Versions Compared

Old Version 74

changes.mady.by.user Unknown User (liesbeth.weeghmans@uxconsult.be)

Saved on

compared with

New Version 75

changes.mady.by.user Unknown User (liesbeth.weeghmans@uxconsult.be)

Saved on

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.

...

MANDATORY & RECOMMENDED UX GUIDELINES

Access to

...

Access to medication information

Access to medication information in a hospital is unlike in primary care, not regulated by governmental guidelines. Each care organisation, including hospitals, are allowed to import and export Vitalink medication via the principle of circle of trust. It is thus up to the hospital security policy to allow hospital staff access to medication information or not. This means that the hospital security management can determine if e.g. administrative staff of a hospital department, a pharmacy assistent has access to the Vitalink information. 

...

  • When opening a patient's EHR, it must be checked automatically if the registration of the informed consent is fulfilled, if there is a Vitalink medication scheme for this patient and whether the EHR has the most recent version of the Vitalink medication scheme.

  • This automatic questioning is done for all patients as soon as their file in the EHR is opened, independent what the reason for hospital visit is (ambulant visit, emergency room visit or admission).
  • An automatic questioning of the Vitalink medication scheme is crucial. The care giver should not take any action (eg no click to start a download).

  • The CG must be able to clearly see whether or not a Vitalink medication scheme has been created for the patient.
    • If not, the CG must be able to indicate that he/she wants to make use of the Vitalink medication scheme for the patient in question, if applicable.
  • The CG must be able to clearly see that the application is still working on importing the information from the Vitalink medication scheme.
  • The CG must be able to clearly see when the import of the Vitalink medication scheme has been completed.
    • Always mention the date & time of the last validation since this is useful to the CG to validate the validity of the Vitalink medication scheme.
    • Other information like date & time of last download, validator, version ... can be visualized via a tooltip (if not enough screen space).
  • The CG must be able to clearly see when the application has failed to import the Vitalink medication scheme.
  • In the case of a hospital, if all mandatory authorizations/mandates are set, it must be possible for a member of administrative staff to prepare the EHR by importing the medication scheme for the patient in question.

...

  • The principle of a combined overview should be kept simple:
    • Provide an indication 'what is on Vitalink' and 'What is in the local EHR'.
    • It is important that this combined overview is automatically displayed, clearly indicating what has changed with respect to the local EHR, any alerts concerning medication lines that may be a problem, etc.
    • Draw attention to changes, new additions, inconsistencies in this combined overview.
    • Afterwards, the CG can take further decisions related to these medication lines (e.g., returning to the previous posology of a particular medication, re-activating deleted medication, etc.) in an ambulant setting or starting the hospital medication in case of an admission.
  • In some cases it is not necessary to show the complete (combined) medication scheme.
    • When the CG would like to have a global overview on the patient, the software can show an reduced combined overview of the active medication, e.g. an abbreviated list. This can be used on the homepage of the patient file, on a dashboard page, ...
    • The presentation of an abbreviated list of the active medication on Vitalink combined with the active medication from the local EHR should display at least the product name, dosage & posology.
    • In this way, the care giver has a first overview of any changes to medication since the last visit of the patient.
    • In this reduced combined overview, it is also visible which medication line is coming from Vitalink & which medication line is coming from the local EHR.
    • In addition, additional information must be provided via a tooltip or fold out action (if applicable: start / stop, from, to) and comments (if applicable).
    • The CG can also adjust medication lines in the abbreviated list. The possibility should therefore be offered that the caregiver can perform actions on the reduced list of the combined overview without having to open the complete medication scheme;

...

  • Emphasise this with a different background colour so that attention is drawn to it (note: people with colour blindness do see colour shades, so for them it is also visible that there is a difference of colour with the other lines).
  • Display a textual label indicating 'new'.
  • Display an icon, indicating that the related medication line of coming from Vitalink.

...

  • Strike through the medication line that has been replaced (in this way the CG clearly sees what he/she had prescribed and how this was replaced by medication prescribed by another health care provider).
  • Display the relevant medication line from the local EHR and the medication line from Vitalink in a clustered way (in this way the 2 'associated' medication lines are placed underneath each other, making the comparison easier for the CG).
  • By keeping the unique URI once the mapping has been made, the connection between 2 'associated' medication lines can be better and faster verified next time. A 'reference algorithm' can be worked out for this.

