Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise

Laura G. Militello, Jason J. Saleem, Morgan R. Borders, Christen E. Sushereba, Donald Haverkamp, Steven P. Wolf, Bradley Doebbeling

    Research output: Contribution to journalArticlepeer-review

    14 Scopus citations


    Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration's EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability.

    Original languageEnglish (US)
    Pages (from-to)74-90
    Number of pages17
    JournalJournal of Cognitive Engineering and Decision Making
    Issue number1
    StatePublished - Mar 1 2016


    • agile software development
    • cancer prevention
    • cognitive task analysis
    • ethnographic observation
    • health promotion

    ASJC Scopus subject areas

    • Human Factors and Ergonomics
    • Engineering (miscellaneous)
    • Applied Psychology
    • Computer Science Applications


    Dive into the research topics of 'Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise'. Together they form a unique fingerprint.

    Cite this