Efficient, accessible, practical use in clinical settings | Multiple (n=8) software companies were interviewed and different software technologies (Windows, iOS, Android, ePUB) were explored.
ePUB technology was dismissed because it was not able to display a full A4 landscape guideline page. The content for this guideline could not reflow and had to retain its algorithmic structure.
HTML5 was potentially suitable due to its cross-platform capability and offline storage of web content, which would have been a significant advantage for clinics with limited internet connectivity. It was rejected because it could only display complex algorithms as static images, within which it would not be possible to search for text. A native application for an Android platform would allow for the content of the guideline to be extracted and stored in a content management system, separating content from presentation and allowing for version control, digital rights management, security and encryption. This was dismissed because it would require costly and sophisticated software development, which was premature given the lack of user testing and feedback to inform specifications.
Adobe InDesign was selected because of its ability to export in PDF with hyperlinks, the accessibility of PDF readers on mobile platforms and the KTU’s familiarity with the program.
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Streamlining digitisation without sacrificing functionality or design | The Adobe InDesign print version of the guideline was converted to a digital format through the following processes:Layout was optimised for the screen in consultation with the graphic artist responsible for the print version. This involved repositioning tabs, converting algorithms that spanned multiple pages into single, scrollable versions, and adjusting algorithm ratios to better fit screen sizes. Hyperlinks and cross-references were used for skipping to certain page numbers. Snapplify e-Reader technology was selected for encryption, security of the document and user authentication, as it is supported on both Android and iOS platforms.
Tablets were selected to optimise display of the A4 landscape guide pages. The KTU has devoted considerable effort over many years into ensuring a ‘one-construct-per-page’ display of content in the paper version. This feature was retained as it allows users to attend to each section of the algorithm as new information is processed while retaining awareness of their progress towards clinical decision-making. This is a departure from the typical way in which algorithms have previously been digitised, displaying only one node at a time, often assuming binary responses and uncoupling the user from an overview of the complete clinical decision-making process. |