...

  • This can be the case when, for example, 2x same type of medication is displayed but with a different product name. 
    • Make sure that these medication lines are grouped/clustered.
    • Next, provide an alert on these medication lines.
  • This can be the case when there is an incomplete medication line.
    • Make sure that it is pointed out that the medication line isn't complete.
    • Aks, via an alert / notification if the CG can complete the medication line. 
  • An alert or notification can be an icon or textual 
    • Via a tooltip, more information can be provided.


  • The combined overview of the active medication (medication coming from Vitalink + medication of the EHR) should be visualized in a scheme view as well as in a list view. 
    • It should depend on the user's preference in which view the active medication will open.
    • It is very important that the CG can have a hour view of the medication scheme.


  • The CG should be able to make changes directly into the medication scheme. Such an interactive medication scheme would allow to easily change the posology, intake moments, comments, ...


  • It should be possible to sort the medication lines via ATC code, CNK code, alphabetical, ...
  • Make it also possible to sort on a column.
    • Visually indicate which column has been sorted.
  • Ensure that this representation is remembered when opening the Vitalink medication scheme for other patients.


  • In some cases it is not necessary to show the complete (combined) medication scheme.
    • When the CG would like to have a global overview on the patient, the software can show an reduced combined overview of the active medication, e.g. an abbreviated list. This can be used on the homepage of the patient file, on a dashboard page, ...
    • The presentation of an abbreviated list of the active medication on Vitalink combined with the active medication from the local EHR should display at least the product name, dosage & posology.
    • In this way, the care giver has a first overview of any changes to medication since the last visit of the patient.
    • In this reduced combined overview, it is also visible which medication line is coming from Vitalink & which medication line is coming from the local EHR.
    • In addition, additional information must be provided via a tooltip or fold out action (if applicable: start / stop, from, to) and comments (if applicable).
    • The CG can also adjust medication lines in the abbreviated list. The possibility should therefore be offered that the caregiver can perform actions on the reduced list of the combined overview without having to open the complete medication scheme;


  • Visualize changes in the following way:
    • Newly added medication with respect to the local EHR:
      • Emphasise this with a different background colour so that attention is drawn to it (note: people with colour blindness do see colour shades, so for them it is also visible that there is a difference of colour with the other lines).
      • Display a textual label indicating 'new'.
      • Display an icon, indicating that the related medication line of coming from Vitalink.
    • Change in posology, intake moment, etc:
      • Strike through the medication line that has been replaced (in this way the CG clearly sees what he/she had prescribed and how this was replaced by medication prescribed by another health care provider).
      • Display the relevant medication line from the local EHR and the medication line from Vitalink in a clustered way (in this way the 2 'associated' medication lines are placed underneath each other, making the comparison easier for the CG).
      • By keeping the unique URI once the mapping has been made, the connection between 2 'associated' medication lines can be better and faster verified next time. A 'reference algorithm' can be worked out for this.
    • Removal of prescribed medication:
      • Strike through the medication line that has been removed.

  • The necessary changes (make the deleted medication line active again, change the modified posology to previous posology, etc) can be done by e.g. using a drop down menu or by having a shortcut (buttons / links) on the related medication line.   
    • When the CG does nothing, he/she agrees with the overview of the active medication that he/she sees (deleted medication will disappear, adapted posology will be retained and the previous posology will disappear, etc).
    • At a next opening of the EHR it is shown as a local scheme.

  • Provide the option to display an alert or notification:
    • This can be the case when, for example, 2x same type of medication is displayed but with a different product name. 
      • Make sure that these medication lines are grouped/clustered.
      • Next, provide an alert on these medication lines.
    • This can be the case when there is an incomplete medication line.
      • Make sure that it is pointed out that the medication line isn't complete.
      • Aks, via an alert / notification if the CG can complete the medication line. 
    • An alert or notification can be an icon or textual 
      • Via a tooltip, more information can be provided

Recommendations

  • Show interactions between medication lines through an alert (like this is already the case in the hospital software).`

Interactive/Dynamic medication scheme

Mandatory

From the combined overview of all active medication it should be possible to open the complete medication scheme with the combined overview via one click.

