Usability of clinical decision support systems

Usability is considered a major success factor for current and future decision support systems. Such systems are increasingly used to assist human decision-makers in high-stakes tasks in complex domains such as health care, jurisdiction or finance. Yet, many if not most expert systems—especially in health care—fail to deliver the degree of quality in terms of usability that its expert users are used to from their personal digital consumer products. In this article, we focus on clinical decision support systems (CDSS) as an example for how important a human-centered design approach is when designing complex software in complex contexts. We provide an overview of CDSS classes, discuss the importance of systematically exploring mental models of users, and formulate challenges and opportunities of future design work on CDSS. We further provide a case study from a current research project to illustrate how we used codesign as a practical approach to produce usable software in a real-world context.Practical Relevance: We make a point for usability to be considered a major success factor and non-negotiable characteristic of expert software. With software evolving into virtual coworkers in terms of supporting human decision-making in complex, high-risk domains, the necessity of and demand for systems that are unambiguously understandable and interpretable for their expert users have never been higher. We show that this is a real-world problem with high practical relevance by describing our work in the domain of clinical decision support systems (CDSS) as an example. We introduce the topic and a classification of CDSS. Thus, we highlight a conceptual framework of how to approach complex domains from a technology designer’s point of view. We continue by explaining why usability must be regarded as a major goal in software development. We derive challenges and opportunities that may well be transferred to other domains. Finally, be including a real-world example from our own professional work we propose a practical approach towards taking the challenges and exploiting the associated opportunities.