A Clinical Decision Support System for Integrating Tuberculosis and HIV Care in Kenya: A Human-Centered Design Approach
Open Access
- 29 August 2014
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 9 (8), e103205
- https://doi.org/10.1371/journal.pone.0103205
Abstract
With the aim of integrating HIV and tuberculosis care in rural Kenya, a team of researchers, clinicians, and technologists used the human-centered design approach to facilitate design, development, and deployment processes of new patient-specific TB clinical decision support system for medical providers. In Kenya, approximately 1.6 million people are living with HIV and have a 20-times higher risk of dying of tuberculosis. Although tuberculosis prevention and treatment medication is widely available, proven to save lives, and prioritized by the World Health Organization, ensuring that it reaches the most vulnerable communities remains challenging. Human-centered design, used in the fields of industrial design and information technology for decades, is an approach to improving the effectiveness and impact of innovations that has been scarcely used in the health field. Using this approach, our team followed a 3-step process, involving mixed methods assessment to (1) understand the situation through the collection and analysis of site observation sessions and key informant interviews; (2) develop a new clinical decision support system through iterative prototyping, end-user engagement, and usability testing; and, (3) implement and evaluate the system across 24 clinics in rural West Kenya. Through the application of this approach, we found that human-centered design facilitated the process of digital innovation in a complex and resource-constrained context.This publication has 44 references indexed in Scilit:
- Community Health Workers and Mobile Technology: A Systematic Review of the LiteraturePLOS ONE, 2013
- “Quality of prenatal and maternal care: bridging the know-do gap” (QUALMAT study): an electronic clinical decision support system for rural Sub-Saharan AfricaBMC Medical Informatics and Decision Making, 2013
- Information technology systems in public sector health facilities in developing countries: the case of South AfricaBMC Medical Informatics and Decision Making, 2013
- Health system barriers to implementation of collaborative TB and HIV activities including prevention of mother to child transmission in South AfricaTropical Medicine & International Health, 2012
- Developing public health clinical decision support systems (CDSS) for the outpatient community in New York City: our experienceBMC Public Health, 2011
- Review of health information technology usability study methodologiesJournal of the American Medical Informatics Association, 2011
- Computerized clinical decision support systems for drug prescribing and management: A decision-maker-researcher partnership systematic reviewImplementation Science, 2011
- Computerized clinical decision support systems for primary preventive care: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomesImplementation Science, 2011
- Evaluation of computer-generated reminders to improve CD4 laboratory monitoring in sub-Saharan Africa: a prospective comparative studyJournal of the American Medical Informatics Association, 2011
- Barriers to implementation of isoniazid preventive therapy in HIV clinics: a qualitative studyAIDS, 2010