JMIR Publications

ABSTRACT

Background:

To support physicians in focusing on relevant information during melanoma treatment, it is essential to design information systems (IS) that integrate into their workflow.

Objective:

This study aims to identify the work steps, knowledge sources, and key information during tumor board registration, revealing the physician’s mental model.

Methods:

We applied the think-aloud method with ten dermatologists from the University Hospital Essen's skin cancer unit, providing direct insights into their work. Voice and screen recordings were transcribed and inductively annotated across three categories: "work step," "information in focus," and "program utilized." These annotations were used to map the mental model via a sequence diagram, alongside a quantitative analysis of code occurrences and overlaps.

Results:

Patient-related data in clinical IS are distributed across nested submodules, requiring physicians to extract key information. On average, the workflow consists of four phases with ten distinct work steps, taking about 13 minutes to complete. Physicians switched between three programs approximately 25 times, often copying information from various reports to compile a free-text case summary. The analysis revealed repetitive input and many steps required to access original reports.

Conclusions:

These insights offer a deeper understanding of physicians' intentions when handling medical information and their challenges with current clinical IS. This understanding forms the basis for designing software solutions that better support workflows at the point of care by organizing and presenting relevant data more effectively.