Evidence-based usability design principles for medication alerting systems

Romaric Marcilly,Erin Roehrer,Julie Niès,Marie-Catherine Beuscart-Zéphir,Elske Ammenwerth

doi:10.1186/s12911-018-0615-9

Abstract

BackgroundUsability flaws in medication alerting systems may have a negative impact on clinical use and patient safety. In order to prevent the release of alerting systems that contain such flaws, it is necessary to provide designers and evaluators with evidence-based usability design principles. The objective of the present study was to develop a comprehensive, structured list of evidence-based usability design principles for medication alerting systems.MethodsNine sets of design principles for medication alerting systems were analyzed, summarized, and structured. We then matched the summarized principles with a list of usability flaws in order to determine the level of underlying evidence.ResultsFifty-eight principles were summarized from the literature and two additional principles were defined, so that each flaw was matched with a principle. We organized the 60 summarized usability design principles into 6 meta-principles, 38 principles, and 16 sub-principles. Only 15 principles were not matched with a usability flaw. The 6 meta-principles respectively covered the improvement of the signal-to-noise ratio, the support for collaborative working, the fit with a clinician’s workflow, the data display, the transparency of the alerting system, and the actionable tools to be provided within an alert.ConclusionsIt is possible to develop an evidence-based, structured, comprehensive list of usability design principles that are specific to medication alerting systems and are illustrated by the corresponding usability flaws. This list represents an improvement over the current literature. Each principle is now associated with the best available evidence of its violation. This knowledge may help to improve the usability of medication alerting systems and, ultimately, decrease the harmful consequences of the systems’ usability flaws.

Highlights

Usability flaws in medication alerting systems may have a negative impact on clinical use and patient safety
Gathering and structuring usability design principles We identified 9 publications on design principles dedicated to medication alerting systems (Table 1)
One publication (Zachariah et al [22]) was included in both sets; this publication was an extension of another set of design principles described by Phansalkar et al [20], it contained a few usability design principles not found in the original publication [20]

Summary

Introduction

Usability flaws in medication alerting systems may have a negative impact on clinical use and patient safety. Medication alerting systems “provide real-time notification of errors, potential hazards or omissions” related to the prescription of medications, and help clinicians to make informed decisions (nota bene: in the present report, a “clinician” is defined as any healthcare professional who interacts with the patient; the term encompasses physicians, nurses and pharmacists) [1]. To prevent the usability of alerting systems from introducing errors, usability activities (e.g. design specifications and prototype evaluation) must be undertaken during the technology development process [14] The implementation of those activities requires a sound knowledge of good usability design principles ( known as usability heuristics and usability criteria). As far as we know, the present study is the first to have provided evidence-based usability design principles for medication alerting systems

Objectives

Methods

Results

Discussion

Conclusion