Early identification and treatment of anxiety and depression reduces patient suffering, increases overall treatment adherence and lowers healthcare utilisation. Research confirms less than 30% of oncology professionals can detect anxiety and depression symptoms in patients and few patients volunteer this information. The Clinical Pathway for the Identification and Management of Anxiety and Depression in Adult Cancer Patients (Clinical Pathway) advocates routine screening of all people with cancer throughout the cancer journey, promoting early identification and prompt access to evidence-based treatment. In busy clinical settings, incorporating recommendations into routine care remains a challenge.
This study aimed to develop a web-based system to operationalise the Clinical Pathway for uptake in NSW Health oncology settings to facilitate services implementing he Clinical Pathway.
Using a three phased approach, phase one mapped recommendations of the Clinical Pathway to patient care practices (i.e. identification, referral, treatment and treatment outcome) providing a system framework. A task analysis identified user interactions, time requirements and alignment with common workflow practices. The second phase, incorporated human factors design for the User Interface. The third phase tested human computer interaction and user acceptability of the system’s interface with 6 health professionals (nurses/psychologists/oncologists) using observational technique and think aloud sessions.
Operationalising an evidence-based clinical pathway is viable to support the adoption of such guidelines. However, difficulty lies in defining functionality boundaries in facilitating Clinical Pathway implementation rather than dictation of clinical practice. Building the web-based system highlighted that iterative design, and an intuitive user interface incorporating automated functionality and responsive web design, are vital in building a system for busy health professionals.
This study contributes to the ADAPT Program which is investigating clinical pathway implementation strategies via a cluster RCT across 12 NSW oncology health settings. The system is currently being piloted at a health service.