This entry is part 37 of 43 in the series Words

Let’s suppose it is 1980. Suppose someone shows up in your ED with a fever, and a history of travel to an area with a new plague characterized by fever. The nurse has heard about this on the news, asks the patient about travel to the area, and gets a “yes.” The nurse not only writes this on the paper […]



As of 2012, a new metric for ED throughput is physician contact time – with the caveat that assigning a physician name on a tracking system, or the time of the first orders, is not adequate to measure this. Surprised? Some docs put their name on the patient as soon as the patient arrives in […]



This entry is part 2 of 3 in the series Charting

“Out of sight, out of mind.” Ever heard the one about the early translation program that converted this aphorism into Chinese and then back? It came out as “invisible idiot.” Regardless, “out of sight, out of mind” is a good general psychological principle. In any nuclear power plant control station, air traffic control center, AWACS plane, aircraft cockpit, or any busy and confusing medical setting whether […]


“Wrong Patient”

This entry is part 11 of 43 in the series Words

Updates, December 2014, October 2016: short addenda at end. Speaking of “Bad Design Killing” a big part of the discussion at the ACEP Informatics Section meeting in San Francisco this month was about one particular usability problem with CPOE: entering orders on the wrong patient. I’ve done this myself – as far as I know […]


Lessons from Tufte

This entry is part 6 of 7 in the series Tracking Systems

Most users (myself included) spend most of their time in front of a computer in a kind of fuzzy autopilot mode, and anything that creates ripples on that placid lake of unawareness is going to be noticed as a disproportionately significant problem. –David Harris, creator of Pegasus Mail In Icons, Pegagogic Vectors, Forms Design and […]