Introduction

This document contains UX guidelines that all medical software that use the Vitalink medication scheme should comply with.

All software packages should also comply with the UX guidelines for every software package in Vitalink found here.

Terminology & Abbreviations

A list of the terminology used in this document can be found here.

Automatic questioning of Vitalink

Wireframes 2.1 - 2.4

Mandatory

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

This automatic questioning is done for all patients.

An automatic questioning of the Vitalink medication scheme is crucial. The general practitioner should not take any action (eg no click to start a download).

Automatic import and analysis of the information from the Vitalink medication scheme in a combined overview should take a minimum of time (preferably 4 to 6 seconds or less on average, with a maximum of 10 seconds). 
This takes place in the background and starts immediately when the patient's medical record is opened. In the meantime, the GP can continue working in the medical file.

It is important that the vendor can monitor the performance in an active way if the automatic import and analysis of the information from the Vitalink medication schedule takes more than a pre-determined number of seconds (eg after more than 10 seconds). If, after an adjustable period of, for example, 60 - 120 seconds, a connection has not yet been established with Vitalink, the connection will be terminated automatically. The GP is hereby informed about the problem in a user-friendly and concrete way and should be able to send the error easily (ask for error report).

The GP must be able to clearly see whether or not a Vitalink medication scheme has been created for the patient. If not, the GP must be able to indicate that he/she wants to make use of the Vitalink medication scheme for the patient in question.

The GP must be able to clearly see that the application is still working on importing the information from the Vitalink medication scheme.

The GP must be able to clearly see when the import of the Vitalink medication scheme has been completed.

The GP must be able to clearly see when the application has failed to import the Vitalink medication scheme.

Recommendations

• Display visually that the application is working on the Vitalink medication scheme.
  
  • This can be done, for example, by a progress indicator or an icon indicating that the Vitalink medication scheme is loading.
    
    
• Display visually that the Vitalink medication scheme has been collected.
  • This can be done, for example, by an icon indicating that all data from Vitalink has been retrieved (+ mandatory information: date & time of last download).
    
    
• If it is not possible to obtain data from the Vitalink medication scheme, also visualize it and indicate why there is a problem / what the problem is (in understandable language).

One combined overview of all active medication

wireframes 2.1-2.4 en 3.1-3.4

Mandatory

It is important that the GP has one overview of the active medication of the patient. Since both information about the active medication can be found in the local EMR and on Vitalink, the general practitioner wishes to see one combined overview. This overview must be shown on the first working screen of the application.

The GP does not want to compare the information from the local EMR and the Vitalink medication scheme manually to determine what has changed. Comparing two different schemes is too time-consuming, too complex and can lead to mistakes. Methods where they can 'update' per line, 'upload' are not well understood. Rows in a table using different status icons can not be interpreted unambiguously.

The principle of a combined overview should be kept simple: provide only an indication 'what is on Vitalink'. 'What is in the local file'. Afterwards, the GP can take further decisions around this.

It is important that this combined overview is automatically displayed, clearly indicating what has changed with respect to the local EMR, any alerts concerning medication lines that may be a problem,etc.

In this phase of the flow it is not necessary to show the complete (combined) medication scheme. The presentation of an abbreviated list of the active medication on Vitalink and the active medication from the local EMR with at least the product name, dosage & posology is sufficient to give the general practitioner a first overview of any changes to medication since the last visit of the patient.

In addition, additional information must be provided with a 'mouse-over' action on the relevant medication line such as at least date information (if applicable: start / stop, from, to) and comments (if applicable).

The aim of this combined overview is that the GP can see at a glance what has changed since the last time he uploaded the patient's medication schedule.

In principle, the GP would then have to make the necessary changes to the medication scheme before prescribing new medication (eg, returning to the previous posology of a particular medication, activating deleted medication, etc.).

You can also adjust this in the abbreviated list. The possibility should therefore be offered that the general practitioner can perform actions on the shortlist of the combined overview without having to open the complete medication scheme.

After obtaining the information from Vitalink, the GP sees who has validated the last Vitalink medication scheme and when.

