Explaining Call Recommendations in Nursing Homes: a User-Centered Design Approach for Interacting with Knowledge-Based Health Decision Support Systems

ABSTRACT Recommender systems are increasingly used in high-risk application domains, including healthcare. It has been shown that explanations are crucial in this context to support decision-making. This paper explores how to explain call recommendations to nursing home staff, providing insights into call priority, notifications, and resident information. We present the design and implementation of a recommender engine and a mobile application designed to support call recommendations and explain these recommendations that may contribute to residents’ safety and quality of care. More specifically, we report on the results of a user-centered design approach with residents (N=12) and healthcare professionals (N=4), and a final evaluation (N=12) after four months of deployment. The results show that our design approach provides a valuable tool for more accurate and efficient decision-making. The overall system encourages nursing home staff to provide feedback and annotate, resulting in more confidence in the system. We discuss usability issues, challenges, and reflections to be considered in future health recommender systems.