Clinical Informatics

Evaluating a Clinical Decision Support System: A basic field study approach


  1. Introduction

  2. Evaluation framework and techniques

  3. Evaluation processes

    1. Basic usability

    2. Field study results

  4. Redesign possibilities

  5. Strengths and weaknesses of the field study approach

  6. Conclusion

  7. References

Redesign Possibilities


The weight factor of the tablets has to be addressed. A possible solution would be to attach these units to a sliding mechanism on the ceiling, or to have a fixed unit at the end of each bed. This would also address the power supply issue and ensures that the units are always ready for use.

Data Entry

Ease of data entry is crucial in a time and task critical environment. In the absence of a mouse or keyboard, a touch sensitive screen is essential to facilitate rapid and flexible data entry.

This issue would become even more critical when the full Electronic Patient Record is implemented, as there would then be a need for a large amount of text entry into these units.

The development and incorporation of hand-writing recognition technology would be the ideal solution in this situation as most people can write faster than they can type using portable units with virtual keyboards.

Voice recognition is another alternative. However, the high ambience noise level in a busy NHS hospital ward would make implementation of voice recognition technically very difficult, if not impossible.

Automated Log-ins, not Log-outs

A new approach is also needed to address the repeated log-ins required with the "secure-access" issue.

In some trusts, the automatic log-out featured have interrupted the work-flow so much in Accident and Emergency units that they have been permanently disabled. This is a trade off between "data security and privacy" versus "efficient patient care" and "uninterrupted clinical workflows".

An ideal system would be secure but yet provide easy access to authorised users.

This can be achieved with an intelligent system which utilises a dual authentication process. The first authentication can be based on fingerprint recognition while the second, based on radio-frequency-identification-device (RFID) technology. The RFID chip can be embedded within the staff ID card for extra security and practicality purposes.

Once the authorised user is log-in, as long as the authorised user is within a defined close proximity, then the system will not log him/her out automatically. But when the user leaves the unit, then the system will log the user out automatically.

Such a system can also be configured so that it can recognised a pool of users in close proximity, and is able to intelligently switch authorisation or log-in for the nearest user, without the user having to go through the 2-step log-in process again.

Expert Access

Advanced or expert features can be added to the system in order to facilitate the use of drugs in special situations. This can take the form of special "high-level access passwords" which are only released to specific individuals. These additional access rights can also be hard-coded into RFID chips for added security.


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Page Updated: 17 May, 2017

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