DesignX in the Emergency Department: Requirements of a Digital Antibiogram

Abstract

Even simple interventions in healthcare may defy a straightforward solution due to incompatible constraints imposed by multiple stakeholders and the nature of the resulting system. This paper presents one of these so-called DesignX problems by describing the design of a digital antibiogram and a first use case in Emergency Medicine. The Infectious Disease department conceived a digital treatment selection tool [antibiogram] to improve antibiotic stewardship and appropriate care in the emergency department where antimicrobial -therapy is usually based on heuristics and limited microbiologic data. Using contextual interviews, observations and paper prototyping, we found that multiple perspectives, expectations and social roles were closely intertwined. The case of the antibiogram demonstrates the complexity of small technological changes in hospitals. Social and technical implications and dependencies turn apparently minor technological interventions into DesignX problems. Accordingly, even small interventions in healthcare call for a careful iterative design process to deliver appropriate solutions.