Table 1.

Major changes to the clinical decision support tool after formative testing.

Original design	Resident feedback	Edited design
At the 6- and 12-month visits, when discussing peanut introduction, if the family had already tried peanut products and reported a reaction, residents were supposed to document if it was an immediate or nonimmediate reaction.	Residents reported that they may need point-of-care education on the definition of an immediate reaction.	A disappearing text description was added with the definition of an immediate reaction.
When assessing family readiness and planning introduction of peanut products, residents were given a hyperlink that took them to literature supporting early peanut introduction.	Residents found the inclusion of a hyperlink was confusing and tedious.	The hyperlink was replaced with a disappearing 1-sentence summary of the recommendations.
Residents freely typed what they discussed with the family in the note’s assessment and plan section.	Residents desired documentation assistance in the plan section of the note about the early peanut introduction discussion with the family.	A description of the discussion with the family regarding peanut introduction was added to the plan section.
At 4-, 6-, and 12-month visits, residents were given a SmartPhrase (an abbreviation that helps to pull long phrases into a note in the Epic system) to type into the after-visit summary that would insert peanut introduction, continuation, or avoidance instructions.	Residents misunderstood the instructions on how to include the early peanut introduction guidance in the after-visit summary.	A drop-down menu to select instructions for either peanut introduction, continuation, or avoidance automatically populated the after-visit summary.