{"id":"https://openalex.org/W2808466979","doi":"https://doi.org/10.1177/1460458218779099","title":"Development of a digital clinical pathway for emergency medicine: Lessons from usability testing and implementation failure","display_name":"Development of a digital clinical pathway for emergency medicine: Lessons from usability testing and implementation failure","publication_year":2018,"publication_date":"2018-06-15","ids":{"openalex":"https://openalex.org/W2808466979","doi":"https://doi.org/10.1177/1460458218779099","mag":"2808466979","pmid":"https://pubmed.ncbi.nlm.nih.gov/29905094"},"language":"en","primary_location":{"id":"doi:10.1177/1460458218779099","is_oa":true,"landing_page_url":"https://doi.org/10.1177/1460458218779099","pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/1460458218779099","source":{"id":"https://openalex.org/S201800618","display_name":"Health Informatics Journal","issn_l":"1460-4582","issn":["1460-4582","1741-2811"],"is_oa":false,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Informatics Journal","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/1460458218779099","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5078674178","display_name":"Marc Gutenstein","orcid":"https://orcid.org/0000-0003-3627-0697"},"institutions":[{"id":"https://openalex.org/I80281795","display_name":"University of Otago","ror":"https://ror.org/01jmxt844","country_code":"NZ","type":"education","lineage":["https://openalex.org/I80281795"]}],"countries":["NZ"],"is_corresponding":true,"raw_author_name":"Marc Gutenstein","raw_affiliation_strings":["University of Otago, New Zealand"],"raw_orcid":"https://orcid.org/0000-0003-3627-0697","affiliations":[{"raw_affiliation_string":"University of Otago, New Zealand","institution_ids":["https://openalex.org/I80281795"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061268711","display_name":"John W. Pickering","orcid":"https://orcid.org/0000-0001-9475-0344"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"John W Pickering","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5025452062","display_name":"Martin Than","orcid":"https://orcid.org/0000-0001-9399-5227"},"institutions":[{"id":"https://openalex.org/I4210159752","display_name":"Canterbury District Health Board","ror":"https://ror.org/05tqtd486","country_code":"NZ","type":"healthcare","lineage":["https://openalex.org/I4210159752"]}],"countries":["NZ"],"is_corresponding":false,"raw_author_name":"Martin Than","raw_affiliation_strings":["Canterbury District Health Board, New Zealand"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Canterbury District Health Board, New Zealand","institution_ids":["https://openalex.org/I4210159752"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5078674178"],"corresponding_institution_ids":["https://openalex.org/I80281795"],"apc_list":{"value":1500,"currency":"USD","value_usd":1500},"apc_paid":null,"fwci":1.6219,"has_fulltext":false,"cited_by_count":23,"citation_normalized_percentile":{"value":0.84279104,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":91,"max":98},"biblio":{"volume":"25","issue":"4","first_page":"1563","last_page":"1571"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12664","display_name":"Clinical practice guidelines implementation","score":0.9995999932289124,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12664","display_name":"Clinical practice guidelines implementation","score":0.9995999932289124,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12790","display_name":"Nursing Diagnosis and Documentation","score":0.9873999953269958,"subfield":{"id":"https://openalex.org/subfields/2910","display_name":"Issues, ethics and legal aspects"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/usability","display_name":"Usability","score":0.7814100980758667},{"id":"https://openalex.org/keywords/workflow","display_name":"Workflow","score":0.7703119516372681},{"id":"https://openalex.org/keywords/documentation","display_name":"Documentation","score":0.6030260920524597},{"id":"https://openalex.org/keywords/clinical-pathway","display_name":"Clinical pathway","score":0.5699256062507629},{"id":"https://openalex.org/keywords/clinical-decision-support-system","display_name":"Clinical decision support system","score":0.557253360748291},{"id":"https://openalex.org/keywords/digital-health","display_name":"Digital