Appl Clin Inform 2024; 15(02): 388-396
DOI: 10.1055/s-0044-1786978
Research Article

Factors Influencing Integration and Usability of Model-Informed Precision Dosing Software in the Intensive Care Unit

Ming G. Chai
1   Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
2   Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
Natasha A. Roberts
1   Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
3   Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia
Chelsea Dobbins
4   School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Queensland, Australia
Jason A. Roberts
1   Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
2   Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
5   Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia
6   Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nimes University Hospital, University of Montpellier, Nimes, France
7   Herston Infectious Diseases Institute, Metro North Health, Brisbane, Australia
Menino O. Cotta
1   Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
› Institutsangaben
Funding M.G.C. is supported by a University of Queensland and the Australian National Health and Medical Research Council (NHMRC) (APP2002981) in the form of a Postgraduate Scholarship. J.A.R. is supported by an Australian National Health and Medical Research Council for a Centre of Research Excellence (APP2007007) and an Investigator Grant (APP2009736) as well as an Advancing Queensland Clinical Fellowship.


Background Antimicrobial dosing in critically ill patients is challenging and model-informed precision dosing (MIPD) software may be used to optimize dosing in these patients. However, few intensive care units (ICU) currently adopt MIPD software use.

Objectives To determine the usability of MIPD software perceived by ICU clinicians and identify implementation barriers and enablers of software in the ICU.

Methods Clinicians (pharmacists and medical staff) who participated in a wider multicenter study using MIPD software were invited to participate in this mixed-method study. Participants scored the industry validated Post-study System Usability Questionnaire (PSSUQ, assessing software usability) and Technology Acceptance Model 2 (TAM2, assessing factors impacting software acceptance) survey. Semistructured interviews were used to explore survey responses. The framework approach was used to identify factors influencing software usability and integration into the ICU from the survey and interview data.

Results Seven of the eight eligible clinicians agreed to participate in the study. The PSSUQ usability scores ranked poorer than the reference norms (2.95 vs. 2.62). The TAM2 survey favorably ranked acceptance in all domains, except image. Qualitatively, key enablers to workflow integration included clear and accessible data entry, visual representation of recommendations, involvement of specialist clinicians, and local governance of software use. Barriers included rigid data entry systems and nonconformity of recommendations to local practices.

Conclusion Participants scored the MIPD software below the threshold that implies good usability. Factors such as availability of software support by specialist clinicians was important to participants while rigid data entry was found to be a deterrent.

Protection of Human and Animal Subjects

This study was approved by the Royal Brisbane and Women's Hospital Human Research Ethics committee (LNR/2020/QRBH/67100).

Supplementary Material


Eingereicht: 28. Oktober 2023

Angenommen: 17. April 2024

Artikel online veröffentlicht:
16. Mai 2024

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