Implementing a clinical decision support system (CDSS) for chronic swelling in NSW public clinics

This study is an evaluation of the implementation of a bespoke lymphoedema clinical decision support system (CDSS) - www.lymbase.com into three health districts in NSW. The CDSS (Lymbase) stores patient data relevant to lymphoedema assessment and treatment including clinician reported and patient reported outcomes. It automates calculations for circumference measures and provides a visual display of size change. Lymbase also provides an easy-to-use compression garment search function, accessible for trained lymphoedema therapists. During the trial period clinicians will use the CDSS for all consenting patients. In Stage 1 occurring over four months (intervention period) the pilot study in Sydney Local Health District, will evaluate implementation for patients and clinicians. Revisions based on these findings will be undertaken before rolling the CDSS out in a further three Health Districts (4 month intervention period) and re-evaluating. These revisions might be to the user experience or content of the platform; or they might be to supporting systems such as the website, contact form, explainer videos, etc. The CPI will undertake a site visit for each site to provide participants with a tablet and access to the software for clinical use in order to provide feedback on the implementation and the CDSS. In addition to semi-structured interviews with clinicians and questionnaires with patients and clinicians an audit of utilisation, including feature utilisation will be undertaken. A single site pre-post survey will explore the patient experience.