- Brittleness
- Robustness
- Diversity
- “Niche” Computer Systems
- Downtime
- Meaningful Use
- Efficiency
- Anticryptography
- Color
- RHIO
- “Wrong Patient”
- Cognitive Friction
- Dialog-Box Rooms
- Ignore
- What’s in a word?
- ALLCAPS
- Layers
- Consistency
- Menu
- Cost Disease
- RAND
- PHR
- Model T
- Giveaway
- Skeuomorphism
- Icon
- Signal-to-Noise Ratio
- Anti-Data Pixels
- iPhones
- Suicide
- Anthropology
- Wireframes
- Fitts’s Law
- Kludge
- Ebola
- Pop-Up
- Clicks
- Bad Apple
- Testing
- Bold
- Point-and-Click
- Anti-User Pixels
- Flat
- Glucose
Faced with a long dinner menu, it’s hard to decide what to order. (Even with a medium-sized menu, my wife always says “You go ahead and order, I haven’t decided yet.” But that’s extreme.)
It’s not just an urban legend. There are scientific studies that demonstrate it.
The study When Choice is Demotivating by Sheena Ivengar of Columbia University showed this:
In a grocery store, set up a jam-tasting station.
First, put out four different jams, and let people taste, and if they wish, buy.
Four out of ten people who stop by will taste some jam. Of those people who stopped to taste, three out of ten will buy some jam.
Next, put out twenty-four jams.
Six out of ten people will stop to taste. But of those who taste, less than one in ten (3%) will buy.
Why?
The more menu choices, the harder it is to decide.
This problem has been known for millennia. Aesop relates the traditional tale of the fox and the cat. The idea is ensconced in the pop psychology literature as analysis paralysis. You can even buy a book about it.
In Cerner FirstNet, I am confronted with a similar plethora of choices. For instance, to get to most of the information in Cerner from FirstNet, I need to click on a menu item called Chart. (There are other ways to get to this information, but this seems the simplest.)
However, the menu I am confronted with is as follows:
ED Summary
Allergies
Orders
Med Grid
EMAR
MAR Sum
Med Review
Flowsheet
Med Profile
VS
IView/IQ
Lab
Micro
Reports
Rad
PowerNote 2G
Impression and Plan
Clin Notes
Caredex
Assess
Nurse Notes
Form Text
Forms
Problems and Diagnoses
Pt. Info
Immunizations
Communication View
36hr
Newborn view
Newborn Genview (new)
Labor _Delivery view
Health Maintenance
Clinical Calculator
Ad Hoc Charting
Depart Process
Tear Off This View
Attach to Chart
Chart Accessed by >
Close Charts
That’s thirty-nine choices. I have highlighted the only options on this menu that I use. I have no idea what most of the rest are. Nor do I need to know what they are to do my job. (P.S.: that ED Summary? I don’t find it useful. Sorry.)
Oh, how much simpler it would be to find my needles if they weren’t in such a big haystack. And I would less-often click on the wrong menu item, if there were fewer items, and they were bigger.
Why can’t I have a shorter menu? All the things I don’t use could be grouped under a single “Rarely-Used” menu item!
Wait, the developer says. People keep asking for all these menu items so we keep adding them.
But I’m not “people” or even “users.” I am an emergency physician. And in my role, I – and all the other people|users – need menus that are customized for our specific roles.
Yes, it takes more work. You have to figure out which menu items I – and my 80 partners – use, and which we don’t. So? We’re worth it. And it makes a much, much better product.
I hope someone at Cerner reads this.
Tags: Human Error, ED Systems, Information Design, Emergency Department, Cognitive Friction, ED, Information Technology, Healthcare, Menus, IT, Choice; Analysis Paralysis, Healthcare IT, Usability, User Interaction Design, User Interface
