Design of a phone-based clinical decision support system for resource-limited settings

While previous work has shown that clinical decision support systems (CDSS) improve patient care in resource-limited settings, there is little access to such systems at the point of care. Moreover, even when CDSS are available, compliance with care suggestions remain low. In this paper, we use a multi-method approach to document four failure modes that can affect CDSS implementations. Building from six iteratively derived design principles, we describe a phone-based system designed to address these failure modes. Through a formal usability evaluation, we discover six core findings that are important for implementers of mobile systems for health care providers in resource-limited settings.