Designing Safer Use of Antipsychotics Among Youths: A Human-Centered Approach to an Algorithm-Based Solution.

Abstract

OBJECTIVE\nGuidelines recommend against prescribing antipsychotics without an indication, yet prescription rates remain undesirably high for youths. Information technology can facilitate guideline-based prescribing, but little is known about providers needs. The Safer Use of Antipsychotics in Youth project is implementing an algorithm-based workflow for peer consultation, care navigation, and expedited psychotherapy access. To optimize workflow for a multisite trial, we engaged providers for input.\n\n\nMETHODS\nGuided by human-centered design, we interviewed 15 providers from Kaiser Permanente Washington and Nationwide Children s Hospital about their prescribing barriers and workflow preferences. We identified qualitative themes on barriers affecting implementation and design opportunities to optimize workflow.\n\n\nRESULTS\nProviders expressed two major barriers: potential disruptions to clinical practice and threats to professional autonomy. Three design opportunities emerged: à la carte orders, passive review of orders, and consultation self-acknowledgment.\n\n\nCONCLUSIONS\nHuman-centered design offers an innovative approach to improve guideline-based prescribing with optimizations that are grounded in providers needs.