title: Accessibility, usability, and usefulness of a Web-based clinical decision support tool to enhance provider-patient communication around Self-management TO Prevent (STOP) Stroke.
abstract: This article reports redesign strategies identified to create a Web-based user-interface for the Self-management TO Prevent (STOP) Stroke Tool. Members of a Stroke Quality Improvement Network (N = 12) viewed a visualization video of a proposed prototype and provided feedback on implementation barriers/facilitators. Stroke-care providers (N = 10) tested the Web-based prototype in think-aloud sessions of simulated clinic visits. Participants' dialogues were coded into themes. Access to comprehensive information and the automated features/systematized processes were the primary accessibility and usability facilitator themes. The need for training, time to complete the tool, and computer-centric care were identified as possible usability barriers. Patient accountability, reminders for best practice, goal-focused care, and communication/counseling themes indicate that the STOP Stroke Tool supports the paradigm of patient-centered care. The STOP Stroke Tool was found to prompt clinicians on secondary stroke-prevention clinical-practice guidelines, facilitate comprehensive documentation of evidence-based care, and support clinicians in providing patient-centered care through the shared decision-making process that occurred while using the action-planning/goal-setting feature of the tool.
authors.affiliation: VA Health Services Research & Development - Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. Debark VAMC, Baylor College of Medicine, USA Jane.Anderson@va.gov.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Anderson
authors.affiliation: VA Health Services Research & Development - Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. Debark VAMC, Baylor College of Medicine, USA.
authors.forename: Kyler M
authors.initials: KM
authors.lastname: Godwin
authors.affiliation: VA Health Services Research & Development - Center on Implementing Evidence Based Practice, Richard Roudebush VAMC, Regenstrief Institute, Inc., USA.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Saleem
authors.affiliation: Health Services Research & Development - Center on Implementing Evidence Based Practice, Richard L. Roudebush Veterans Affairs Medical Center, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Russell
authors.affiliation: US Department of Veterans Affairs, USA.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Robinson
authors.affiliation: The University of Texas Health Science Center at Houston, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kimmel
mesh_terms: D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D005260:Female; D006282:Health Personnel; D006293:Health Promotion / Q000458:organization & administration*; D006297:Health Services Accessibility; D006801:Humans; D033183:Interdisciplinary Communication; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012648:Self Care / Q000379:methods*; D020521:Stroke / Q000517:prevention & control*; D014481:United States
keywords: Clinical decision support tool; clinical-practice guidelines; prevention; provider–patient communication; stroke