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User-centered design process step 3: Patterns and standards

Editor’s Note: This blog series provides readers an inside look at how members of our user experience team approach new projects. As they go through the design process for a specific solution, they’ll share how they use science and a rigorous process to create a better experience for our users. This is the third post in a four-part series.

In my first post, I talked about how we turn to science in medicine for good practice. The same applies to design. Using knowledge of how humans perceive, think, decide and respond when designing decreases the cognitive load for our users and reduces their burden.

This post covers how we use best practice design patterns, standards and the science of design in the creation of the new Rx Writer solution within Allscripts Sunrise™.

Overcoming personal biases

Usability certainly has a subjective aspect to it because everyone has preferences about what they like and need. Often, our desires go against the science for how to make information easy to scan and process.

For example, I hear a lot that there are too many clicks and too much scrolling in EHRs. Yet focusing only on removing clicks and scrolling can actually make it harder to find data and causes a huge burden on cognitive processing. That’s harder to overcome than the physical acts of clicking and scrolling.

Our philosophy is that we will reduce all unnecessary clicks, but we will never reduce a click only to shift the physical burden of the click to a cognitive burden.

Presenting the information in a consumable way

There are multiple elements that go into making a screen difficult to read and consume:

  1. Font size: EHRs tend to have very small fonts, likely due to the request to show as much information on the screen as possible. This results in data that is hard to read (especially for older clinicians). The font in the new Rx Writer starts at 11-point font with more important information being displayed in larger font sizes.

  1. White space: Human beings have a natural fear of empty spaces. Because of this fear, we tend to favor filling blank spaces with objects and elements instead of leaving spaces blank or empty. As we reduce white space, we also reduce the value associated with the area. Science has shown that an increase in information can lead to sub-optimal decision making. Adding white space to a screen enables you to easily consume the data in it and process the information correctly. In Rx Writer, you will notice more spacing between medications and form fields, which enables you to quickly scan and process the information on the screen.
  2. Hierarchy: Seeing the most important information first increases your processing fluency and decreases the cognitive load. Using tools such as differing font sizes, position on the page, highlighting (bold, italics, underlining) and nesting information can allow you to quickly scan a list to find what you need. In Rx Writer, when we show a list of medications, we increased the font and bolded the medication name, which enables you to easily scan the medications. Separating the additional details from the Prescription instructions allows you to focus on what you care about the most. Bolding the Values (and de-emphasizing the labels) in the Pricing information section enables you to focus on the value itself, to quickly find the least expensive price.
  1. Color: Certain colors (like red, yellow and green) have meaning and will inherently convey information (stop, be aware, or all is good). Color attracts our attention and can distract you from important tasks/information. Color should be used sparingly and match what it is trying to be conveyed (think of coming across a green stop sign). When using color, always check the contrast between the background color and font color. Anything less than a 4.5:1 ratio (7:1 for smaller text) is much harder to read. In Rx Writer, we have used a neutral grey color as a background so it will not interfere with the information you are trying to read. We also limited the use of color for things like alerts, formulary status, errors and unsubmitted medications. In this screenshot you can easily see that prednisone medication has an alert, is not covered by the patient’s insurance and that there are things that need to be fixed on the form. Once a prescription is expanded, the alert is inline and at the top drawing your attention to potential problems. By limiting the use of color, it is easier for the provider to see what the issues are and where to fix them.
Use of standard controls

Using controls that are familiar to users in other applications enables users to easily adapt to an interface, such as entering a date using a calendar control or search fields that display with a magnifying glass in it.

The new Rx Writer strives to ensure that the interactive items on the screen are familiar to users. We also are using controls established in our other newer modules (Compass, Timeline) to ensure consistency throughout the application. The goal is to create an interface that feels easy to use and helps you be more efficient and accurate in your work.

The use of established User Interface patterns and standard controls enables us to create designs that are geared toward helping our users, but how do we know this works? Formative User Testing is used to prove all of these concepts and ensures that we are meeting the goals that we created for the design.

In my next blog post we will cover step four of the UCD process: User testing.

View the previous posts in our series:

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