Alternative computer mouse trigger designs in computerized physician order entry (CPOE) system to reduce clinicians’ drop-down menu selection errors

Abstract

BackgroundExtended daily computer use and overload of clinicians has been associated with a reported increase of prescription error. New mouse activity designs offer alternative strategies to potentially decrease drop-down menu selection error in computerized physician order entry (CPOE) prescription. ObjectiveThis study aimed to evaluate the use of alternative computer mouse trigger designs by clinicians during a prescription task. Data related to mouse activities and prescription error were collected in order to better understand the mouse trigger impact and interaction with level of urgency for physician to prescribe orders in CPOE. Materials and methodsThirty healthy, right-handed clinicians (16 female; 14 male) participated in this study. All participants completed eight prescription trials in which three factors were manipulated: mouse click strategies (single-click vs. double-click), mouse release strategies (down vs. up) and level of urgency (urgent vs. non-urgent). Human performance in terms of drop-down menu selection error was captured for each mouse design. Multiple aspects of participants’ behavior related to prescribing medication were measured in conditions simulating prescription of medication. ResultsThere were significant main effects for mouse click strategies and urgency (F (1, 20) = 11.03, P = 0.002; F (1, 20) = 14.24, P = 0.001), and no significant main effects for mouse release strategies (F (1, 20) = 2.39, P = 0.134) on drop-down menu selection error. A significant interaction, mouse click strategies × urgency, was revealed (F (1, 20) = 5.44, P = 0.027). There was a significant change found in error rate associated with mouse click strategy changes (adjusted OR = 2.38, 95% CI 1.57 to 3.61, P < 0.001) and urgent condition changes (adjusted OR = 0.56, 95% CI 0.37 to 0.83, P = 0.004). ConclusionWhen clinicians input physician orders into CPOE, regardless of mouse release strategy, double clicks were associated with lower error rates than single-click strategy. In urgent situations, double clicks also were associated with a lower error rate compared with single-click strategy. These findings may have wide-ranging applications, and computer engineers may consider adopting a double-click strategy in CPOE to reduce medical error, especially in urgent situations.