Open Access Research article

Redesign of a computerized clinical reminder for colorectal cancer screening: a human-computer interaction evaluation

Jason J Saleem1234*, David A Haggstrom1235, Laura G Militello6, Mindy Flanagan3, Chris L Kiess2, Nicole Arbuckle7 and Bradley N Doebbeling1235

Author Affiliations

1 VA HSR&D Center of Excellence on Implementing Evidenced-Based Practice (CIEBP), Richard L. Roudebush VA Medical Center (11-H), 1481 West Tenth St, Indianapolis, IN, 46202, USA

2 Center for Health Services Research, Regenstrief Institute, Inc., 410 West Tenth St, Suite 2000, Indianapolis, IN, 46202, USA

3 Center for Health Services & Outcomes Research, Indiana University (IU), 410 West Tenth St, Suite 2000, Indianapolis, IN, 46202, USA

4 Department of Electrical & Computer Engineering, School of Engineering and Technology, 723 West Michigan Street, SL 160, Indiana University-Purdue University at Indianapolis (IUPUI), Indianapolis, IN, 46202, USA

5 Department of Medicine, Indiana University (IU) School of Medicine, 545 Barnhill Drive, EH 317, Indianapolis, IN, 46202, USA

6 Applied Decision Science, 1776 Mentor Ave., Suite 424, MB#118, Cincinnati, OH, 45212, USA

7 University of Dayton Research Institute, University of Dayton, 300 College Park, Dayton, 45469, OH, USA

For all author emails, please log on.

BMC Medical Informatics and Decision Making 2011, 11:74  doi:10.1186/1472-6947-11-74

Published: 29 November 2011



Based on barriers to the use of computerized clinical decision support (CDS) learned in an earlier field study, we prototyped design enhancements to the Veterans Health Administration's (VHA's) colorectal cancer (CRC) screening clinical reminder to compare against the VHA's current CRC reminder.


In a controlled simulation experiment, 12 primary care providers (PCPs) used prototypes of the current and redesigned CRC screening reminder in a within-subject comparison. Quantitative measurements were based on a usability survey, workload assessment instrument, and workflow integration survey. We also collected qualitative data on both designs.


Design enhancements to the VHA's existing CRC screening clinical reminder positively impacted aspects of usability and workflow integration but not workload. The qualitative analysis revealed broad support across participants for the design enhancements with specific suggestions for improving the reminder further.


This study demonstrates the value of a human-computer interaction evaluation in informing the redesign of information tools to foster uptake, integration into workflow, and use in clinical practice.