Usability of the IDDEAS prototype in child and adolescent mental health services: A qualitative study for clinical decision support system development

Carolyn Clausen; Bennett Leventhal; Øystein Nytrø; Roman Koposov; Thomas Brox Røst; Odd Sverre Westbye; Kaban Koochakpour; Thomas Frodl; Line Stien; Norbert Skokauskas

doi:10.3389/fpsyt.2023.1033724

Usability of the IDDEAS prototype in child and adolescent mental health services: A qualitative study for clinical decision support system development

Front Psychiatry. 2023 Feb 23:14:1033724. doi: 10.3389/fpsyt.2023.1033724. eCollection 2023.

Authors

Affiliations

¹ Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
² Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States.
³ Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway.
⁴ RKBU Northern Norway, UiT The Arctic University of Norway, Tromsø, Norway.
⁵ Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway.
⁶ Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany.

Abstract

Introduction: Child and adolescent mental health services (CAMHS) clinical decision support system (CDSS) provides clinicians with real-time support as they assess and treat patients. CDSS can integrate diverse clinical data for identifying child and adolescent mental health needs earlier and more comprehensively. Individualized Digital Decision Assist System (IDDEAS) has the potential to improve quality of care with enhanced efficiency and effectiveness.

Methods: We examined IDDEAS usability and functionality in a prototype for attention deficit hyperactivity disorder (ADHD), using a user-centered design process and qualitative methods with child and adolescent psychiatrists and clinical psychologists. Participants were recruited from Norwegian CAMHS and were randomly assigned patient case vignettes for clinical evaluation, with and without IDDEAS. Semi-structured interviews were conducted as one part of testing the usability of the prototype following a five-question interview guide. All interviews were recorded, transcribed, and analyzed following qualitative content analysis.

Results: Participants were the first 20 individuals from the larger IDDEAS prototype usability study. Seven participants explicitly stated a need for integration with the patient electronic health record system. Three participants commended the step-by-step guidance as potentially helpful for novice clinicians. One participant did not like the aesthetics of the IDDEAS at this stage. All participants were pleased about the display of the patient information along with guidelines and suggested that wider guideline coverage will make IDDEAS much more useful. Overall, participants emphasized the importance of maintaining the clinician as the decision-maker in the clinical process, and the overall potential utility of IDDEAS within Norwegian CAMHS.

Conclusion: Child and adolescent mental health services psychiatrists and psychologists expressed strong support for the IDDEAS clinical decision support system if better integrated in daily workflow. Further usability assessments and identification of additional IDDEAS requirements are necessary. A fully functioning, integrated version of IDDEAS has the potential to be an important support for clinicians in the early identification of risks for youth mental disorders and contribute to improved assessment and treatment of children and adolescents.

Keywords: attention deficit and hyperactivity disorder (ADHD); child and adolescent mental health services (CAMHS); children and adolescents; clinical decision support system (CDSS); usability.

Grants and funding

The IDDEAS project (269117) was funded and sponsored by the Norwegian Research Council (Norges Forskningsråd- NFR). The Norwegian Research Council will provide funding in line with HELSEVEL (Programme on Health, Care and Welfare Services Research), which promotes integrated patient and user pathways and research and innovation activities aimed toward improving the quality of expertise and efficiency in health care services. The Norwegian Research Council had no role in the design of the study, the collection, analysis and interpretation of data, and in writing the manuscript.