1. Mayo Clinic, Rochester, MN
User-Centered Design and Usability Assessment of an EHR Integrated Automated SOFA Calculator Application
Christopher A Aakre, MD, MSc1, Jaben E Kitson2, Man Li, MD2, Vitaly Herasevich, MD, PhD3,4
1Department of Medicine, 2Department of Information Technology, 3Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C.), 4Department of Anesthesiology and Perioperative Medicine
Mayo Clinic, Rochester, MN
Abstract
Results
Sepsis is a frequently encountered, life-threatening condition with significant in-hospital mortality.
A recent change to the clinical definition of sepsis introduced the need for frequent recalculation and comparison of the Sequential Organ Failure Assessment (SOFA) score.
Automation can overcome this clerical burden.
We describe the user-centered user-interface design and usability assessment of an EHR-integrated app for a previously validated near real-time automated SOFA scoring algorithm that meets clinicians’ needs.
Among the 12/50 (24%) usability survey respondents, our user-centered UX design process resulted in > 75% favorability of survey items in the domains of system usability, information quality, and interface quality.
Introduction
In March 2016, the Third International Consensus Definitions for Sepsis and Septic Shock (SEPSIS-3) redefined sepsis to include a change in SOFA score ≥ 2 points over baseline.
Subsequently, the SOFA score must be frequently recalculated to identify sepsis – increasing clerical burden.
In response to the increased task-load, we developed and validated an automated SOFA score calculator algorithm.
We describe a user-centered design process for the creation of an “app” that integrates this automated SOFA score calculator algorithm into our local critical care EHR.
Methods
We utilized an agile development process to create a user interface (UX) for an automated SOFA score calculator integrated into our local critical care EHR.
Clinician stakeholders were interviewed to determine:
(1) essential
(2) nice to have features
(3) how to display each SOFA component.
UX prototyping was performed using Pencil, an open source graphical user interface prototyping tool, and modified iteratively with feedback from prospective end-users until consensus was attained.
The final UX’s usability was assessed with the Computer Systems Usability Questionnaire by clinician end-users with real world usage of the app over a two-month period in the medical intensive care unit.
Conclusions
By engaging end-user stakeholders throughout the UX design process, we successfully created a user-centered UX for an automated SOFA score calculator app integrated into our local critical care EHR.
Emerging interoperable platforms may allow for rapid creation and distribution of clinical decision support algorithms and calculators as apps.
App developers will need to consider UX usability and user-centered design during creation of these tools.
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