted in the MOSAIC project to define the sequence of multidisciplinary methods organized in three phases, user needs , implementation and evaluation . The research was qualitative, the total number of participants was ninety, about five-seventeen involved in each round of experiment. Results Prediction models for the onset of T2D are built on clinical studies, while for T2D care are derived from healthcare registries. Accordingly, two set of DSSs were defined: the first, T2D Screening , introduces a novel routine; in the second case, T2D Care , DSSs can support managers at population level, and daily practitioners at individual level. In the user needs phase , T2D Screening and solution T2D Care at population level share similar priorities, as both deal with risk-stratification. End-users of T2D Screening and solution T2D Care at individual level prioritize easiness of use and satisfaction, while managers prefer the tools to be available every time and everywhere. In the implementation phase , three Use Cases were defined for T2D Screening , adapting the tool to different settings and granularity of information. Two Use Cases were defined around solutions T2D Care at population and T2D Care at individual , to be used in primary or secondary care. Suitable filtering options were equipped with “attractive” visual analytics to focus the attention of end-users on specific parameters and events. In the evaluation phase , good levels of user experience versus bad level of usability suggest that end-users of T2D Screening perceived the potential, but they are worried about complexity. Usability and user experience were above acceptable thresholds for T2D Care at population and T2D Care at individual . Conclusions By using a holistic approach, we have been able to understand user needs, behaviours and interactions and give new insights in the definition of effective Decision Support Systems to deal with the complexity of T2D care.
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ISSN:1472-6947
1472-6947
DOI:10.1186/s12911-019-0887-8