Usability testing to guide development of a clinical decision support system for substance use screening and interventions in primary care.

Alcohol and drug use are significant drivers of preventable morbidity and mortality that are not routinely identified or treated in medical settings. Screening, brief intervention, and referral to treatment (SBIRT) to address substance use in primary care is widely promoted, but has proven challenging to implement. Validated screening tools that can quickly and accurately identify substance use have been designated common data elements (CDEs), but are not widely integrated into electronic health records (EHRs). As part of a study of the NIDA Clinical Trials Network (CTN-0062-Ot), a clinical decision support system (CDSS) was developed to support the delivery of substance use screening and interventions in primary care.

This presentation reports on usability testing performed to address the challenges of developing the CDSS. Usability testing identified important issues related to workflow and content, as well as human-computer interactions problems. An iterative process of usability testing and content adaptation allowed researchers to successfully modify a commercial EHR for delivery of a complex behavioral intervention, though some limitations to its functionality remain. Future phases of this study will examine adoption of this CDSS in multiple primary care clinics.

Related protocols: CTN-0062-Ot