A Decision Support Tool for Healthcare Professionals in the Management of Hyperphosphatemia in Hemodialysis.

Hyperphosphatemia is known as one of the more challenging conditions in end-stage renal disease patients. This study set out to present and evaluate a healthcare-oriented decision support tool in the management of hyperphosphatemia within hemodialysis therapy. A prototype module was designed to fit into the interface of a modern dialysis machine (Fresenius 5008). The prototype included three main functions: 1) immediate bedside blood sample access, 2) a model based prognosis tool with estimates of P-phosphate and 3) an overview of the user's phosphate related activities during dialysis treatments. The prototype was evaluated by a) heuristic evaluation with five human computer interaction experts and b) user testing with think-aloud by three users as (clinical) domain experts. The two evaluation procedures identified a total of 103 usability problems and led to some specific amendments to improve its practical potential. The overall results will guide further development of the decision support tool to ensure that the functions will support the user's needs. In conclusion, the prototype was evaluated to be relevant and potentially beneficial in the management of hyperphosphatemia in hemodialysis patients. Furthermore, it was found that some of the functions could be used for educational purposes or as decision support for some patient groups, e.g. for patient doing home-dialysis.