
If I can't get a list with predictive search (where the search field starts guessing what I want from the few characters I've typed so far), then at least give me a heads-up list on one page. Make the list short and comprehensive enough.
I want to find about 80% of my commonly used diagnoses on one page, then multi-select all the diagnoses that I need, and then click "OK". If I can do that, I will be very happy. I've seen it done in at least one EMR.
See, I'm not hard to please.
How would you build the list?
- Make a fairly comprehensive list first, sorted by how often I (or family physicians in general) select that diagnosis.
- Then create the list on a page or two.
- Then add columns (to allow more items) and shrink the font until it is still readable. Test readability with a few 50-60 year old users wearing bifocals.
- Trim the list to one (or two, A-L and M-Z) pages.
- Get it on a single visual plane in plain sight. (expand to a second page, if needed, or if users wanted it).
- List alphabetically. Avoid organ system grouping, which takes more cognitive effort and more visual scanning time.
- Use simple, frequently-used-by-clinician word choice (e.g. “headache” instead of “cephalgia”).
- Put most relevant words first (e.g. “diabetes mellitus, type 2”, not “type 2 diabetes”)
- Make font big enough to read.
- Eliminate words that don’t add benefit for user (e.g. for “250.41 Diabetes 1 w/ renal changes”, do include “w/ renal changes”. For “250.00 Diabetes 2 uncomplicated”, I’d argue that the “uncomplicated” is optional, and takes up space).
- I don't have to use the keyboard.
- I can select 6 diagnoses with only 6 clicks.
- I press OK once, and not 6 times.
- I can go a lot faster.
- I'll develop muscle memory finding the commonly picked items on the page (could pick them blindfolded!).
2 comments:
Jeff:
Funny that you posted this just now. I had recently mocked up an idea for Cerner for improving the diagnosis workflow, so I though you might have thoughts.
You can download a very short powerpoint overview of the idea here: http://bit.ly/problemdx
It basically addresses most/all of your needs.
I had a short meeting with them this afternoon to discuss it and I referenced this post.
Anyway, take care.
Craig Bradley, MD
Texas Tech University Health Sciences Center
University Medical Center, Lubbock, TX
Craig,
Thanks for the feedback. I'd love to look at your PowerPoint, but I encountered an error message at dropbox.com. Can you share that folder with me at JeffBelden@gmail.com? I have a dropbox account.
I think "meaningful use" will drive many more of our docs to complete their problem lists, so this tool will be a great help, IMHO.
Post a Comment