Since this is a combined overview of information from the local EMR and information from Vitalink, it is important that it clearly shows when (date & time) and by whom the version of Vitalink was last modified.

Just like in the shortlist of the combined overview of the active medication, the general practitioner wants to see the following in the complete medication schedule:

  • What has changed to the active medication of the patient?
  • Information regarding changes, additions, deletion, ... of a medication line.

...

      • .


Recommendations

  • The CG wants to see the following extra information per medication line:
    • Name of the health care provider who prescribed / adjusted the medication.
    • This information is sent with the medication scheme to Vitalink. This gives added value to the interpretation of the scheme and in this way it is clear to other care providers which medication is prescribed by whom.
    • For which pathology is the medication prescribed? (not compulsory to enter during prescribing, but desirable).
      • The pathology should be selected in a quick way when prescribing medication. Preferably, the offered choice list prefers the diagnoses present in the EMR.
    • with the medication scheme to Vitalink.
    • This gives added value to the interpretation of the scheme and in this way it is clear to other care providers which medication is prescribed by whom.
    • For which pathology is the medication prescribed? (not compulsory to enter during prescribing, but desirable).
      • The pathology should be selected in a quick way when prescribing medication. Preferably, the offered choice list prefers the diagnoses present in the EHR.


  • In addition, the CG also has certain expectations regarding the visualization and use of this medication scheme. The CG does not view this as a static page, but wants to use it for:
    • Adjusting intake moments: provide dynamic input fields to adjust the intake moments to the medication scheme itself (bi-directional operation).
    • Removing a medication line: provide check boxes to select one or more medication line(s) and remove them with one click (this gives the GP
    In addition, the CG also has certain expectations regarding the visualisation and use of this medication scheme. The CG does not view this as a static page, but wants to use it for:
    • Adjusting intake moments: provide dynamic input fields to adjust the intake moments to the medication scheme itself (bi-directional operation).
    • Removing a medication line: provide check boxes to select one or more medication line(s) and remove them with one click (this gives the GP a complete overview of all active medication before removal).
    • Adjusting a medication line: double click (or other action such as right-click) on a medication line leads to the prescription module where, for example, the posology can be adjusted.
    • Not showing a medication line on Vitalink (by default, everything is on 'show on Vitalink').
    • Adding a note: provide a dynamic input field to enter a comment on a medication line (in this way the comments field will be used more and better).
    • Adding new medication: provide an action button to start the flow to add new medication (this gives the CG a complete overview of all active medication before prescribing new medicationremoval).
    • To upload the complete medication scheme to Vitalink (validate).
    • Placing the medication scheme on a 'to do' list for later upload to Vitalink (delayed validation). IS DIT IETS WAT MOET KUNNEN BIJ ZIEKENHUIZEN
    In addition to the name of the health care provider, show the specialty of the health care provider who has added or adjusted a medication line if this is given via Vitalink.
    Make it possible to drag medication from the 'chronic' to 'temporary' or 'if necessary' category, taking into account the corresponding specifications for each of these categories (eg with regard to the end date).
    Visualise medication that was prescribed during the current consultation in a different way (icon and / or color).
    Showing the version number is less important for the CG, but can be interesting for a print version of the medication scheme or for other reasons.
    The CG wants to know possible interactions between medication lines.
  • In some cases, the CG may want to adjust the order of the medication lines in the Vitalink medication scheme.
    • Make sorting possible on the columns of the medication scheme that is shown locally (eg alphabetically, per pathology (if indication is entered), per intake moment, most recently added medication on top (so also the last changes are at the top), chronic / temporary /If necessary.
    • Visually indicate which column has been sorted.
    • Ensure that this representation is remembered when opening the Vitalink medication scheme for other patients.

...

    • Adjusting a medication line: click on edit icon or link of medication line will lead to the prescription module where, for example, the posology can be adjusted.
    • Not showing a medication line on Vitalink (by default, everything is on 'show on Vitalink').
    • Adding a note: provide a dynamic input field to enter a comment on a medication line (in this way the comments field will be used more and better).
    • Adding new medication: provide an action button to start the flow to add new medication (this gives the CG a complete overview of all active medication before prescribing new medication).
    • To upload the complete medication scheme to Vitalink (validate).


