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Using multi-perspective methodologies to study users’ interactions with the prototype front end of a guideline-based decision support system for diabetic foot care
Authors:Mor Peleg  Aviv Shachak  Eddy Karnieli
Affiliation:a Department of Management Information Systems, University of Haifa, Haifa, Israel
b Galil Center for Medical Informatics, Telemedicine and Personalized Medicine, Technion - Israel Institute of Technology, Haifa, Israel
c Biomedical Informatics Program, University of Rochester, NY, USA
d Institute of Endocrinology, Diabetes & Metabolism, RAMBAM Medical Center, Haifa, Israel
Abstract:

Purpose

Clinical practice guidelines are important instruments for improving the quality of care; in paper form, however, they are not used as effectively as possible. In order to develop a guideline-based decision support system (DSS) prototype to help clinicians deal with diabetic patients’ foot problems, we drew on methodologies from qualitative research, cognitive science, and information systems. This multi-perspective approach was intended to facilitate user-centered design and evaluation.

Methods

We employed field observations, structured interviews, and document analyses to collect and analyze users’ workflow patterns, decision support goals, and preferences regarding interactions with a DSS. Next, we aligned their requirements with sequence diagrams and followed Nielsen's heuristics to develop a DSS prototype. We then performed think-aloud analyses and used the technology acceptance model to direct our evaluation of users’ perceptions of the prototype.

Results

Users had a positive response to the DSS prototype in terms of its clarity of design and ease of use. They expressed a high intention of using the system in the future.

Conclusion

Applying multi-perspective methodologies is an effective way to study and design user interactions with the front end of a guideline-based DSS.
Keywords:Clinical practice guidelines   Clinical decision support systems   Usability heuristics   Technology acceptance   Sequence diagrams
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