Iterative user-centered evaluation of a context-driven clinical dashboard for melanoma treatment

Abstract

This study evaluated a user-centered clinical dashboard using FHIR-Server data to improve information accessibility for physicians treating melanoma patients. Current electronic health record systems distribute critical information across multiple modules and prioritize billing and research over clinical decision-making. We employed a mixed-methods approach combining think-aloud protocols, qualitative content analysis, and standardized usability questionnaires across three iterative evaluation cycles with nine participants in eleven sessions. Our dashboard implementation demonstrated substantial workflow improvements, reducing required interactions from 17 to 23 clicks to just 5–6 clicks, enabling physicians to focus more on treatment decisions than information gathering. The Post-Study System Usability Questionnaire showed progressive enhancement across iterations, with overall scores improving from 2.4 to 1.8. Affinity diagrams revealed key improvements in information accessibility and workflow integration. These findings indicate the value of a user-centered, holistic approach to clinical dashboard development, showing that FHIR-based interoperability infrastructures can be transformed into point-of-care applications when information is structured around clinicians’ mental models rather than technically derived data structures. Beyond the melanoma context, this approach provides a transferable foundation for systematically exploring clinical contexts and translating these insights into meaningful, workflow-integrated applications across clinical domains.