The abbreviated list means the following:

• If after the automatic questioning it is determined that the active medication from the local EMR corresponds with the Vitalink medication scheme, no further action is taken.
  • Still, it remains valuable to see the active medication.
  • Showing a short list with at least the product name, dosage & posology is sufficient to give the general practitioner a first overview of any changes.
  • For example, a tooltip with a 'mouse-over' action shows additional information such as a start or stop date and/or a note regarding the medication line. In the overview itself it can be indicated that there is additional information so that the GP knows which medication lines he/she can possibly carry out a 'mouse-over' action on.
  • With all medication lines the indication 'Vitalink' will be displayed so that the GP clearly knows that there is no difference between the local EMR and the Vitalink medication scheme.
    
    
• If, after the automatic questioning, it is determined that the active medication from the local EMR does not match the Vitalink medication scheme, one combined overview of all active medication from the local EMR and all active medication stored in the Vitalink medication schedule will automatically be shown.
  
  • The display of a list with at least the product name, dosage and posology is sufficient to give the general practitioner a first overview of any changes.
  • Draw attention to changes, new additions, inconsistencies in this combined overview.
  • Additional information such as a start or stop date and/or a note regarding the medication line is shown via, for example, a tooltip. In the overview itself it can be indicated that there is additional information so that the GP knows which medication lines he/she can possibly carry out a 'mouse-over' action on.
  • The list of medication stored in the local EMR can continue to exist here, but the focus should be on the combined overview of information from Vitalink and information from the local EMR.
    
    
• Visualize clearly which medication line comes from where (Vitalink vs. local). A medication line from Vitalink has the Vitalink icon displayed. A medication line from the local EMR is displayed without an icon.
  
  
• Draw attention to changes, new additions, inconsistencies in this combined overview.
  
  
• Visualize changes in the following way:
  
  • Newly added medication with respect to the local EMR:
    
    • Emphasize this with a different background color so that attention is drawn to it (note: people with color blindness do see color shades, so for them it is also visible that there is a difference of color with the other lines).
  • Change in posology, intake moment, etc:
    
    • Cross out the medication line that has been replaced (in this way the GP 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 EMR and the medication line from Vitalink in a clustered way (in this way the 2 'associated' medication lines are placed underneath each other, making comparison easier for the general practitioner). 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:
    
    • Cross out 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 right-clicking on the relevant medication line or by clicking on an action button.
  
  • When the GP 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) and at a next opening of the EMR it is shown as a local scheme.
    
    
• Provide the opportunity to display an alert:
  
  • With, for example, 2x same type of medication but with a different product name. These will also be displayed under each other for clustering.
  • For example, an incomplete medication line.
  • Give, for example, a tooltip after a 'mouse-over' action for the relevant medication line, more information about why there is an alert (eg incomplete medication line).

Recommendations

• Show interactions between medication lines through an alert.

Start Vitalink with one click

zie wireframe 2.1

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.

If it is indicated that there will be worked with Vitalink for this patient, the active medication from the local EMR will be shown in a combined overview with the medication from Vitalink if a Vitalink medication scheme already exists for this patient. If this is not the case, the active medication will be shown from the local EMR and will then be uploaded to Vitalink.

The GP must be able to see at all times that a Vitalink medication scheme is available for the patient.

When in the settings of the application it is stated overarching to work with Vitalink, the data of the Vitalink medication scheme is automatically retrieved and thus shown in the combined overview.

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 to Vitalink.
  • It is not the intention that the GP will transfer all medication lines manually, line by line.
  • Afterwards, details of intake, comments, ... can be entered on the medication scheme itself.

Interactive/Dynamic medication scheme

zie wireframes 4.1 - 4.5

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.

If the local medication scheme is made interactive, this should work bi-directionally (an adjustment of an intake moment on the medication schedule should lead to an adjustment in the list of active medication).

Recommendations

• The GP 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 who.

Prescribe medication

x

Validate the Vitalink medication scheme

x

Visualization of the print version of the Vitalink medication scheme

x

How to handle errors

x