Evaluation of the Acceptability and Usability of a Decision Support System to Encourage Safe and Effective Use of Opioid Therapy for Chronic, Noncancer Pain by Primary Care Providers

Abstract

Usability testing optimized the CDSS to better address barriers such as lack of provider education, confusion in dosing calculations and titration schedules, access to relevant patient information, provider discontinuity, documentation, and access to validated assessment tools. It also highlighted barriers to good clinical practice that are difficult to address with CDSS technology in its current conceptualization. For example, clinicians indicated that constraints on time and competing priorities in primary care, discomfort in patient-provider communications, and lack of evidence to guide opioid prescribing decisions impeded their ability to provide effective, guideline-adherent pain management. Iterative testing was essential for designing a highly usable and acceptable CDSS; however, identified barriers may limit the impact of the ATHENA-Opioid Therapy system and other CDSS on clinical practices and outcomes unless CDSS are paired with parallel initiatives to address these issues.

Behavioral medicine perspectives on the design of health information technology to improve decision-making, guideline adherence, and care coordination in chronic pain management

“…One surprising finding was the frequency at which behavioral medicine specialists warned against making assumptions about or trying to systematize the roles of a given provider type within a pain management system. Discussions with primary care doctors during development had suggested that tailoring the CDS for other provider types might be helpful [20]. Behavioral medicine specialists interviewed here cautioned about making too many changes to the system for specific providers.…”

“…While ATHENA-OT was found to be generally helpful to PCPs [20], the CDS has not yet been designed for use by health professionals in other disciplines or to assist in collaborative care. Perceptions of the use of computers in a clinical setting vary across professions [21], and decision-support needs may differ depending on job function in a clinic.…”

CrimeTelescope: crime hotspot prediction based on urban and social media data fusion

“…Therefore, in order to evaluate our platform from a user experience perspective, we use the System Usability Scale (SUS) survey [10], which is a popular usability evaluation method that has been used to assess various online (a) (b) Figure 13 Crime hotspot map for two crime types: a Rape; b Grand Larceny of Motor Vehicle systems, such as clinical decision support systems [34], search engines [14], disaster management systems [43], social network applications [44], etc. This SUS survey contains a questionnaire with ten statements, where participants are supposed to indicate the degree of agreement with each statement according to the Likert Scale [21], i.e., a five-point scale from 1 ("Strongly disagree") to 5 ("Strongly agree").…”

Challenges in Developing Effective Clinical Decision Support Systems

“…This work focused on the development and evaluation of a CDSS to assist physicians in treating patients with chronic heart failure, and provides definitive support for the concept of iterative evaluation during CDSS development (Trafton et al, 2010) combined with a multidisciplinary approach to organizational and social aspects of the system environment (Kaplan, 2001). The CDSS was developed after discussions with a multidisciplinary panel, and evaluation took place during three stages over a 6 month period that involved an editorial check, interviews with potential users, and educational meetings with users.…”

“…• (Trafton et al, 2010) developed and implemented a CDSS using iterative evaluation throughout system analysis, design, development, implementation, including simulation and in-clinic assessments of usability for providers followed by targeted system revisions. Volunteers that evaluated the system at particular times provided detailed feedback that was used to guide improvements in the graphical user interface, system content, and design changes that increased clinical usefulness, understandability, clinical workflow fit, and ease of completing recommended practices according to specific guidelines.…”