Khajouei Reza, de Jongh Dennis, Jaspers Monique W M
Department of Medical Informatics, Academic Medical Center - University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Stud Health Technol Inform. 2009;150:532-6.
Despite CPOE (Computerized Physician Order Entry) systems' potential to enhance patient safety by reducing medication errors, recent studies have cast some doubts on their role in error reduction. CPOE systems with poorly designed interfaces have proven to cause users dissatisfaction and to introduce new kind of errors in the ordering process, suggesting a threat instead of an enhancement of patient safety. The main objective of this study is to identify usability problems related to a CPOE medication system's design and determining their severities. Two experts completed a cognitive walkthrough (CW) of an ordering task based on a clinical scenario for ordering the consolidation phase of chemotherapy for a leukemic patient. Fifty five usability problems were found and classified into eleven categories. CW identified cosmetic to catastrophic problems leading to inefficient use of the CPOE system and potentially resulting in users' confusion, longer ordering duration, and medication errors. The complexity of the CPOE design, its rigidness and lack of user guidance suggests the necessity to redesign the current user interface in order to match clinicians' ordering behaviors and to fully support them in the medication ordering process.
尽管计算机化医生医嘱录入（CPOE）系统有潜力通过减少用药错误来提高患者安全，但最近的研究对其在减少错误方面的作用提出了一些质疑。事实证明，界面设计不佳的CPOE系统会导致用户不满，并在医嘱下达过程中引入新的错误类型，这表明它对患者安全构成了威胁，而非增强作用。本研究的主要目的是识别与CPOE用药系统设计相关的可用性问题，并确定其严重程度。两位专家基于为白血病患者开具化疗巩固期医嘱的临床场景，对一项医嘱下达任务进行了认知走查（CW）。共发现55个可用性问题，并将其分为11类。认知走查识别出了从表面问题到严重问题，这些问题导致CPOE系统使用效率低下，并可能导致用户困惑、医嘱下达时间延长和用药错误。CPOE设计的复杂性、其僵化性以及缺乏用户指导表明，有必要重新设计当前的用户界面，以匹配临床医生的医嘱下达行为，并在用药医嘱过程中为他们提供充分支持。
