No Errors from Tall Men

I recently learned about Tall Man lettering.
acetAZOLAMIDE

Not to be confused with Mad Men.
MADMEN

I had been annoyed by the ugliness (the typography snob inside) of drug names like acetAZOLAMIDE instead of acetazolamide. Now I know why the words benefit from being homely.

• Aiming for patient safety.
• Helps distinguish drugs that otherwise have similar-looking names.
• acetAMINPHEN
• acetAZOLAMIDE

http://www.fda.gov/cder/drug/MedErrors/nameDiff.htm
Tall Man lettering of drugs

Refill alerts on a medication list - help reduce unnecessary work

What if the doctor and patient took care of all the necessary work at a visit for managing chronic disease?

Disclosure: I hate getting calls and faxes for refill requests. It seems totally avoidable. I’m not winning this battle.


It’s fairly common for primary care physician offices to get dozens of phone calls or faxes a week about medication refills.

It might be about a patient I just saw last week.

• These calls take time and money: mine and the staff.
• This is unreimbursed work.
• I get whiney about it.

If there is a discrepancy between the pharmacy (or patient) request and my records, it gets a lot worse.

Then calls go back and forth, trying to reconcile the difference, and the outcome is not always satisfactory. 


So, what can we do about it?

How about adding a little alert to the medication list?

• Don’t make me think (that is, don’t make me “sort by last refill date”, figure out the interval since last refill, count the meds and remember their names), just show me! 
• Dark red (or gray) could mean “due for refill in <3 months”. 
• Pink (or lighter gray) could mean “due for refill in <6 months”. 
• These intervals (3 and 6 months) match the numbers for “frequency of diabetic lab tests” and “limit on controlled substance refills”.

With this information right in my face, it would be easy to see if, and which, medications need to be refilled today. That avoids an extra call for the patient, an extra fax/call or two for my staff, and a headache for me.

That makes me happy!
(special thanks for the idea to Phil Vinyard at University Physicians Family Medicine Clinics)

Personalizing User Preferences, within Guardrails

EMRs are complex applications.

No Joke.

Here's an example of a fairly typical User Preference Setting dialogs (with my annotations):

 

It's not always easy to find my way to the preference settings. They might be buried deep in a menu as "Options" or "Settings" or "Preferences". When I look at the options to check, it might be quite hard to understand what will happen if I check or uncheck an option.

Trainers and support staff have nightmares as a result of the complexity.
Offer users more flexibility and the troubleshooting is more complicated, but if users' initial settings are not "just right", then the application won't behave as expected.

How can we empower the physician or nurse user?

How can the preference settings be made more understandable and accessible?

How can we help users have an experience that is "right for them"?

One way would be to place the preference settings closer to where they have an effect (see mock-up image below).

• Make the range of choices smaller (The Simplicity Principle of Usability). 
• Make the range of choices "safer" (The Forgiveness Principle of Usability). Don't let me change things I might regret, and be unable to fix. Offer "personalization within guardrails".
• Put the choices close to the action ("Preservation of Context" and "Efficient Interactions" Principles of Usability).

I like to call this "just-in-time personalization".

The little "gears" icon  shows up whenever there a few user preference (or "personalization") settings.

It's that easy.