Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians’ and Human Factors Engineers’ Perspectives

Savoy, April; Patel, Himalaya; Flanagan, Mindy E.; Weiner, Michael; Russ, Alissa L.

doi:10.1007/s10916-017-0775-7

Cited by 18 publications

(12 citation statements)

References 29 publications

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“…Third, based on warnings literature [33] alert language should be concise, displaying short statements or bullet points rather than complete sentences. Consistent with our findings, the use of lengthy text was identified as a common problem during another recent heuristic evaluation of physician consultation order templates [26]. Fourth, changes could be made to prevent potential usability-related errors.…”

Section: Discussionsupporting

confidence: 86%

“…A heuristic evaluation is “one method for measuring usability … through which experts identify potential usability problems by comparing designs against established principles (i.e., heuristics).” [26] We followed established techniques to conduct a heuristic evaluation of MTM alerts [27–30]. A heuristic evaluation was chosen to understand how well MTM alerts align with established human factors principles and to maximize our ability to identify opportunities to enhance MTM alert design.…”

Section: Methodsmentioning

confidence: 99%

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Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation

Snyder

Jaynes

Gernant

et al. 2019

BMC Med Inform Decis Mak

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Background Medication therapy management (MTM) is a service, most commonly provided by pharmacists, intended to identify and resolve medication therapy problems (MTPs) to enhance patient care. MTM is typically documented by the community pharmacist in an MTM vendor’s web-based platform. These platforms often include integrated alerts to assist the pharmacist with assessing MTPs. In order to maximize the usability and usefulness of alerts to the end users (e.g., community pharmacists), MTM alert design should follow principles from human factors science. Therefore, the objectives of this study were to 1) evaluate the extent to which alerts for community pharmacist-delivered MTM align with established human factors principles, and 2) identify areas of opportunity and recommendations to improve MTM alert design. Methods Five categories of MTM alerts submitted by community pharmacists were evaluated: 1) indication, 2) effectiveness ; 3) safety ; 4) adherence ; and 5) cost-containment . This heuristic evaluation was guided by the Instrument for Evaluating Human-Factors Principles in Medication-Related Decision Support Alerts (I-MeDeSA) which we adapted and contained 32 heuristics. For each MTM alert, four analysts’ individual ratings were summed and a mean score on the modified I-MeDeSA computed. For each heuristic, we also computed the percent of analyst ratings indicating alignment with the heuristic. We did this for all alerts evaluated to produce an “overall” summary of analysts’ ratings for a given heuristic, and we also computed this separately for each alert category. Our results focus on heuristics where ≤50% of analysts’ ratings indicated the alerts aligned with the heuristic. Results I-MeDeSA scores across the five alert categories were similar. Heuristics pertaining to visibility and color were generally met. Opportunities for improvement across all MTM alert categories pertained to the principles of alert prioritization; text-based information; alarm philosophy; and corrective actions. Conclusions MTM alerts have several opportunities for improvement related to human factors principles, resulting in MTM alert design recommendations. Enhancements to MTM alert design may increase the effectiveness of MTM delivery by community pharmacists and result in improved patient outcomes. Electronic supplementary material The online version of this article (10.1186/s12911-019-0866-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation

Snyder

Jaynes

Gernant

et al. 2019

BMC Med Inform Decis Mak

Self Cite

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“…We found evidence in the literature that VA has hardware infrastructure and architecture to support a variety of informatics tools (Fihn et al, 2014), for example, My HealtheVET, the Blue Button, the Primary Care Almanac, Templates, Interactive Kiosks, computerized patient record system (CPRS), and VistA (Cohen et al, 2013;Coughlin et al, 2017;Hogan et al, 2014;Hysong et al, 2019;Rajeevan et al, 2017;Savoy et al, 2017). Note.…”

Section: Evidence From the Initial Literature Reviewmentioning

confidence: 98%

Stakeholder Engagement for a Planned Automated Quality Measurement System

et al. 2020

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We sought to evaluate the context of potential implementation of an automated quality measurement system for inpatients with heart failure in the U.S. Department of Veterans Affairs (VA). The research methodology was guided by the Promoting Action on Research Implementation in Health Sciences (PARIHS) framework and the sociotechnical model of health information technology. Data sources comprised semi-structured interviews ( n = 15), archival review of internal VA documents, and literature review. The interviewees consisted of four VA key informants and 11 subject matter experts (SMEs). Interviewees were VA quality management (QM) staff, clinicians, data analysts, and quality measurement experts, among others. Our interviews identified themes, which confirmed that the automated system is aligned with current internal organizational features, hardware and software infrastructure, and workflow and communication needs. We also identified facilitators and barriers to adoption of the automated system. The themes found will be used to inform future implementation of the system.

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“…Informatics-based approaches to system design consistently include domain experts to identify design flaws, [57][58][59] as expert review is considered a cost effective and rigorous way to identify critical design flaws in visualization. 51,57 As five experts are recommended to identify flaws, 51,60 five doctorally prepared nurses with expertise in informatics, visualization, and participatory design from the visualization design studio of a funded center of excellence and informatics department at Columbia University were invited to participate.…”

Section: Expertsmentioning

confidence: 99%

Developing Infographics to Facilitate HIV-Related Patient–Provider Communication in a Limited-Resource Setting

Stonbraker

Halpern²,

Bakken

et al. 2019

Appl Clin Inform

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Background Productive patient–provider communication is a recognized component of high-quality health care that leads to better health outcomes. Well-designed infographics can facilitate effective communication, especially when culture, language, or literacy differences are present. Objectives This study aimed to rigorously develop infographics to improve human immunodeficiency virus (HIV)-related patient–provider communication in a limited-resource setting. A secondary purpose was to establish through participant feedback that infographics convey intended meaning in this clinical and cultural context. Methods We adapted a participatory design methodology, developed in a high-resource setting, for use in the Dominican Republic. Initially, content to include was established using a data-triangulation method. Then, infographics were iteratively generated and refined during five phases of design sessions with three stakeholder groups: (1) 25 persons living with HIV, (2) 8 health care providers, and (3) 5 domain experts. Suggestions for improvement were incorporated between design sessions and questions to confirm interpretability of infographics were included at the end of each session. Results Each participant group focused on different aspects of infographic designs. Providers drew on past experiences with patients and offered clinically and contextually relevant recommendations of symbols and images to include. Domain experts focused on technical design considerations and interpretations of infographics. While it was difficult for patient participants to provide concrete suggestions, they provided feedback on the meaning of infographics and responded clearly to direct questions regarding possible changes. Fifteen final infographics were developed and all participant groups qualitatively confirmed that they displayed the intended content in a culturally appropriate and clinically meaningful way. Conclusion Incorporating perspectives from various stakeholders led to the evolution of designs over time and generated design recommendations that will be useful to others creating infographics for use in similar populations. Next steps are to assess the feasibility of using infographics to improve clinical communication and patient outcomes.

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Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians’ and Human Factors Engineers’ Perspectives

Cited by 18 publications

References 29 publications

Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation

Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation

Stakeholder Engagement for a Planned Automated Quality Measurement System

Developing Infographics to Facilitate HIV-Related Patient–Provider Communication in a Limited-Resource Setting

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