Tailoring Interface for Spanish Language: A Case Study with CHICA System.
ABSTRACT We developed a clinical decision support system (CDSS) – Child Health Improvement through Computer Automation (CHICA) - to
deliver patient specific guidance at the point of clinical care. CHICA captures structured data from families, physicians,
and nursing, staff using a scannable paper user interface - Adaptive Turnaround Documents (ATD) while remaining sensitive
to the workflow constraints of a busy outpatient pediatric practice. The system was deployed in November 2004 with an English
language only user interface. In July 2005, we enhanced the user interface with a Spanish version of the pre-screening questionnaire
to capture information from Spanish speaking families in our clinic. Subsequently, our results show an increase in rate of
family responses to the pre-screening questionnaire by 36% (51% vs. 87%) in a four month time period before and after the
Spanish interface deployment and up to 32% (51% vs. 83%) since November 2004. Furthermore, our results show that Spanish speaking
families, on average, respond to the questionnaire more than English speaking families (85% vs. 49%). This paper describes
the design, implementation challenges and our measure of success when trying to adapt a computer scannable paper interface
to another language.
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ABSTRACT: This paper reviews clinical decision support systems (CDSS) literature, with a focus on evaluation. The literature indicates a general consensus that clinical decision support systems are thought to have the potential to improve care. Evidence is more equivocal for guidelines and for systems to aid physicians with diagnosis. There also is general consensus that a variety of systems are little used despite demonstrated or potential benefits. In the evaluation literature, the main emphasis is on how clinical performance changes. Most studies use an experimental or randomized controlled clinical trials design (RCT) to assess system performance or to focus on changes in clinical performance that could affect patient care. Few studies involve field tests of a CDSS and almost none use a naturalistic design in routine clinical settings with real patients. In addition, there is little theoretical discussion, although papers are permeated by a rationalist perspective that excludes contextual issues related to how and why systems are used. The studies mostly concern physicians rather than other clinicians. Further, CDSS evaluation studies appear to be insulated from evaluations of other informatics applications. Consequently, there is a lack of information useful for understanding why CDSSs may or may not be effective, resulting in making less informed decisions about these technologies and, by extension, other medical informatics applications.International Journal of Medical Informatics 12/2001; 64(1):15-37. · 2.06 Impact Factor
Article: Rationale for the Arden Syntax.[Show abstract] [Hide abstract]
ABSTRACT: The Arden Syntax, a language designed for writing and sharing task-specific knowledge for Medical Logic Modules (MLMs), has been recently accepted as a standard by the ASTM. The syntax is concerned with the critical task of sharing medical knowledge bases across many institutions. Because of the relative lack of agreement on vocabularies and data standards and because of the many other obstacles, the developers of the Arden Syntax took a pragmatic, straightforward approach that has borne fruit in a very short period of time. The syntax provides a vehicle for the health care community to begin sharing, so that we can see what works and what does not work, and we can begin to address the critical obstacles. In designing a language like the Arden Syntax, the authors make many decisions--but the final document gives only the result of these decisions without any explanation. By writing down the rationale behind the design of the syntax, we hope to aid users of the language, implementors of the language, and future designers of new languages.Computers and Biomedical Research 09/1994; 27(4):291-324.
Article: Protocol-based computer reminders