What do healthcare professionals need to turn risk models for type 2 diabetes into usable computerized clinical decision support systems? Lessons learned from the MOSAIC project
Open accessAbstract
BACKGROUND: To understand user needs, system requirements and organizational conditions towards successful design and adoption of Clinical Decision Support Systems for Type 2 Diabetes (T2D) care built on top of computerized risk models. METHODS: The holistic and evidence-based CEHRES Roadmap, used to create eHealth solutions through participatory development approach, persuasive design techniques and business modelling, was adopted in the MOSAIC project to define the sequence of multidisciplinary methods organized in three phases, user needs, implementation and evaluation. The research was qualitative, the total number of participants was ninety, about five-seventeen involved in each round of experiment. RESULTS: Prediction models for the onset of T2D are built on clinical studies, while for T2D care are derived from healthcare registries. Accordingly, two set of DSSs were defined: the first, T2D Screening, introduces a novel routine; in the second case, T2D Care, DSSs can support managers at population level, and daily practitioners at individual level. In the user needs phase, T2D Screening and solution T2D Care at population level share similar priorities, as both deal with risk-stratification. End-users of T2D Screening and solution T2D Care at individual level prioritize easiness of use and satisfaction, while managers prefer the tools to be available every time and everywhere. In the implementation phase, three Use Cases were defined for T2D Screening, adapting the tool to different settings and granularity of information. Two Use Cases were defined around solutions T2D Care at population and T2D Care at individual, to be used in primary or secondary care. Suitable filtering options were equipped with "attractive" visual analytics to focus the attention of end-users on specific parameters and events. In the evaluation phase, good levels of user experience versus bad level of usability suggest that end-users of T2D Screening perceived the potential, but they are worried about complexity. Usability and user experience were above acceptable thresholds for T2D Care at population and T2D Care at individual. CONCLUSIONS: By using a holistic approach, we have been able to understand user needs, behaviours and interactions and give new insights in the definition of effective Decision Support Systems to deal with the complexity of T2D care.
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Multiple authors in the included studies indicated that usability tests should be conducted with a broad range of stakeholders, not only end users such as patients, but also caregivers, managers, technology developers, and experts on content and design.
“First, multiple authors indicated that usability tests should be conducted with a broad range of stakeholders: not only end users such as patients, but also caregivers, managers, technology developers, and experts on content and design”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [64]
Multiple authors in the included studies stated that ideally, multiple methods should be combined to paint a full picture of a prototype's usability.
“Second, authors stated that ideally, multiple methods should be combined to paint a full picture of a prototype’s usability”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [64]
Authors stated that values should be formulated in such a way that they are neither too specific to prevent overlap with requirements nor too broad and vague.
“First, authors stated that values should be formulated in such a way that they are neither too specific to prevent overlap with requirements nor too broad and vague.”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [64]
When shaping a multi-method or mixed methods development process, an iterative and flexible development approach is key.
“the lessons learned illustrated that when shaping a multi-method or mixed methods development process, an iterative and flexible development approach is key [33,54,55,64,113,115].”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [64]
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- Authors
- Fico, G., Hernanzez, L., Cancela, J., Dagliati, A., Sacchi, L., Martinez-Millana, A., Posada, J., Manero, L., Verdú, J., Facchinetti, A., Ottaviano, M., Zarkogianni, K., Nikita, K., Groop, L., Gabriel-Sanchez, R., Chiovato, L., Traver, V., Merino-Torres, J. F., Cobelli, C., Bellazzi, R., & Arredondo, M. T.
- Affiliations
- Universidad Politécnica de Madrid (ES)
- University of Manchester (GB)
- University of Pavia (IT)
- Medtronic (Spain) (ES)
- University of Padua (IT)
- National Technical University of Athens (GR)
- Lund University (SE)
- Istituti Clinici Scientifici Maugeri (IT)
- Universitat Politècnica de València (ES)
- Hospital Universitari i Politècnic La Fe (ES)
- Corresponding author
- Fico, Giuseppe
- ORCID
- Venue
- BMC Medical Informatics and Decision Making
- Published
- 2019-08-16
- Volume
- 19
- Issue
- 1
- Pages
- 163-163
- ISSN
- 1472-6947 (ISSN-L)
- PMC
- PMC6697904
- OpenAlex
- W2968940548
- Cited by
- 22
- References
- 46
- Citations by year
- 2024: 4 · 2023: 3 · 2022: 10 · 2021: 2 · 2020: 2
- FWCI
- 3.81
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medical Informatics and Decision Making (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivo Digital UPM (Universidad Politécnica de Madrid) (acceptedVersion, cc-by-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- RiuNet (Universitat Politècnica de València) (submittedVersion, cc-by-nc-nd)
- Padua Research Archive (University of Padova) (submittedVersion)
- Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, cc-by)
- Funders
- FP7 International Cooperation (600914)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Keywords
- type 2 diabetes, clinical decision support systems, risk prediction model, diabetes screening, risk stratification, user needs, usability, user experience, visual analytics, digital health adoption, primary and secondary care, health information systems, MOSAIC project
- MeSH terms
- Adult, Aged, Computer Simulation, Diabetes Mellitus, Type 2, Female, Humans, Male, Mass Screening, Middle Aged, Software, Telemedicine, Risk Assessment, Decision Support Systems, Clinical
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