Accessibility, usability, and usefulness of a Web-based clinical decision support tool to enhance provider-patient communication around Self-management TO Prevent (STOP) Stroke

Health Informatics J. 2014 Dec;20(4):261-74. doi: 10.1177/1460458213493195. Epub 2013 Dec 18.


This article reports redesign strategies identified to create a Web-based user-interface for the Self-management TO Prevent (STOP) Stroke Tool. Members of a Stroke Quality Improvement Network (N = 12) viewed a visualization video of a proposed prototype and provided feedback on implementation barriers/facilitators. Stroke-care providers (N = 10) tested the Web-based prototype in think-aloud sessions of simulated clinic visits. Participants' dialogues were coded into themes. Access to comprehensive information and the automated features/systematized processes were the primary accessibility and usability facilitator themes. The need for training, time to complete the tool, and computer-centric care were identified as possible usability barriers. Patient accountability, reminders for best practice, goal-focused care, and communication/counseling themes indicate that the STOP Stroke Tool supports the paradigm of patient-centered care. The STOP Stroke Tool was found to prompt clinicians on secondary stroke-prevention clinical-practice guidelines, facilitate comprehensive documentation of evidence-based care, and support clinicians in providing patient-centered care through the shared decision-making process that occurred while using the action-planning/goal-setting feature of the tool.

Keywords: Clinical decision support tool; clinical-practice guidelines; prevention; provider–patient communication; stroke.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Decision Support Systems, Clinical / statistics & numerical data*
  • Female
  • Health Personnel
  • Health Promotion / organization & administration*
  • Health Services Accessibility
  • Humans
  • Interdisciplinary Communication
  • Internet / statistics & numerical data*
  • Male
  • Physician-Patient Relations
  • Qualitative Research
  • Self Care / methods*
  • Stroke / prevention & control*
  • United States