This document summarizes a summer school on clinical decision making that proposes using connected health technologies like a patient dashboard to give clinicians access to lifestyle data from patients. It outlines an iterative user-centered design process for developing such a technology, including conducting interviews and prototyping. The evaluation strategy involves randomized controlled trials to assess impacts on decision making, health outcomes, and other proximal and distal measures. Challenges discussed include security, standards, ethics, and ensuring benefits across diverse patient populations. The goal is to improve clinical decisions and prevent errors by providing relevant information to clinicians during appointments.

1. 2017 EIT Health/ACM SIGCHI
Summer School
Partners Dorota Filipczuk, University of Southampton
Clair Kelly, IPPOSI
Gillian O’Neill, University College Dublin
Beth J. Bollinger, University of Washington
Stefanie Broes, KU Leuven
Kathleen Ryan, University College Cork
Experts Kristen Miller, MedStar Health
Ryan Arnold, MedStar Health

2. Background
Clinical decision making
clinician Patient
Traditional
Health Summer School ‘17

4. She is totally
lying….
Hmm…forgot
on Saturday
…and
Monday
…and
Thursday
Medication compliance..

5. Come on.....really?
Nutrition...

6. Mental health….
Social factors….

7. Substance use...

8. Background
Improved informed
clinical decision
making?
clinician Patient
Today
Health Summer School ‘17

10. Monday Tuesday Wednesday

14. Health Summer School ‘17
What do we propose?
clinician Patient
Tomorrow
Improved informed
clinical decision making

15. User-centered process
Vision and business
plan
UCSD
Construct and deploy
Implementation strategy
User needs and
requirement analysis
 interviews
Design for usability by
prototyping
Evaluation in use
context
Feedback plan
Iterative design process
Based on Key principles for user-centred systems design, Gulliksen J, 2003 Health Summer School ‘17

16. Specific methods used
- Learn: Activity Analysis
- Look: Day in the Life
- Ask: Surveys & Questionnaires
- Try: Quick-and-dirty prototyping
Health Summer School ‘17

17. Connected Health Patient Dashboard

18. “Widgets”
Physical Activity
Nutrition
Sleep
Mental Health
Stress, Anxiety, Mood
Women’s Health
Social Well-being
Home Violence
Medical Adherence
Illicit Drug Use

19. Evaluation Strategy
Outcome measures of Success for Usable and Effective Clinical Decision Support
Health Summer School ‘17
Proximal Outcomes DISTAL OUTCOMES
Mix of objective and subjective measures
Usability
Acceptability
Quality of encounter
Appointment efficiency
Satisfaction with provision of care
Mix of objective and subjective measures
Clinician decision making
Patient health

20. Selection of
participants
Self-mon
App+
Self-mon
App-
Control
App+
Control
App-
- Data collection
- Analysis
- outcomes
Self-mon Control
Randomization Randomization
Evaluation Strategy
Health Summer School ‘17

21. Ideal Scenario
• Jenny’s Doctor now has access to her lifestyle information
• He sees issues with her diet and exercise
• He then focuses the consultation towards lifestyle choices
• He doesn’t increase Jenny’s medication on this occasion

22. Thank you
Dorota, Clair, Gillian, Beth,
Stefanie, Kathleen, Kristen, Ryan

23. Security and privacy, diverging data
standards, artificial intelligence
techniques…
Challenges
Technical
Informed consent, data protection,
liability, cross-border healthcare,
non-discrimination…
Divergent patient population
(diabilities, elderly, children…)...
Informed consent, trust, autonomy,
privacy, dignity, ownership…
Legal
HCI Ethical
Health Summer School ‘17

24. Scoping the market
• Medical errors in prescription and medication dosing were named the third
leading cause of death in the US in 2013
• In 2008, medical errors cost the United States $19.5 billion1
• Giving clinicians access to the right information at the right time through
evidence-based clinical decision support can prevent these errors and reduce
instances of patient harm
1 The economics of health care quality and medical errors, Andel C., J Healthcare Finance, 2012 Health Summer School ‘17