Novel User Interface Design for Medication Reconciliation: An Evaluation of Twinlist
Plaisant, C., Wu, J., Hettinger, A., Powsner, S., Shneiderman, B.
January 2014
In Journal of the American Medical Informatics Association 22, 2 (2015) 340-9. [Published Version]

Objective. The primary objective was to evaluate time, number of interface actions, and accuracy on medication reconciliation tasks using a novel user interface (Twinlist which lays out the medications in 5 columns based on similarity and uses animation to introduce the grouping) compared to a Baseline interface (where medications are presented side by side in 2 columns). To assess participant agreement with statements regarding clarity and utility and to elicit comparisons.

Material and Methods. A 1x2 within-subjects experimental design was used with interface (Twinlist or Baseline) as an independent variable and time, number of clicks, scrolls, and errors as dependent variables. Participants were practicing medical providers with experience performing medication reconciliation but no experience with Twinlist. They reconciled two cases in each interface (in a counterbalanced order), then provided feedback on the design of the interface.

Results. Twenty medical providers participated in the study for a total of 80 trials. The trials using Twinlist were statistically significantly faster (18%), with fewer clicks (40%) and scrolls (60%). Serious errors were noted 11 and 31 times in TwinList and Baseline trials respectively.

Discussion. Trials using Twinlist were faster and more accurate. Subjectively, participants rated Twinlist more favorably than Baseline. They valued the novel layout of the drugs but indicated that the included animation would be valuable for novices, but not necessarily for advanced users. Additional feedback from participants provides guidance for further development and clinical implementations.

Conclusions. Cognitive support of medication reconciliation through interface design can significantly improve performance and safety.

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