BMC Health Serv Res: Challenges of using e-health technologies to support clinical care in rural Africa (2)

17 January, 2023

Neil and HIFA colleagues

This looks like a case-study in how not to design a computerised CDSS! A system that is complicated to use, does not fit smoothly into workflows, and that diverts clinical staff time from care to admin is not a support system. (The sample size may be small but sometimes that does not matter e.g. if the question is just whether something happens – tasting one drop of an ocean is enough to tell you if it is salty!). [ ]

A useful fairly recent (non-technical) overview on CDSS and their design requirements can be found in the Nature Partner Journal Digital Medicine (Sutton, R.T., Pincock, D., Baumgart, D.C. et al. An overview of clinical decision support systems: benefits, risks, and strategies for success. npj Digit. Med. 3, 17 (2020). <> . This review includes a section “Pitfalls of CDSS”, several of which were clearly observed in the reported study.


Dr Geoff Royston

geoff.royston AT

HIFA profile: Geoff Royston is an Independent Health Analyst and Researcher, former Head of Strategic Analysis and Operational Research in the Department of Health for England, and Past President of the UK Operational Research Society. His work has focused on informing the design, implementation and evaluation of policies and programmes in health and social care, and on fostering the capabilities of others to work in these areas. Associated activities have included modelling for understanding the performance of complex systems, analysis and communication of risk, and horizon scanning and futures thinking. He has also worked on information and communication technology in the health sector, notably in leading the design and national launch of the telephone and online health information and advice service NHS Direct. He has served on both scientific and medical UK Research Council panels, and as an impact assessor for the UK higher education Research Excellence Framework. He is a member of the editorial board for the journal Health Care Management Science and in 2012 was Guest Editor for its special issue on Global Health. He has been a consultant for the World Health Organisation, is a long standing member of the EURO Working Group on Operational Research Applied to Health Services, and is an expert adviser to the mHIFA (mobile Healthcare Information for All) programme. He is also a member of the main HIFA Steering Group and the HIFA working group on Evaluating the Impact of Healthcare Information. geoff.royston AT