Russ Alissa L, Melton Brittany L, Daggy Joanne K, Saleem Jason J
Center for Health Information and Communication, Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service, Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States; Regenstrief Institute, Inc., Indianapolis, IN, United States; College of Pharmacy, Purdue University, West Lafayette, IN, United States.
School of Pharmacy, University of Kansas, Lawrence, KS, United States.
J Biomed Inform. 2017 Feb;66:11-18. doi: 10.1016/j.jbi.2016.11.011. Epub 2016 Nov 28.
Prescribers commonly receive alerts during medication ordering. Prescribers work in a complex, time-pressured environment; to enhance the effectiveness of safety alerts, the effort needed to cognitively process these alerts should be minimized. Methods to evaluate the extent to which computerized alerts support prescribers' information processing are lacking.
To develop a methodological protocol to assess the extent to which alerts support prescribers' information processing at-a-glance; specifically, the incorporation of information into their working memory. We hypothesized that the method would be feasible and that we would be able to detect a significant difference in prescribers' information processing with a revised alert display that incorporates warning design guidelines compared to the original alert display.
A counterbalanced, within-subject study was conducted with 20 prescribers in a human-computer interaction laboratory. We tested a single alert that was displayed in two different ways. Prescribers were informed that an alert would appear for 10s. After the alert was shown, a white screen was displayed, and prescribers were asked to verbally describe what they saw; indicate how many total warnings; and describe anything else they remembered about the alert. We measured information processing via the accuracy of prescribers' free recall and their ability to identify that three warning messages were present. Two analysts independently evaluated participants' responses against a comprehensive catalog of alert elements and then discussed discrepancies until reaching consensus.
This feasibility study demonstrated that the method seemed to be effective for evaluating prescribers' information processing of medication alert displays. With this method, we were able to detect significant differences in prescribers' recall of alert information. The proportion of total data elements that prescribers were able to accurately recall was significantly greater for the revised versus original alert display (p=0.006). With the revised display, more prescribers accurately reported that three warnings were shown (p=0.002).
The methodological protocol was feasible for evaluating the alert display and yielded important findings on prescribers' information processing. Study methods supplement traditional usability evaluation methods and may be useful for evaluating information processing of other healthcare technologies.
开处方者在药物订购过程中通常会收到警报。开处方者工作在一个复杂、时间紧迫的环境中；为提高安全警报的有效性，应尽量减少认知处理这些警报所需的精力。目前缺乏评估计算机化警报在多大程度上支持开处方者信息处理的方法。
制定一种方法学方案，以评估警报在多大程度上支持开处方者一目了然地进行信息处理；具体而言，是将信息纳入其工作记忆的程度。我们假设该方法可行，并且与原始警报显示相比，我们能够通过结合警告设计指南的修订警报显示检测到开处方者信息处理方面的显著差异。
在人机交互实验室对20名开处方者进行了一项平衡的、受试者内研究。我们测试了以两种不同方式显示的单个警报。告知开处方者警报将显示10秒。警报显示后，显示白色屏幕，并要求开处方者口头描述他们看到的内容；指出总共的警告数量；并描述他们对警报的其他记忆。我们通过开处方者自由回忆的准确性及其识别存在三条警告信息的能力来测量信息处理情况。两名分析师根据警报元素的综合目录独立评估参与者的回答，然后讨论差异直至达成共识。
这项可行性研究表明，该方法似乎对评估开处方者对药物警报显示的信息处理有效。通过这种方法，我们能够检测到开处方者对警报信息回忆方面的显著差异。与原始警报显示相比，开处方者能够准确回忆的总数据元素比例在修订后的警报显示中显著更高（p=0.006）。使用修订后的显示，更多的开处方者准确报告显示了三条警告（p=0.002）。
该方法学方案对于评估警报显示是可行的，并在开处方者的信息处理方面产生了重要发现。研究方法补充了传统的可用性评估方法，可能有助于评估其他医疗技术的信息处理。
