Guideline Compilation Project

Methods for the identification and compilation of applicable guidelines

Data Source

Medline (1946-2012) was used for literature search. Terms and keywords used for searching are shown as follows:

  • Guidelines (MeSH & “explode”), Principle, Heuristic
  • Software design (MeSH & “explode”), Information systems (MeSH & “explode”), usability

The “explode” box of searching tool was ticked. It included all narrowed terms under the MeSH terms listed above. The terms and keywords were conjunct by “or” in each category, and “and” between categories.

In addition, we searched the literature by Google and Google scholar using the above terms. Reference lists of identified articles were also carefully examined to ensure all relevant articles to be properly reviewed.

Inclusion and Exclusion Criteria

In the review, we included articles that complied with the following criteria:

  • Computer-based system
  • Usability, HCI, human factor related
  • Guidelines or principles that concretely construct Dos and Don’ts in a system design
  • The guidelines are from a trustable source or supported by empirical studies, validation procedure

Study Selection and Information Extraction

We reviewed the full papers of the identified citations and applied a screening algorithm based on the inclusion and exclusion criteria described above. Two of us rated each article as “potentially relevant” or “potentially not relevant.” The results collected the following information from each “potentially relevant” article: year of publication, author, high/low level about descriptive granularity, high/low reliability, healthcare related, a number of guidelines and URL. Since Google searching leads uneven coverage of the literature, we circulated the results to a group of usability experts for justification and uncovered items.

Compilation of Existing Guidelines

The compilation was based upon the guideline documents that were qualified for inclusion. Every piece of document included a great number of instructional system design principles in detail. Initially, all principles were extracted and put into an excel spreadsheet for reviewing, which ensured retaining all usability guidelines that were applicable to the design and development of EHR systems, and specifically addressed Meaningful Use (MU) objectives at stages. Two curators were recruited to conduct this task, basically a matching process separately. All conflicts were resolved by discussions.

The matching process targeted at labeling extracted principles by MU objectives. In stage one, eight MU objectives were announced. They were medication list, drug-drug and drug allergy interaction checks, medication allergy list, e-prescribing, CPOE, clinical decision support, electronic medication administration record and clinical information reconciliation. It was believed that, upon classified principles by MU objectives, our guideline would instruct a more useful, usable and satisfying design of EHR.

In this process, there were two noticeable situations – not fitting into any of the objectives or fitting into majority of them. The curators would remove principles fell into the former situation and label the latter ones as general principles.