Testing and improving the acceptability of a web-based platform for collective intelligence to improve diagnostic accuracy in primary care clinics

JAMIA Open. 2019 Feb 1;2(1):40-48. doi: 10.1093/jamiaopen/ooy058. eCollection 2019 Apr.

Abstract

Objectives: Usable tools to support individual primary care clinicians in their diagnostic processes could help to reduce preventable harm from diagnostic errors. We conducted a formative study with primary care providers to identify key requisites to optimize the acceptability of 1 online collective intelligence platform (Human Diagnosis Project; Human Dx).

Materials and methods: We conducted semistructured interviews with practicing primary care clinicians in a sample of the US community-based clinics to examine the acceptability and early usability of the collective intelligence online platform using standardized clinical cases and real-world clinical cases from the participants' own practice. We used an integrated inductive-deductive qualitative analysis approach to analyze the interview transcripts.

Results and discussion: Perceived usefulness, perceived accuracy, quality assurance, trust, and ease of use emerged as essential domains of acceptability required for providers to use a collective intelligence tool in clinical practice. Participants conveyed that the collective opinion should: (1) contribute to their clinical reasoning, (2) boost their confidence, (3) be generated in a timely manner, and (4) be relevant to their clinical settings and use cases. Trust in the technology platform and the clinical accuracy of its collective intelligence output emerged as an incontrovertible requirement for user acceptance and engagement.

Conclusion: We documented key requisites to building a collective intelligence technology platform that is trustworthy, useful, and acceptable to target end users for assistance in the diagnostic process. These key lessons may be applicable to other provider-facing decision support platforms.

Keywords: clinical reasoning; collective intelligence; diagnostic accuracy; diagnostic error; human diagnosis project.