Literature DB >> 21486886

Does user-centred design affect the efficiency, usability and safety of CPOE order sets?

Julie Chan1, Kaveh G Shojania, Anthony C Easty, Edward E Etchells.   

Abstract

BACKGROUND: Application of user-centred design principles to Computerized provider order entry (CPOE) systems may improve task efficiency, usability or safety, but there is limited evaluative research of its impact on CPOE systems.
OBJECTIVE: We evaluated the task efficiency, usability, and safety of three order set formats: our hospital's planned CPOE order sets (CPOE Test), computer order sets based on user-centred design principles (User Centred Design), and existing pre-printed paper order sets (Paper). PARTICIPANTS: 27 staff physicians, residents and medical students.
SETTING: Sunnybrook Health Sciences Centre, an academic hospital in Toronto, Canada. Methods Participants completed four simulated order set tasks with three order set formats (two CPOE Test tasks, one User Centred Design, and one Paper). Order of presentation of order set formats and tasks was randomized. Users received individual training for the CPOE Test format only. MAIN MEASURES: Completion time (efficiency), requests for assistance (usability), and errors in the submitted orders (safety).
RESULTS: 27 study participants completed 108 order sets. Mean task times were: User Centred Design format 273 s, Paper format 293 s (p=0.73 compared to UCD format), and CPOE Test format 637 s (p<0.0001 compared to UCD format). Users requested assistance in 31% of the CPOE Test format tasks, whereas no assistance was needed for the other formats (p<0.01). There were no significant differences in number of errors between formats.
CONCLUSIONS: The User Centred Design format was more efficient and usable than the CPOE Test format even though training was provided for the latter. We conclude that application of user-centred design principles can enhance task efficiency and usability, increasing the likelihood of successful implementation.

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Year:  2011        PMID: 21486886      PMCID: PMC3078654          DOI: 10.1136/amiajnl-2010-000026

Source DB:  PubMed          Journal:  J Am Med Inform Assoc        ISSN: 1067-5027            Impact factor:   4.497


  20 in total

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Journal:  J Am Med Inform Assoc       Date:  2003-01-28       Impact factor: 4.497

2.  Computer physician order entry: benefits, costs, and issues.

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3.  Using usability heuristics to evaluate patient safety of medical devices.

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4.  CPOE systems: success factors and implementation issues.

Authors:  Patricia P Sengstack; Brian Gugerty
Journal:  J Healthc Inf Manag       Date:  2004

5.  A user-centered, object-oriented methodology for developing Health Information Systems: a Clinical Information System (CIS) example.

Authors:  Georgios Konstantinidis; George C Anastassopoulos; Alexandros S Karakos; Emmanouil Anagnostou; Vasileios Danielides
Journal:  J Med Syst       Date:  2010-04-23       Impact factor: 4.460

6.  Effect of CPOE user interface design on user-initiated access to educational and patient information during clinical care.

Authors:  S Trent Rosenbloom; Antoine J Geissbuhler; William D Dupont; Dario A Giuse; Douglas A Talbert; William M Tierney; W Dale Plummer; William W Stead; Randolph A Miller
Journal:  J Am Med Inform Assoc       Date:  2005-03-31       Impact factor: 4.497

7.  Clinical decision support in electronic prescribing: recommendations and an action plan: report of the joint clinical decision support workgroup.

Authors:  Jonathan M Teich; Jerome A Osheroff; Eric A Pifer; Dean F Sittig; Robert A Jenders
Journal:  J Am Med Inform Assoc       Date:  2005-03-31       Impact factor: 4.497

8.  Types of unintended consequences related to computerized provider order entry.

Authors:  Emily M Campbell; Dean F Sittig; Joan S Ash; Kenneth P Guappone; Richard H Dykstra
Journal:  J Am Med Inform Assoc       Date:  2006-06-23       Impact factor: 4.497

9.  Usability testing in medical informatics: cognitive approaches to evaluation of information systems and user interfaces.

Authors:  A W Kushniruk; V L Patel; J J Cimino
Journal:  Proc AMIA Annu Fall Symp       Date:  1997

10.  Cognitive and usability engineering methods for the evaluation of clinical information systems.

Authors:  Andre W Kushniruk; Vimla L Patel
Journal:  J Biomed Inform       Date:  2004-02       Impact factor: 6.317

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  30 in total

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Authors:  David A Haggstrom; Jason J Saleem; Alissa L Russ; Josette Jones; Scott A Russell; Neale R Chumbler
Journal:  J Am Med Inform Assoc       Date:  2011-10-08       Impact factor: 4.497

2.  Retail pharmacy staff perceptions of design strengths and weaknesses of electronic prescribing.

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Journal:  J Am Med Inform Assoc       Date:  2012-06-29       Impact factor: 4.497

3.  Computerized physician order entry: promise, perils, and experience.

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Journal:  Neurohospitalist       Date:  2014-01

4.  Comparison of two kinds of interface, based on guided navigation or usability principles, for improving the adoption of computerized decision support systems: application to the prescription of antibiotics.

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Review 5.  Quality of care delivered to hospitalized inflammatory bowel disease patients.

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6.  Toward successful migration to computerized physician order entry for chemotherapy.

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Review 7.  Usability Flaws in Medication Alerting Systems: Impact on Usage and Work System.

Authors:  R Marcilly; E Ammenwerth; E Roehrer; S Pelayo; F Vasseur; M-C Beuscart-Zéphir
Journal:  Yearb Med Inform       Date:  2015-06-30

8.  Data-driven order set generation and evaluation in the pediatric environment.

Authors:  Y Zhang; J E Levin; R Padman
Journal:  AMIA Annu Symp Proc       Date:  2012-11-03

9.  Use of order sets in inpatient computerized provider order entry systems: a comparative analysis of usage patterns at seven sites.

Authors:  Adam Wright; Joshua C Feblowitz; Justine E Pang; James D Carpenter; Michael A Krall; Blackford Middleton; Dean F Sittig
Journal:  Int J Med Inform       Date:  2012-07-18       Impact factor: 4.046

10.  Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.

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Journal:  BMJ Qual Saf       Date:  2019-11-27       Impact factor: 7.035

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