“Wrong Patient”

This entry is part 11 of 44 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 I’ve always caught it before anything bad occurred. Many of my partners have had the same problem, and so have many of those at the Section meeting, with widely-different CPOE systems.Banana Peel

There are a variety of suggestions for why this is so, and what to do about it. Read the rest of this entry
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Cognitive Friction

This entry is part 12 of 44 in the series Words

The Whorf-Sapir hypothesis says that our language shapes how we think. It’s been moderately debunked in recent decades, but it’s likely true, at least in small part. And one of those small parts is when someone coins a new word that encapsulates a new idea. There has been a debate within philosophy since Plato’s time about whether words (names) – such as “circle” – correspond with some sort of actual ideal thing in some abstract realm – such as the one ideal circle of which our best drawn circles are only a pale imitation. Plato said yes, establishing the philosophical school known as Realism: “real” in this case means that there really, truly is an ideal circle somewhere out there. Nominalism says no, that “circle” is just a name, but Conceptualism, thanks to Peter Abelard, says that “circle” refers to something real, but that what’s real is about “circle” is that it’s a concept held in our brains. (If you’re a philosopher, I apologize for the gross oversimplification; but I’m a scientist, and as Bacon said: We are more likely to reach the truth through error than confusion.) And coining a new phrase can do just that – create new concepts in our brains. And that can change how we think about things.

And  if all those corporate executives who are responsible for our medical software were to get one particular concept into their brains, all of us in the medical field would find our lives a lot easier and error-free.

Cognitive friction is that term, coined by Alan Cooper in The Inmates Are Running the Asylum: Why High Tech Products Drive Us Crazy and How to Restore the Sanity.

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Dialog-Box Rooms

This entry is part 13 of 44 in the series Words

An experimental study recently (late 2011) ballyhooed in the press looks at how we tend to forget things as we move into a doorway, and that walking back into the room doesn’t help you recover the memories. (Duh. I could have told anyone this. As could everyone.) Not sure why prior studies on the same topic haven’t been so widely reported. And does this have something to do with the fact that those with Parkinson’s Disease get stuck in doorways?

Combine this with Alan Cooper’s dictum, from the first edition of About Face: The Essentials of User Interface Design: “A dialog box is another room. Have a good reason to go there.”Doorways

We get another heuristic (rule of thumb) for usability: “The more pages or dialog boxes a user has to traverse to accomplish a task, the less likely they are to remember what they were thinking at the beginning.”

In settings where distractions are rife, this effect is more likely to result in error, as you don’t have the cueing of the original screen to remind you where you were. The high degree of interruptions in the Emergency Department is a classic example.

Therefore, for applications for such environments should use techniques such as breadcrumb trails.

Again, duh. But the point is that the transition from page to page, or page to dialog box, is the transition where most of the forgetting occurs.

It’s not just you.

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Ignore

This entry is part 14 of 44 in the series Words

No, I’m not talking about a system error message like Windows’ infamous “Abort, Retry, Fail?”

I’m talking about active cognitive ignoring.

This occurred to me as I’ve been using an electronic medical record system called DocuTAP. It has many very, very busy screens, each with a hundred or so items from which to choose.

But I and other have learned to use it relatively quickly and efficiently. It’s hard, and it takes a lot of concentration and time, but we’ve done it.

Quoting from the website: “The DocuTAP system is extremely user-friendly and easy to learn. We can typically teach a new staff member how to use the system in less than two hours.” –Greg Troyer Owner. Yes, but how long does it take to learn to use it efficiently and effectively? I probably shouldn’t be picking on DocuTAP, as it’s no worse than many other point-and-click charting solutions, and at least you can learn to use it fairly efficiently, which is not true of a fair number of its competitors, so I’d rate it better-than-average. Read the rest of this entry
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What’s in a word?

This entry is part 15 of 44 in the series Words

What’s in a word? That which we call a roseWilliam Shakespeare portrait
By any other name would smell as sweet.
Romeo and Juliet (II, ii, 1-2)

OK, I cheated. I changed “name” to “word.” It sounded better for the purposes of this essay, which is about the need to choose words carefully. Yes, I changed a word of The Bard’s, and for the worse. So sue me. It makes the point.

This blog is about the usability of medical software. So I am going to offer a real-life example where the choice of a single word can have a major effect on usability. Read the rest of this entry
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