Appl Clin Inform 2017; 08(01): 162-179
DOI: 10.4338/ACI-2016-09-RA-0152
Research Article
Schattauer GmbH

Evaluating a Modular Decision Support Application For Colorectal Cancer Screening

Laura G. Militello
1  Applied Decision Science, Dayton, Ohio
Julie B. Diiulio
1  Applied Decision Science, Dayton, Ohio
Morgan R. Borders
1  Applied Decision Science, Dayton, Ohio
Christen E. Sushereba
1  Applied Decision Science, Dayton, Ohio
Jason J. Saleem
2  Department of Industrial Engineering, University of Louisville, Louisville, KY, USA
Donald Haverkamp
3  Centers for Disease Control and Prevention, Albuquerque, NM, USA
Thomas F. Imperiale
4  Department of Medicine, Indiana University School of Medicine
5  Regenstrief Institute
6  Richard L Roudebush, VA Medical Center’s Center of Innovation
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Received: 11. September 2016

Accepted: 05. Februar 2016

20. Dezember 2017 (online)


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.