My contribution and takeaways
- Wireframing
- Exploration of various eye tracking tools and software
- Usability testing using eye tracking
- Survey designing and interviews
- Data extraction and visualization
Problem
Harmful drug interaction alerts are critical for patient safety but largely ignored by doctors during medication prescribing. Despite efforts to improve alert designs, physicians continue to distrust computerized recommendations.
Unsolved challenges
Alert fatigue
Poor visual display
Inadequate timing and interaction mechanics
Lack of trust in given advice
Physicians trust alerts based on
- Specialization
- Role in medical hierarchy
- Demonstrated experience
- Evidence of understanding the patient's situation
- Empathy
- Demonstrated knowledge of evidence from literature
- Collaborative and Inclusive language
- Timeliness of the advice
Design directions for Trust-based alerts
Endorsed alerts - Sponsorship of clinical alerts by a specialist , administrator, journal or an individual respected in the local environment.
Transparent alerts - Physicians' decisions to comply/ override clinical alerts are made visible in a patient's medical record as an effort towards awareness and self monitoring.
Team-sensing alerts - Alerts that would deliver guidance during team discussion, via either high-technology (speech recognition) or low-technology (scribe entering test orders)
Collaborative alerts - Use of inclusive language to support team-building and to mitigate feelings of criticism while encouraging acceptance of advice.
Empathy-driven alerts - Incorporating markers of empathy into clinical alerts, such as patient-specific or physician specific information.
Conflict-mitigating alerts - In situations of conflicting advice from specialists, clinical alerts would address this tension (prioritizing different courses of action based on patient's condition)
Agency-laden alerts - Alerts would explicitly leverage individual physicians' notes towards providing recommendations and thus garner an increased level of trust.
Wireframing
Design decisions
Overlay instead of pop-up
In order to draw physicians' attention to the warning modal window, an lightbox on an overlay would help them focus on the warning message that the system is trying to communicate.
Highlighted button color instead of same colored buttons
In order to aid physicians avoid dismissing a the warning lightbox without understanding the consequences of their actions, a highlighted button suggests them of the action supposed to be taken.
Explicit button label instead of Cancel and Okay
To help physicians avoid dismissing a lightbox without understanding the consequences of their actions, use an explicit button label (Cancel Amiodarone) that states exactly what will happen when the user clicks it.
High fidelity prototype
Variations of early prototype
Why eye tracking?
Eye tracking shows physicians' actual eye movements, without any conscious filtering.
Helps understand where physicians expect to find certain elements
Find out if certain elements are distracting in a negative way
Check efficiency of the design in guiding physicians' through the alert message
Helps differentiate between new users and experienced users
Understand how physicians read - in detail or by scanning
Evaluation using Eye Tracking
Qualitative data collection
- Screen recording using Tobii Studio
- User quotes on each screen design
- Heatmaps
Quantitative data collection
- Saccade pathways
- Behavioral logs that includes clicks on the main 'theme' of the design and time on task
- Results from post-task questionnaire using System Usability Scale
- Eye-tracking data including gaze and fixations on each section on the alerts
- Preference data about the decision to cancel or continue the order
Consolidating heatmaps and resulting saccade pathways
from 35 physicians
Outcome
Harmful drug interactions reduced by 85%
Trusted alerts resulted in better decision making
Physicians spending ample time to look at the trust cues before making a decision
For details on design process, explorations and iterations, feel free to reach out to me.
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