Many decision-support tools aim to support clinical decision-making but clinicians often choose not to use them. One reason is that such tools do not align with the workflows and cognitive processes of clinicians. This challenge is evident in specialties like movement disorders, where diagnostic work is complex, uncertain, and shaped by long-term care. Our research team interviewed movement disorder specialists to understand how they structure diagnostic workflows and reason through complex cases. Our findings show that specialists do not always follow one concrete workflow. Instead, they adapt their activities based on contextual factors—such as diagnostic certainty, resource constraints, administrative needs, and patient/family behavior. Specialists also face a range of challenges—diagnostic, disease-related, logistical, and interpersonal—and draw on their experience to manage them. From these insights, we outline design implications for digital tools that support specialists’ diagnostic workflows by improving how tools represent information, how clinicians interact with tools during diagnostic work, and how tools support collaboration.
Ikhile et al. (Tue,) studied this question.