health","score":0.5014481544494629},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.48132216930389404},{"id":"https://openalex.org/keywords/multidisciplinary-approach","display_name":"Multidisciplinary approach","score":0.4562559723854065},{"id":"https://openalex.org/keywords/flexibility","display_name":"Flexibility (engineering)","score":0.44208580255508423},{"id":"https://openalex.org/keywords/protocol","display_name":"Protocol (science)","score":0.44197994470596313},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.355773389339447},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.3404800593852997},{"id":"https://openalex.org/keywords/decision-support-system","display_name":"Decision support system","score":0.3308585286140442},{"id":"https://openalex.org/keywords/nursing","display_name":"Nursing","score":0.16019028425216675},{"id":"https://openalex.org/keywords/human\u2013computer-interaction","display_name":"Human\u2013computer interaction","score":0.15505486726760864}],"concepts":[{"id":"https://openalex.org/C170130773","wikidata":"https://www.wikidata.org/wiki/Q216378","display_name":"Usability","level":2,"score":0.7814100980758667},{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.7703119516372681},{"id":"https://openalex.org/C56666940","wikidata":"https://www.wikidata.org/wiki/Q788790","display_name":"Documentation","level":2,"score":0.6030260920524597},{"id":"https://openalex.org/C2778373050","wikidata":"https://www.wikidata.org/wiki/Q1774706","display_name":"Clinical pathway","level":2,"score":0.5699256062507629},{"id":"https://openalex.org/C63527458","wikidata":"https://www.wikidata.org/wiki/Q5133829","display_name":"Clinical decision support system","level":3,"score":0.557253360748291},{"id":"https://openalex.org/C2780433410","wikidata":"https://www.wikidata.org/wiki/Q5276090","display_name":"Digital health","level":3,"score":0.5014481544494629},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.48132216930389404},{"id":"https://openalex.org/C22467394","wikidata":"https://www.wikidata.org/wiki/Q849359","display_name":"Multidisciplinary approach","level":2,"score":0.4562559723854065},{"id":"https://openalex.org/C2780598303","wikidata":"https://www.wikidata.org/wiki/Q65921492","display_name":"Flexibility (engineering)","level":2,"score":0.44208580255508423},{"id":"https://openalex.org/C2780385302","wikidata":"https://www.wikidata.org/wiki/Q367158","display_name":"Protocol (science)","level":3,"score":0.44197994470596313},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.355773389339447},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.3404800593852997},{"id":"https://openalex.org/C107327155","wikidata":"https://www.wikidata.org/wiki/Q330268","display_name":"Decision support system","level":2,"score":0.3308585286140442},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.16019028425216675},{"id":"https://openalex.org/C107457646","wikidata":"https://www.wikidata.org/wiki/Q207434","display_name":"Human\u2013computer interaction","level":1,"score":0.15505486726760864},{"id":"https://openalex.org/C199360897","wikidata":"https://www.wikidata.org/wiki/Q9143","display_name":"Programming language","level":1,"score":0.0},{"id":"https://openalex.org/C204787440","wikidata":"https://www.wikidata.org/wiki/Q188504","display_name":"Alternative medicine","level":2,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.0},{"id":"https://openalex.org/C77088390","wikidata":"https://www.wikidata.org/wiki/Q8513","display_name":"Database","level":1,"score":0.0},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.0},{"id":"https://openalex.org/C105795698","wikidata":"https://www.wikidata.org/wiki/Q12483","display_name":"Statistics","level":1,"score":0.0},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.0},{"id":"https://openalex.org/C33923547","wikidata":"https://www.wikidata.org/wiki/Q395","display_name":"Mathematics","level":0,"score":0.0},{"id":"https://openalex.org/C36289849","wikidata":"https://www.wikidata.org/wiki/Q34749","display_name":"Social science","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D004635","descriptor_name":"Emergency Medicine","qualifier_ui":"Q000295","qualifier_name":"instrumentation","is_major_topic":false},{"descriptor_ui":"D004635","descriptor_name":"Emergency