Previous activities (cross-walking the guideline logic to local conventions and developing the workflow design) will already have gone some way towards developing a framework for the intervention designs. In this activity, the design work for the CDS is completed, working closely with users. Exactly how this phase progresses will be dependent on the systems design methods in place for the EMR at the implementation site.
Clinician users should be closely engaged as the design unfolds. Preferably, UI design should be performed iteratively using prototyping tools and techniques that allow users to engage with the system as the design progresses and to understand the implications of the design for their clinical workflow.
- Documentation templates
- Assessment forms for completion by patients, clinicians
- Data flow sheets (combination of data display and data form entry)
- Presentation of relevant data for documentation or ordering
- Choice lists
- Order sets
- Tools for complex ordering including guided dose algorithms
- Calculators Context sensitive links to knowledge sources (infobuttons)
- Encounter-linked reminders
- Dynamically-generated alerts
User Centered Design: With CDS design, perhaps even more than other clinical EHR applications, it is critical to involve users closely in design, and to critique the usability of the design prior to deployment. Use case documentation, and iterative prototyping techniques are particularly helpful in shaping designs.
Design Standards: It is important to determine policies and standards for CDS design up front. For example, should intervention design be prescriptive or suggestive? What incentives should be provided for to users to use the CDS? What feedback/reporting should be given to CDS users?
Intervention Specifications: It may be useful to capture all pertinent design information for each specific CDS intervention in a single specification form, to be integrated with the systems development methodology in place at each site.