We hypothesized that a systematic user interface design process, accomplished by first identifying the essential task requirements and then incorporating user interface design principles in the design process, would dramatically improve the efficiency of the MR process. First, the WDO for the MR task was developed and used as the framework for a prototype design. The prototype was developed according to the WDO and the user interface design guidelines with an overall goal to improve efficiency and reduce the user’s cognitive load. When the prototype was compared to the LHS and PAML electronic MR tools by means of a KLM analysis, we found that the prototype required the fewest number of mental operations, the fewest number of physical steps, and the least amount of time.
The strengths of this study revolve around the utilization of a WDO, in conjunction with design guidelines, to inform prototype creation. Creating a WDO ensures that the essential goals, operations, objects, relations and constraints of a health-related information task are supported by the resulting tool. However, this study has several limitations. Primarily, while the predictive nature of a KLM analysis gives us insight into the tool’s efficiency, we did not conduct an actual usability study. As a result, we are only able to predict task times if we assume that user actions are optimal. In order to get a greater sense of the prototype’s value, we need to construct a higher-fidelity prototype and put it through rigorous usability and learnability testing.
Other studies have created MR tools and tested them in a variety of healthcare settings. Unlike our prototype, however, these tools were either paper-based or combined a number of different interventions such as home-visits, surveillance, computer prescription order entry, and intervention programs11,13,30–32
. Other studies were focused on clinical improvement, rather than efficiency, medication adherence, or went beyond the scope of MR as defined by NIST.14–15
Generally, the aforementioned studies have identified MR as necessary, but do not have a definitive solution to current issues. Unfortunately, the variety of solutions means that our outcomes cannot be easily compared to other MR tools. The strength of our study lies in the fact that we have developed a design process for creating a tool that matches the fundamental requirements of MR and then embeds these requirements in a user-centered tool.
While the prototype predicts improved user efficiency, considerable work remains. In addition to creating a fully functional prototype, it is imperative to conduct usability testing. Doing so will allow for both interface improvement and reduced likelihood of inefficiency and errors. While the MR tool predicts increased efficiency and reduced cognitive load, there are still unanswered questions regarding its effectiveness at reducing the number of medication related adverse events. Accordingly, future research will resolve around creating a high-fidelity prototype, integrating the tool into a working system, and performing a clinical study documenting the number of medication related adverse events that occur. The outcomes from the study will then be compared to the number of medication related adverse events occurring via traditional means of MR. This will allow us to understand if a tool created with a WDO and modeled on design guidelines not only improves efficiency and reduces cognitive load, but also decreases the number of medication related adverse events.