title: Design of a Tablet Computer App for Facilitation of a Molecular Blood Culture Test in Clinical Microbiology and Preliminary Usability Evaluation.
abstract: BACKGROUND
  User mobility is an important aspect of the development of clinical information systems for health care professionals. Mobile phones and tablet computers have obtained widespread use by health care professionals, offering an opportunity for supporting the access to patient information through specialized applications (apps) while supporting the mobility of the users. The use of apps for mobile phones and tablet computers may support workflow of complex tasks, for example, molecular-based diagnostic tests in clinical microbiology. Multiplex Blood Culture Test (MuxBCT) is a molecular-based diagnostic test used for rapid identification of pathogens in positive blood cultures. To facilitate the workflow of the MuxBCT, a specialized tablet computer app was developed as an accessory to the diagnostic test. The app aims to reduce the complexity of the test by step-by-step guidance of microscopy and to assist users in reaching an exact bacterial or fungal diagnosis based on blood specimen observations and controls. Additionally, the app allows for entry of test results, and communication thereof to the laboratory information system (LIS).
  
  
  OBJECTIVE
  The objective of the study was to describe the design considerations of the MuxBCT app and the results of a preliminary usability evaluation.
  
  
  METHODS
  The MuxBCT tablet app was developed and set up for use in a clinical microbiology laboratory. A near-live simulation study was conducted in the clinical microbiology laboratory to evaluate the usability of the MuxBCT app. The study was designed to achieve a high degree of realism as participants carried out a scenario representing the context of use for the MuxBCT app. As the MuxBCT was under development, the scenario involved the use of molecular blood culture tests similar to the MuxBCT for identification of microorganisms from positive blood culture samples. The study participants were observed, and their interactions with the app were recorded. After the study, the participants were debriefed to clarify observations.
  
  
  RESULTS
  Four medical laboratory technicians, for example, representative of end users of the app, participated in the clinical simulation study. Using the MuxBCT app, the study participants successfully identified and reported all microorganisms from the positive blood cultures examined. Three of the four participants reported that they found the app useful, while one study participant reported that she would prefer to make notes on paper and later enter them into the LIS.
  
  
  CONCLUSIONS
  The preliminary usability evaluation results indicate that use of the MuxBCT tablet app can facilitate the workflow of the MuxBCT diagnostic test.
authors.affiliation: Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. lsamson@hst.aau.dk.
authors.forename: Lasse L
authors.identifier: http://orcid.org/0000-0002-5400-1848
authors.initials: LL
authors.lastname: Samson
authors.forename: Louise
authors.identifier: http://orcid.org/0000-0002-1655-8792
authors.initials: L
authors.lastname: Pape-Haugaard
authors.forename: Michelle C
authors.identifier: http://orcid.org/0000-0003-2896-0356
authors.initials: MC
authors.lastname: Meltzer
authors.forename: Martin
authors.identifier: http://orcid.org/0000-0001-5024-8969
authors.initials: M
authors.lastname: Fuchs
authors.forename: Henrik C
authors.identifier: http://orcid.org/0000-0002-7599-4658
authors.initials: HC
authors.lastname: Schønheyder
authors.forename: Ole
authors.identifier: http://orcid.org/0000-0003-3578-8750
authors.initials: O
authors.lastname: Hejlesen
keywords: clinical microbiology; clinical simulation; diagnostic test; health information systems; mobile applications; tablet computers; usability