Unifying evidence-based frameworks to design, develop, implement, and evaluate health information technology tools in radiation oncology

Radiation oncology (RO) has a long history of implementing in-house health information technology (HIT) tools such as quality assurance (QA) checklists. QA checklists have been deployed in multiple institutions without formal human factors and human-computer interaction evaluation and narrowly evaluated. We evaluated our current dosimetry QA checklist (DQC) using Systems Engineering Initiative for Patient Safety model. We enhanced it using evidence-based frameworks from multiple disciplines to match the specific safety needs of a RO clinic. The enhanced DQC’s perceived usability (as measured by a single easy questionnaire, system usability scale, and post-study system usability), perceived cognitive workload of dosimetrists (as measured by National Aeronautics Space Agency- Task Load Index), performance (as measured by the time taken to complete QA tasks) and patient safety (as measured by the number of patient safety events reported) was statistically significant than the current DQC (p<0.05). The evidence generated from the study was used to develop a unifying and comprehensive framework for designing, developing, implementing, and evaluating in-house HIT tools in radiation oncology.