Evaluating a modular decision support application for colorectal cancer screening

Laura G. Militello, Julie B. Diiulio, Morgan R. Borders, Christen E. Sushereba, Jason J. Saleem, Donald Haverkamp, Thomas Imperiale

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: There is a need for health information technology evaluation that goes beyond randomized controlled trials to include consideration of usability, cognition, feedback from representative users, and impact on efficiency, data quality, and clinical workflow. This article presents an evaluation illustrating one approach to this need using the Decision-Centered Design framework. Objective: To evaluate, through a Decision-Centered Design framework, the ability of the Screening and Surveillance App to support primary care clinicians in tracking and managing colorectal cancer testing. Methods: We leveraged two evaluation formats, online and in-person, to obtain feedback from a range primary care clinicians and obtain comparative data. Both the online and in-person evaluations used mock patient data to simulate challenging patient scenarios. Primary care clinicians responded to a series of colorectal cancer-related questions about each patient and made recommendations for screening. We collected data on performance, perceived workload, and usability. Key elements of Decision-Centered Design include evaluation in the context of realistic, challenging scenarios and measures designed to explore impact on cognitive performance. Results: Comparison of means revealed increases in accuracy, efficiency, and usability and decreases in perceived mental effort and workload when using the Screening and Surveillance App. Conclusion: The results speak to the benefits of using the Decision-Centered Design approach in the analysis, design, and evaluation of Health Information Technology. Furthermore, the Screening and Surveillance App shows promise for filling decision support gaps in current electronic health records.

Original languageEnglish (US)
Pages (from-to)162-179
Number of pages18
JournalApplied Clinical Informatics
Volume8
Issue number1
DOIs
StatePublished - 2017

Fingerprint

Early Detection of Cancer
Colorectal Neoplasms
Screening
Application programs
Health
Medical Informatics
Primary Health Care
Information technology
Workload
Feedback
Efficiency
Aptitude
Workflow
Electronic Health Records
Cognition
Randomized Controlled Trials
Testing

Keywords

  • Cancer screening
  • Colorectal cancer
  • Decision support techniques
  • Evaluation methodology
  • Health information technology

ASJC Scopus subject areas

  • Computer Science Applications
  • Health Informatics
  • Health Information Management

Cite this

Militello, L. G., Diiulio, J. B., Borders, M. R., Sushereba, C. E., Saleem, J. J., Haverkamp, D., & Imperiale, T. (2017). Evaluating a modular decision support application for colorectal cancer screening. Applied Clinical Informatics, 8(1), 162-179. https://doi.org/10.4338/ACI-2016-09-RA-0152

Evaluating a modular decision support application for colorectal cancer screening. / Militello, Laura G.; Diiulio, Julie B.; Borders, Morgan R.; Sushereba, Christen E.; Saleem, Jason J.; Haverkamp, Donald; Imperiale, Thomas.

In: Applied Clinical Informatics, Vol. 8, No. 1, 2017, p. 162-179.

Research output: Contribution to journalArticle

Militello, LG, Diiulio, JB, Borders, MR, Sushereba, CE, Saleem, JJ, Haverkamp, D & Imperiale, T 2017, 'Evaluating a modular decision support application for colorectal cancer screening', Applied Clinical Informatics, vol. 8, no. 1, pp. 162-179. https://doi.org/10.4338/ACI-2016-09-RA-0152
Militello LG, Diiulio JB, Borders MR, Sushereba CE, Saleem JJ, Haverkamp D et al. Evaluating a modular decision support application for colorectal cancer screening. Applied Clinical Informatics. 2017;8(1):162-179. https://doi.org/10.4338/ACI-2016-09-RA-0152
Militello, Laura G. ; Diiulio, Julie B. ; Borders, Morgan R. ; Sushereba, Christen E. ; Saleem, Jason J. ; Haverkamp, Donald ; Imperiale, Thomas. / Evaluating a modular decision support application for colorectal cancer screening. In: Applied Clinical Informatics. 2017 ; Vol. 8, No. 1. pp. 162-179.
@article{917503da32b942db8dc8bf9719d526dd,
title = "Evaluating a modular decision support application for colorectal cancer screening",
abstract = "Background: There is a need for health information technology evaluation that goes beyond randomized controlled trials to include consideration of usability, cognition, feedback from representative users, and impact on efficiency, data quality, and clinical workflow. This article presents an evaluation illustrating one approach to this need using the Decision-Centered Design framework. Objective: To evaluate, through a Decision-Centered Design framework, the ability of the Screening and Surveillance App to support primary care clinicians in tracking and managing colorectal cancer testing. Methods: We leveraged two evaluation formats, online and in-person, to obtain feedback from a range primary care clinicians and obtain comparative data. Both the online and in-person evaluations used mock patient data to simulate challenging patient scenarios. Primary care clinicians responded to a series of colorectal cancer-related questions about each patient and made recommendations for screening. We collected data on performance, perceived workload, and usability. Key elements of Decision-Centered Design include evaluation in the context of realistic, challenging scenarios and measures designed to explore impact on cognitive performance. Results: Comparison of means revealed increases in accuracy, efficiency, and usability and decreases in perceived mental effort and workload when using the Screening and Surveillance App. Conclusion: The results speak to the benefits of using the Decision-Centered Design approach in the analysis, design, and evaluation of Health Information Technology. Furthermore, the Screening and Surveillance App shows promise for filling decision support gaps in current electronic health records.",
keywords = "Cancer screening, Colorectal cancer, Decision support techniques, Evaluation methodology, Health information technology",
author = "Militello, {Laura G.} and Diiulio, {Julie B.} and Borders, {Morgan R.} and Sushereba, {Christen E.} and Saleem, {Jason J.} and Donald Haverkamp and Thomas Imperiale",
year = "2017",
doi = "10.4338/ACI-2016-09-RA-0152",
language = "English (US)",
volume = "8",
pages = "162--179",
journal = "Applied Clinical Informatics",
issn = "1869-0327",
publisher = "Schattauer GmbH",
number = "1",

