An information management system for patients with tuberculosis: usability assessment with end-users.
BACKGROUND
Information systems with clinical decision support (CDS) offer great potential to assist the co-ordination of patients with chronic diseases and to improve patient care. Despite this, few have entered routine clinical use.


BACKGROUND
Tuberculosis (TB) is an infection of public health importance. It has complex interactions with many comorbid conditions, requires close supervised care and prolonged treatment for effective cure. These features make it suitable for use with an information management system with CDS features. In close consultation with key stakeholders, a clinical application was developed for the management of TB patients in Victoria.


METHODS
A formal usability assessment using semi-structured case-scenario based exercises was performed. Subjects were 12 individuals closely involved in the care of TB patients, including Infectious Diseases and Respiratory Physicians, and Public Health Nurses. Two researchers conducted the sessions, independently analysed responses and discrepancies compared to the voice record for validity.


RESULTS
Despite varied computer experience, responses were positive regarding user interface and content. Data location was not always intuitive, however this improved with familiarity of the program. Decision support was considered valuable, with useful suggestions for expansion of these features. Automated reporting for correspondence and notification to the Health Department were felt worth the initial investment in data entry. An important workflow-based issue regarding dismissal of alerts and several errors were detected.


CONCLUSIONS
Usability assessment validated many design elements of the system, provided a unique insight into workflow issues faced by users and hopefully will impact on its ultimate clinical utility.
Infectious Diseases Department, St Vincent's Hospital, Melbourne, Fitzroy, Victoria. Jonathan.Darby@svhm.org.au
Jonathan
J
Darby
Jim
J
Black
David
D
Morrison
Kirsty
K
Buising
D006801:Humans; D019451:Information Management / Q000458:organization & administration*; D010358:Patient Participation; D012648:Self Care; D013647:Task Performance and Analysis; D014376:Tuberculosis; D014584:User-Computer Interface