Table 2 User requirements and potential solutions based on the insights from the contextual inquiry sessions
ID | User requirement | Potential solution(s) |
|---|---|---|
1 | The system shall provide the user with information about the alert logic and whether it has taken into consideration the medication reactions or allergies | Check for documented allergies/adverse reactions in the EHR and include information with the alert |
2 | The system shall provide the user with enough context about the patient’s BP readings so that the user can take context into consideration (e.g., falsely elevated BP due to pain) | Include the date the BP was taken, link to associated note, vital signs pain score Make it clear that the values are from the ambulatory BP flowsheet Acknowledge reasons should be based on BP history Explore existing problem-oriented views |
3 | User needs to know the patients’ baseline BP to interpret/make decisions | Show high BPs, and most recent BP |
4 | System should provide an easy way for the user to see trends and correlations between other patient data | Graph BP along with medications and labs, or vitals like weight Provide access to graphical views of trending data |
5 | User needs easier ways to access BP measurements from home, have patients take measurements at home | Integration with other hypertension management efforts across the health system |
6 | Discussion with patient about medication adherence needs to be part of the decision to change/add a medication; or have more information from pharmacy | Ideally, alerts would be suppressed if patient was non-adherent and we would provide separate warnings along the lines of “patient BP running high and not taking medications” |
7 | System provides user with important/relevant information at the appropriate time during the visit (when reviewing history of present illness) | Pop-up alert later in the visit after physician has repeated falsely elevated BP and has had time to talk with patient Explore available trigger points: opening chart, signing orders, closing chart |
8 | User can easily identify values requiring attention (deviating from patient’s baseline) | Prepopulate note with “outstanding labs and vitals,” and other things that need attention during the visit |
9 | System provides user with guidelines and recommendations that are integrated into note workflow/visit workflow | Alerts pull into note when related to a problem that is pulled in Prepopulate note with alert |
10 | System supports the user in prioritizing patient reminders and alerts and addressing them efficiently | Alerts should be patient specific, provider specific and context specific with one-click actionable recommendations Buttons to directly order medications from alert |