}

TY - JOUR

T1 - Evaluating a modular decision support application for colorectal cancer screening

AU - Militello, Laura G.

AU - Diiulio, Julie B.

AU - Borders, Morgan R.

AU - Sushereba, Christen E.

AU - Saleem, Jason J.

AU - Haverkamp, Donald

AU - Imperiale, Thomas

PY - 2017

Y1 - 2017

N2 - Background: There is a need for health information technology evaluation that goes beyond randomized controlled trials to include consideration of usability, cognition, feedback from representative users, and impact on efficiency, data quality, and clinical workflow. This article presents an evaluation illustrating one approach to this need using the Decision-Centered Design framework. Objective: To evaluate, through a Decision-Centered Design framework, the ability of the Screening and Surveillance App to support primary care clinicians in tracking and managing colorectal cancer testing. Methods: We leveraged two evaluation formats, online and in-person, to obtain feedback from a range primary care clinicians and obtain comparative data. Both the online and in-person evaluations used mock patient data to simulate challenging patient scenarios. Primary care clinicians responded to a series of colorectal cancer-related questions about each patient and made recommendations for screening. We collected data on performance, perceived workload, and usability. Key elements of Decision-Centered Design include evaluation in the context of realistic, challenging scenarios and measures designed to explore impact on cognitive performance. Results: Comparison of means revealed increases in accuracy, efficiency, and usability and decreases in perceived mental effort and workload when using the Screening and Surveillance App. Conclusion: The results speak to the benefits of using the Decision-Centered Design approach in the analysis, design, and evaluation of Health Information Technology. Furthermore, the Screening and Surveillance App shows promise for filling decision support gaps in current electronic health records.

AB - Background: There is a need for health information technology evaluation that goes beyond randomized controlled trials to include consideration of usability, cognition, feedback from representative users, and impact on efficiency, data quality, and clinical workflow. This article presents an evaluation illustrating one approach to this need using the Decision-Centered Design framework. Objective: To evaluate, through a Decision-Centered Design framework, the ability of the Screening and Surveillance App to support primary care clinicians in tracking and managing colorectal cancer testing. Methods: We leveraged two evaluation formats, online and in-person, to obtain feedback from a range primary care clinicians and obtain comparative data. Both the online and in-person evaluations used mock patient data to simulate challenging patient scenarios. Primary care clinicians responded to a series of colorectal cancer-related questions about each patient and made recommendations for screening. We collected data on performance, perceived workload, and usability. Key elements of Decision-Centered Design include evaluation in the context of realistic, challenging scenarios and measures designed to explore impact on cognitive performance. Results: Comparison of means revealed increases in accuracy, efficiency, and usability and decreases in perceived mental effort and workload when using the Screening and Surveillance App. Conclusion: The results speak to the benefits of using the Decision-Centered Design approach in the analysis, design, and evaluation of Health Information Technology. Furthermore, the Screening and Surveillance App shows promise for filling decision support gaps in current electronic health records.

KW - Cancer screening

KW - Colorectal cancer

KW - Decision support techniques

KW - Evaluation methodology

KW - Health information technology

UR - http://www.scopus.com/inward/record.url?scp=85013167832&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013167832&partnerID=8YFLogxK

U2 - 10.4338/ACI-2016-09-RA-0152

DO - 10.4338/ACI-2016-09-RA-0152

M3 - Article

C2 - 28197619

AN - SCOPUS:85013167832

VL - 8

SP - 162

EP - 179

JO - Applied Clinical Informatics

JF - Applied Clinical Informatics

SN - 1869-0327

IS - 1

ER -