A process model for quality in use evaluation of clinical decision support systems

Context: Clinical decision support systems (CDSSs) are used to help healthcare professionals in making decisions, offering them a tool for improved medical care practices based on monitoring and management procedures. Although CDSSs exhibit many advantages, challenges remain in terms of their adoption in the clinician community. One such issue is related to user satisfaction and the system reliability. Ensuring the quality of CDSSs is a way to improve their acceptance and adoption. Objective: This study aims to propose a process model for evaluation of the quality in use characteristics of a CDSS to identify deficiencies that reduce its use by healthcare professionals. Methods: We reviewed the existing literature on CDSS assessment and developed a process model based on the international standards ISO/IEC 25010 System and software quality models, and ISO/IEC 25022 Measurement of quality in use. To select measures for evaluating these characteristics, we adopted the Goal-Question-Metric (GQM) method. We evaluated the quality in use characteristics because they can represent system usability. Measurement of these characteristics helps us understand user needs, improve the user experience, and mitigate the low acceptance of CDSS, particularly by the primary users. Results: We developed a process model for measuring the quality in use (QiU) characteristics of CDSSs, explaining its applicability through an illustrative example focused on the characteristics of satisfaction and efficiency. Conclusion: We consider that the proposed process model will benefit the CDSS adoption and contribute to the improvement of the quality of such systems by measuring its QiU.