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A Clinical Decision Support System for Integrating Tuberculosis and HIV Care in Kenya: A Human-Centered Design Approach

机译：肯尼亚结合结核病和艾滋病毒治疗的临床决策支持系统：以人为本的设计方法

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With the aim of integrating HIV and tuberculosis care in rural Kenya, a team of researchers, clinicians, and technologists used the human-centered design approach to facilitate design, development, and deployment processes of new patient-specific TB clinical decision support system for medical providers. In Kenya, approximately 1.6 million people are living with HIV and have a 20-times higher risk of dying of tuberculosis. Although tuberculosis prevention and treatment medication is widely available, proven to save lives, and prioritized by the World Health Organization, ensuring that it reaches the most vulnerable communities remains challenging. Human-centered design, used in the fields of industrial design and information technology for decades, is an approach to improving the effectiveness and impact of innovations that has been scarcely used in the health field. Using this approach, our team followed a 3-step process, involving mixed methods assessment to (1) understand the situation through the collection and analysis of site observation sessions and key informant interviews; (2) develop a new clinical decision support system through iterative prototyping, end-user engagement, and usability testing; and, (3) implement and evaluate the system across 24 clinics in rural West Kenya. Through the application of this approach, we found that human-centered design facilitated the process of digital innovation in a complex and resource-constrained context.
机译：为了在肯尼亚农村地区整合艾滋病毒和结核病护理，一组研究人员，临床医生和技术人员使用以人为中心的设计方法来促进针对患者的新型结核病临床决策支持系统的设计，开发和部署过程提供者。在肯尼亚，约有160万人感染了艾滋病毒，并且死于结核病的风险高20倍。尽管结核病的预防和治疗药物已被广泛使用，已被证明可以挽救生命，并且被世界卫生组织列为优先事项，但要确保其到达最脆弱的社区仍然具有挑战性。在工业设计和信息技术领域中使用了数十年的以人为中心的设计是一种提高健康领域中很少使用的创新的有效性和影响力的方法。使用此方法，我们的团队遵循一个三步过程，涉及混合方法评估，以（1）通过收集和分析现场观察会议以及关键信息提供者访谈来了解情况。 （2）通过迭代原型，最终用户参与和可用性测试开发新的临床决策支持系统； （3）在肯尼亚西部乡村的24个诊所实施和评估该系统。通过应用这种方法，我们发现以人为本的设计在复杂且资源受限的环境中促进了数字创新的过程。

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