Summative software evaluation of a therapeutic guideline assistance system for empiric antimicrobial therapy in ICU.

Objective: While developing the patient data management system ICUData in close cooperation with the software company (IMESO GmbH, Hüttenberg, Germany), a therapeutic guideline assistance system for empiric antimicrobial therapy in ICU (called "Antibiotic Wizard") could be introduced and integrated into the existing software. After its introduction into clinical routine, the first version was to be tested, checked for usability and compared to other software products with the help of the IsoMetrics(s) inventory (based on the EN ISO 9241-10 for computer-assisted workflows).

Methods: Half a year after introducing the "Antibiotic Wizard" in the ICUs, 40 physicians from different specialties at different levels of training were surveyed in order to detect deficiencies in the use of the program. The results of these surveys were compared to surveys on the word processing software Word for Windows (WinWord) from Microsoft, the hospital information system IS-H*MED from SAP (online and paper surveys) and the administrative program, SAP R/3 HR, also from SAP.

Results: Reliabilities (Cronbach's Alpha) of the subscales ranged from satisfactory (alpha > 0.70) to good (alpha > 0.80), except for "Controllability" (alpha = 0.663) and "Error tolerance" (alpha = 0.693). Medians for individual subscales ranged between 3.04 ("Error tolerance") and 3.96 ("Suitability for learning"). The "Antibiotic Wizard" showed significantly better results compared to both IS-H*MED and SAP R/3 HR in the subscales of "Suitability for the task", "Self-descriptiveness" and "Suitability for learning". In contrast, "Self-descriptiveness" "Controllability" and "Error tolerance" were significantly worse compared to WinWord.

Conclusions: In generally, the usability of the "Antibiotic Wizard" was deemed good. Some weaknesses were found in the fields of "Error tolerance" and "Controllability". These problems will be corrected in future versions.