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This thesis addresses the question of how usable openEHR-aware clinicaldecision support can be designed and developed in order to improve the qualityof health care. To answer this research question, several sub-questions wereidentified and investigated. This included analyzing state of the art in twodifferent aspects of design and development and evaluation of Clinical DecisionSupport (CDS) and also investigating application of a customized user-centereddesign (UCD) process in developing openEHR-based clinical applications.Analysis of state of the art in interplay between Human-Computer Interaction(HCI) and CDS and also the intersection between CDS and Electronic HealthRecords (EHR) revealed that consideration of both HCI and integration of CDSinto EHR is more appreciated in theory than in practice and there is still along way to go before reaching an acceptable level in these two success factorsof CDS. Moreover, the experience in designing an openEHR-based clinicalapplication revealed that apart from benefits offered by openEHR approach, suchas specifying different roles and involvement of domain experts in definingdomain concepts, there are various shortcomings that need to be improved, forinstance the limited support for openEHR application developers. Additionally,this study revealed that there are characteristics of the domain, tasks andusers in the domain that developers should be informed about while applying UCDmethods.

Towards Usable openEHR-aware Clinical Decision Support: A User-centered Design Approach