  • In addition to the name of the health care provider, show the specialty of the health care provider who has added or adjusted a medication line if this is given via Vitalink.
  • Make it possible to drag medication from the 'chronic' to 'temporary' or 'if necessary' category, taking into account the corresponding specifications for each of these categories (eg with regard to the end date).
  • Visualize medication that was prescribed during the current consultation in a different way (icon and / or color).
  • Showing the version number is less important for the CG, but can be interesting for a print version of the medication scheme or for other reasons.

  • Show interactions between medication lines through (e.g. via an alert).

Start Vitalink with one click

Mandatory

  • If there is no Vitalink medication scheme present or not yet used, it must be possible to start the creation / use it with one click.

Recommendations

  • If starting with the creation of a Vitalink medication scheme, it is important that all active medication is automatically uploaded from the local EMR EHR to Vitalink.
    • It is not the intention that the caregiver will transfer all medication lines manually, line by line.
    • Afterwards, details of intake, comments, ... can be entered on the medication scheme itself.

Prescribe

During an ambulant visit

Mandatory

  • Prescribed medication is automatically added to the medication scheme (combined overview), unless explicitly chosen not to.
  • This means that the medication is entered via structured entry fields.

...

  • Visualize newly added medication in a different way in the medication scheme. In this way the CG has a clear overview of what will be added.
  • During the prescription of a medication, the CG must be able to indicate whether the medication may or may not be shown on Vitalink.
    • By default, all medication is shown on Vitalink if the CG has indicated to work with

...

Recommendations

  • If the CG decides to prescribe medication during the consultation, the shortened list of the combined overview (information derived from local EMR and from
    • Vitalink
    ) with product name, dosage, posology or the complete medication scheme (with the extensive combined overview) should be the base of the page on which they start when creating a prescription.
    • .


Recommendations

  • On this prescription page it is important that the complete medication scheme can be opened with one click (if it is not already fully shown) or it can be displayed that the CG wishes to work .
  • While prescribing, the CG should be able to indicate that he/she would like to starting working with Vitalink (if this is not yet the case for the patient).there isn't yet a Vitalink medication scheme). 

  • With regard to prescribing itself, the focus should be on its speed. This can be done by focusing on the simple prescription flow, which can simplify the user interface..

    • Split the functionalities for easy prescribing vs.
    • Split the functionalities for easy prescribing vs. complex prescribing.
    • Place the complex prescribing module behind a button / link. This can then be reached via one extra click (this is not a problem since complex prescribing (weekly scheme, 'phasing out' scheme, etc.) occurs less frequently). Belgisch Artsen Syndicaat or other health professional associations can provide best practices with regard to good interfaces for complex prescribing.
    • Provide structured entry fields so that a one-off data input is possible (automatic transfer of data to the Vitalink medication scheme).
    • Provide standard posologies for frequently used medication.
    • Show the most frequently used dosage, administration unit, drug route, ... via eg radio buttons so that a quick selection is possible. Less used options can be included behind a choice menu (drop-down list).
    • Simplify working with templates to save frequently used prescriptions (eg provide two action buttons: Prescribe vs. Prescribe and save as template).
  • Simplify the addition of indications / pathologies (pharmacists & patients are asking for this).
    • Provide quick selections / suggestions for indications / pathologies per medication. In this way, the CG can send the most current indication to the Vitalink medication scheme in one click. 
    • If the suggestion of indication / pathology does not match, the CG should simply be able to enter another indication / pathology as free text.
  • The CG can indicate whether or not medication can be shown on Vitalink, both in the prescription module and on the interactive medication scheme (combined overview).
  • Ensure that prescription by substance name is possible (this is then adjusted by a pharmacy in the Vitalink medication scheme to the generic variant).

During a hospital stay

Mandatory

  • Make sure that it is easy & quick to substitute home medication with hospital medication.
  • The home medication should be remembered since it is important for the re-substitution to home medication afterwards.

At discharge

...

  •  
  • New prescriptions made during a hospital stay are not uploaded to Vitalink.
  • Only if they stay applicable for the home medication, they will be validated and uploaded to Vitalink when discharging the patient (of when having a weekend at home during a hospitalization). 

Validate the Vitalink medication scheme

...