Integrating Clinical Decision Support System Development into a Development Process of Clinical Practice – Experiences from Dementia Care

This paper describes the process of developing the decision-support system DMSS (Dementia Management and Support System) and some lessons learned. An action research and participatory design approach has been adopted during development, with a strong research focus on optimizing support to physicians in dementia diagnosis assessment, involving a number of physicians and clinics in the process. A stand-alone version is currently used in 11 clinics distributed over four countries. Results from evaluation studies show that the system and the physician comply in 84,6% of the patient cases and that reasons for non-compliance lie primarily in physician’s insufficient knowledge. The impact the system has had on the individual physician’s diagnostic procedure in observation studies, factors identified enabling the integration and obstacles to use are presented and discussed. The system’s support for assessing basic cognitive functions is being improved, primarily as a feature for personalization of a future web-based version of DMSS.