Design and Usability Evaluation of a Digital Guideline Management Application for a Pediatric Cardiac Center

Background. Complex cases in specialized pediatric care require consistent adherence to evidence-based clinical pathways and protocols to ensure safe, high-quality, and equitable care. Currently, clinical pathways and supporting documentation are frequently distributed across multiple platforms, leading to fragmentation. Human-centered design principles can guide the development of healthcare technologies that minimize cognitive load and support rapid, efficient access to relevant information in clinical settings. The purpose of this study is to design and evaluate perceived usability of a pediatric cardiac center digital guideline management system that is embedded within the electronic health record leveraging human-centered design. Methods. This study used a mixed-methods usability evaluation to assess a digital guideline management system prototype embedded into clinical workflow. Through human-centered design principles, the prototype provides a centralized digital document library that organizes cardiac-specific clinical pathways, guidelines, procedures, and related resources. A small but diverse sample, encompassing a wide variety of roles and clinical areas within the pediatric cardiac center, was recruited to evaluate the perceived usability of the prototype. Usability was evaluated by stakeholders using the validated System Usability Scale (SUS) with additional optional questions to understand perceptions of the information architecture and clinical value. Results. Preliminary usability testing showed a mean SUS composite score of 76.5, indicating above average usability. Questions related to the complexity of the system and user confidence received high scores across participants. Lower scores were observed for questions related to usage frequency and ability to learn the system very quickly. Conclusion. Leveraging human-centered design when building a digital guideline management system embedded within clinical workflow revealed positive perception from participants. By centralizing access to clinical resources, this prototype can reduce current-state fragmentation. Further evaluation of larger samples is needed to develop a list of future recommendations.