Dec
12

Ignore

By kconover Posted in Tutorials | Comments Off on Ignore

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 »

Dec
12

Calendar

By kconover Posted in Tutorials | Comments Off on Calendar

This is not directly related to medical informatics, but it is a user-interaction topic, and has some lessons for the usability of medical software.

First: Unlike many nerds, I like Microsoft Word. It’s a mature product and works well. It has many complications into which one may delve, and for those who want to delve, there is a wealth of online information resources. Yes, I have UltraEdit and I know that some writers prefer a simple editor like UltraEdit for creating books and articles. But I still like Word best for this.

I also use Microsoft Outlook. Not for email – it’s so insecure unless you’re behind a solid corporate firewall. I use Pegasus Mail instead. It’s one of the hacker’s email programs.Outlook 2016 Logo

I use Outlook as a personal information manager. Not because it’s the best PIM – it’s not. But if you want compatibility, Outlook has it. I can use gSyncit to sync my contacts between Outlook and Google Contacts, which is what my Android phone uses. I can sync my notes and tasks and calendar with my Android phone using CompanionLink and the Android app, DejaOffice.

Read the rest of this entry »

Nov
23

Dialog-Box Rooms

By kconover Posted in Tutorials | Comments Off on Dialog-Box Rooms

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.

Oct
28

Cognitive Friction

By kconover Posted in Tutorials | Comments Off on Cognitive Friction

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.

It’s quite simple. If you make a process cognitively easy, we do it rapidly and without error. If you make it cognitively hard, it takes us longer and we make mistakes.

And we know how to make things cognitively easier – how to lubricate software to reduce cognitive friction. At least, the information is out there, no matter that most medical software vendors are blissfully unaware of it. Read the rest of this entry »

Oct
28

Scribes

By kconover Posted in Tutorials | Comments Off on Scribes

“This job would be great if I didn’t have to chart.” Physicians say this all the time. One way to not have to chart (much) is to work with a Federal Disaster Medical Assistance Team (DMAT) team. Although the National Disaster Medical System now has an electronic medical record (EMR) system, it used to just use scribbling on paper charts. And, since you have sovereign immunity against lawsuits, and you aren’t using your charts for billing, charting could be quite minimal. I have personal knowledge of a medical team in the field, after Hurricane Katrina, in a small, isolated town for a several-hour medical clinic; the team used 8.5×11″ paper on a clipboard for charting, and each patient got one line.Scribe

This isn’t feasible for most real-life physician medical charting. We do have to use our charts for billing, and for protection against lawsuits. (“If you didn’t chart it, it wasn’t done.”)

We also are sometimes faced with the demand for charting so that, instead of a narrative string of ASCII text, our charts are a small database of discrete, labeled elements (e.g., Chief Complaint: chest pain. Duration: 1 day.) This latter is known as structured charting, and is eagerly promoted by researchers, who want structured data, and billing companies, who enjoy the resulting ease of assuring compliance with billing and coding rules. Read the rest of this entry »

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