Medicine","qualifier_ui":"Q000295","qualifier_name":"instrumentation","is_major_topic":false},{"descriptor_ui":"D004635","descriptor_name":"Emergency Medicine","qualifier_ui":"Q000295","qualifier_name":"instrumentation","is_major_topic":false},{"descriptor_ui":"D004635","descriptor_name":"Emergency Medicine","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":false},{"descriptor_ui":"D004635","descriptor_name":"Emergency Medicine","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":false},{"descriptor_ui":"D004635","descriptor_name":"Emergency Medicine","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":false},{"descriptor_ui":"D004635","descriptor_name":"Emergency Medicine","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D004635","descriptor_name":"Emergency Medicine","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D004635","descriptor_name":"Emergency Medicine","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D004636","descriptor_name":"Emergency Service, Hospital","qualifier_ui":"Q000458","qualifier_name":"organization & administration","is_major_topic":false},{"descriptor_ui":"D004636","descriptor_name":"Emergency Service, Hospital","qualifier_ui":"Q000458","qualifier_name":"organization & administration","is_major_topic":false},{"descriptor_ui":"D004636","descriptor_name":"Emergency Service, Hospital","qualifier_ui":"Q000458","qualifier_name":"organization & administration","is_major_topic":false},{"descriptor_ui":"D004636","descriptor_name":"Emergency Service, Hospital","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D004636","descriptor_name":"Emergency Service, Hospital","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D004636","descriptor_name":"Emergency Service, Hospital","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006804","descriptor_name":"Ergonomics","qualifier_ui":"Q000295","qualifier_name":"instrumentation","is_major_topic":false},{"descriptor_ui":"D006804","descriptor_name":"Ergonomics","qualifier_ui":"Q000295","qualifier_name":"instrumentation","is_major_topic":false},{"descriptor_ui":"D006804","descriptor_name":"Ergonomics","qualifier_ui":"Q000295","qualifier_name":"instrumentation","is_major_topic":false},{"descriptor_ui":"D006804","descriptor_name":"Ergonomics","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":false},{"descriptor_ui":"D006804","descriptor_name":"Ergonomics","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":false},{"descriptor_ui":"D006804","descriptor_name":"Ergonomics","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":false},{"descriptor_ui":"D006804","descriptor_name":"Ergonomics","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D006804","descriptor_name":"Ergonomics","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D006804","descriptor_name":"Ergonomics","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D008962","descriptor_name":"Models, Theoretical","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D008962","descriptor_name":"Models, Theoretical","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D008962","descriptor_name":"Models, Theoretical","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D009520","descriptor_name":"New Zealand","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009520","descriptor_name":"New Zealand","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009520","descriptor_name":"New Zealand","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014584","descriptor_name":"User-Computer Interface","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014584","descriptor_name":"User-Computer Interface","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014584","descriptor_name":"User-Computer Interface","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D019091","descriptor_name":"Critical Pathways","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D019091","descriptor_name":"Critical Pathways","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D019091","descriptor_name":"Critical Pathways","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D019091","descriptor_name":"Critical Pathways","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D019091","descriptor_name":"Critical Pathways","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D019091","descriptor_name":"Critical