Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systems
Abstract Background In prehospital emergency care, providers face significant challenges in making informed decisions due to factors such as limited cognitive support, high-stress environments, and lack of experience with certain patient conditions. Effective Clinical Decision Support Systems (CDSS)...
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BMC
2025-01-01
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| Series: | BMC Medical Informatics and Decision Making |
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| Online Access: | https://doi.org/10.1186/s12911-024-02844-1 |
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| author | Enze Bai Zhan Zhang Yincao Xu Xiao Luo Kathleen Adelgais |
| author_facet | Enze Bai Zhan Zhang Yincao Xu Xiao Luo Kathleen Adelgais |
| author_sort | Enze Bai |
| collection | DOAJ |
| description | Abstract Background In prehospital emergency care, providers face significant challenges in making informed decisions due to factors such as limited cognitive support, high-stress environments, and lack of experience with certain patient conditions. Effective Clinical Decision Support Systems (CDSS) have great potential to alleviate these challenges. However, such systems have not yet been widely adopted in real-world practice and have been found to cause workflow disruptions and usability issues. Therefore, it is critical to investigate how to design CDSS that meet the needs of prehospital providers while accounting for the unique characteristics of prehospital workflows. Methods We conducted semi-structured interviews with 20 prehospital providers recruited from four Emergency Medical Services (EMS) agencies in an urban area in the northeastern U.S. The interviews focused on the decision-making challenges faced by prehospital providers, their technological needs for decision support, and key considerations for the design and implementation of a CDSS that can seamlessly integrate into prehospital care workflows. The data were analyzed using content analysis to identify common themes. Results Our qualitative study identified several challenges in prehospital decision-making, including limited access to diagnostic tools, insufficient experience with certain critical patient conditions, and a lack of cognitive support. Participants highlighted several desired features to make CDSS more effective in the dynamic, hands-busy, and cognitively demanding prehospital context, such as automatic prompts for possible patient conditions and treatment options, alerts for critical patient safety events, AI-powered medication identification, and easy retrieval of protocols using hands-free methods (e.g., voice commands). Key considerations for successful CDSS adoption included balancing the frequency and urgency of alerts to reduce alarm fatigue and workflow disruptions, facilitating real-time data collection and documentation to enable decision generation, and ensuring trust and accountability while preventing over-reliance when using CDSS. Conclusion This study provides empirical insights into the challenges and user needs in prehospital decision-making and offers practical and system design implications for addressing these issues. |
| format | Article |
| id | doaj-art-f93b578cb38f4a4fbae268b3f784784b |
| institution | Kabale University |
| issn | 1472-6947 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj-art-f93b578cb38f4a4fbae268b3f784784b2025-01-19T12:26:10ZengBMCBMC Medical Informatics and Decision Making1472-69472025-01-0125111210.1186/s12911-024-02844-1Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systemsEnze Bai0Zhan Zhang1Yincao Xu2Xiao Luo3Kathleen Adelgais4School of Computer Science and Information Systems, Pace UniversitySchool of Computer Science and Information Systems, Pace UniversitySchool of Computer Science and Information Systems, Pace UniversitySchool of Business, Oklahoma State UniversitySchool of Medicine, University of ColoradoAbstract Background In prehospital emergency care, providers face significant challenges in making informed decisions due to factors such as limited cognitive support, high-stress environments, and lack of experience with certain patient conditions. Effective Clinical Decision Support Systems (CDSS) have great potential to alleviate these challenges. However, such systems have not yet been widely adopted in real-world practice and have been found to cause workflow disruptions and usability issues. Therefore, it is critical to investigate how to design CDSS that meet the needs of prehospital providers while accounting for the unique characteristics of prehospital workflows. Methods We conducted semi-structured interviews with 20 prehospital providers recruited from four Emergency Medical Services (EMS) agencies in an urban area in the northeastern U.S. The interviews focused on the decision-making challenges faced by prehospital providers, their technological needs for decision support, and key considerations for the design and implementation of a CDSS that can seamlessly integrate into prehospital care workflows. The data were analyzed using content analysis to identify common themes. Results Our qualitative study identified several challenges in prehospital decision-making, including limited access to diagnostic tools, insufficient experience with certain critical patient conditions, and a lack of cognitive support. Participants highlighted several desired features to make CDSS more effective in the dynamic, hands-busy, and cognitively demanding prehospital context, such as automatic prompts for possible patient conditions and treatment options, alerts for critical patient safety events, AI-powered medication identification, and easy retrieval of protocols using hands-free methods (e.g., voice commands). Key considerations for successful CDSS adoption included balancing the frequency and urgency of alerts to reduce alarm fatigue and workflow disruptions, facilitating real-time data collection and documentation to enable decision generation, and ensuring trust and accountability while preventing over-reliance when using CDSS. Conclusion This study provides empirical insights into the challenges and user needs in prehospital decision-making and offers practical and system design implications for addressing these issues.https://doi.org/10.1186/s12911-024-02844-1Clinical decision support systemEmergency medical servicesPrehospital workflowUser-centered design |
| spellingShingle | Enze Bai Zhan Zhang Yincao Xu Xiao Luo Kathleen Adelgais Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systems BMC Medical Informatics and Decision Making Clinical decision support system Emergency medical services Prehospital workflow User-centered design |
| title | Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systems |
| title_full | Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systems |
| title_fullStr | Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systems |
| title_full_unstemmed | Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systems |
| title_short | Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systems |
| title_sort | enhancing prehospital decision making exploring user needs and design considerations for clinical decision support systems |
| topic | Clinical decision support system Emergency medical services Prehospital workflow User-centered design |
| url | https://doi.org/10.1186/s12911-024-02844-1 |
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