Pathways","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1177/1460458218779099","is_oa":true,"landing_page_url":"https://doi.org/10.1177/1460458218779099","pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/1460458218779099","source":{"id":"https://openalex.org/S201800618","display_name":"Health Informatics Journal","issn_l":"1460-4582","issn":["1460-4582","1741-2811"],"is_oa":false,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Informatics Journal","raw_type":"journal-article"},{"id":"pmid:29905094","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/29905094","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health informatics journal","raw_type":null}],"best_oa_location":{"id":"doi:10.1177/1460458218779099","is_oa":true,"landing_page_url":"https://doi.org/10.1177/1460458218779099","pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/1460458218779099","source":{"id":"https://openalex.org/S201800618","display_name":"Health Informatics Journal","issn_l":"1460-4582","issn":["1460-4582","1741-2811"],"is_oa":false,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Informatics Journal","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.6700000166893005,"id":"https://metadata.un.org/sdg/16","display_name":"Peace, Justice and strong institutions"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":22,"referenced_works":["https://openalex.org/W1964975183","https://openalex.org/W1965509542","https://openalex.org/W1968583858","https://openalex.org/W1969129400","https://openalex.org/W1986631119","https://openalex.org/W2005440935","https://openalex.org/W2058924226","https://openalex.org/W2073924861","https://openalex.org/W2079171222","https://openalex.org/W2104030526","https://openalex.org/W2111658156","https://openalex.org/W2137650094","https://openalex.org/W2153495717","https://openalex.org/W2160271672","https://openalex.org/W2160599603","https://openalex.org/W2164765923","https://openalex.org/W2166635140","https://openalex.org/W2206818914","https://openalex.org/W2291784660","https://openalex.org/W2464080581","https://openalex.org/W2725687299","https://openalex.org/W4239496300"],"related_works":["https://openalex.org/W2046929026","https://openalex.org/W2779278343","https://openalex.org/W2533987749","https://openalex.org/W1996434451","https://openalex.org/W1569026615","https://openalex.org/W2791725133","https://openalex.org/W2112831187","https://openalex.org/W2122149485","https://openalex.org/W4232131108","https://openalex.org/W2128124510"],"abstract_inverted_index":{"Clinical":[0],"pathways":[1],"are":[2],"used":[3,19,58],"to":[4,25,59,104,117],"support":[5,54,112],"the":[6,21,38,64,90,94,99],"management":[7],"of":[8,40,52,75,96,120],"patients":[9],"in":[10,128,140],"emergency":[11,141],"departments.":[12],"An":[13],"existing":[14,65,118],"document-based":[15],"clinical":[16,31,42],"pathway":[17,32,130,138],"was":[18,83],"as":[20],"foundation":[22],"on":[23],"which":[24],"design":[26,56,139],"and":[27,47,93,108],"build":[28,60],"a":[29,72,78],"digital":[30,129,137],"for":[33],"acute":[34,109],"chest":[35],"pain,":[36],"with":[37,71],"aim":[39],"improving":[41],"calculations,":[43],"clinician":[44],"decision-making,":[45],"documentation,":[46],"data":[48],"collection.":[49],"Established":[50],"principles":[51],"decision":[53,111],"system":[55],"were":[57,101],"an":[61],"application":[62,100],"within":[63,98],"electronic":[66],"health":[67],"record,":[68],"before":[69],"testing":[70,87],"multidisciplinary":[73],"team":[74],"doctors":[76],"using":[77],"think-aloud":[79],"protocol.":[80],"Technical":[81],"authoring":[82],"successful,":[84],"however,":[85],"usability":[86],"revealed":[88],"that":[89,123],"user":[91],"experience":[92],"flexibility":[95],"workflow":[97,122],"critical":[102],"barriers":[103],"implementation.":[105],"Emergency":[106],"medicine":[107],"care":[110],"systems":[113],"face":[114],"particular":[115],"challenges":[116],"models":[119],"linear":[121],"should":[124],"be":[125],"deliberately":[126],"addressed":[127],"design.":[131],"We":[132],"make":[133],"key":[134],"recommendations":[135],"regarding":[136],"medicine.":[142]},"counts_by_year":[{"year":2025,"cited_by_count":1},{"year":2024,"cited_by_count":6},{"year":2023,"cited_by_count":5},{"year":2022,"cited_by_count":4},{"year":2021,"cited_by_count":3},{"year":2020,"cited_by_count":2},{"year":2019,"cited_by_count":2}],"updated_date":"2026-05-21T06:26:12.895304","created_date":"2025-10-10T00:00:00"}