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

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 pharmacist 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 pharmacist can continue working in the EMR.
When the Vitalink medication scheme has been received, the pharmacist can easily switch between his/her work screen (delivery screen, ...) and the Vitalink medication scheme (eg through tabs or other interaction mechanisms). This may not take more than one click on the screen.

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

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

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

The pharmacist 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).

Delivery of medication

Mandatory

x

Recommendations

x

One combined overview of all active medication

wireframes 2.1-2.4 en 3.1-3.4

Mandatory

It is important that the pharmacist 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 pharmacist wishes to see one combined overview. This overview must be shown on the first working screen of the application.

The pharmacist 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 pharmacist can take further decisions around this.

It is important that this combined overview is displayed automatically, clearly indicating what has changed with respect to the local EMR, any alerts regarding medication lines that may be a problem, etc.
The purpose of this combined overview is that the pharmacist can see at a glance what has changed since the last time he uploaded the patient's medication scheme.

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

Concretely, the combined overview means the following:

• Draw attention to changes, new additions, inconsistencies in this combined overview.
  
  
• The list of medication stored in the local EMR can continue to exist, 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.
  
• 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 pharmacist clearly sees what has changed).
    • 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 pharmacist). 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 pharmacist 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.

Create a Vitalink medication scheme with one click

Mandatory

x

Recommendations

x

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.

The pharmacist wants to see the following in the complete medication scheme:

• 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 scheme should lead to an adjustment in the list of active medication).

Recommendations

x

Validate the Vitalink medication scheme

Mandatory

Pharmacists state that if they have final responsibility for the uploaded of the Vitalink medication scheme, they want to see the full Vitalink medication scheme (combined overview) before uploading the scheme.

This means that if they choose to see the Vitalink medication scheme when scanning medication or actively go there, they can press a 'Validate Vitalink medication scheme' button (or a 'Validate Vitalink medication scheme later' button).

The pharmacist can choose whether he/she is validating at that time or is not yet doing anything and is waiting for the creation of the bill.

On the screen regarding the creation of the bill, the pharmacist must be able to call up the Vitalink medication scheme and then validate or validate it without opening it (when the pharmacist has already checked the Vitalink medication scheme during the delivery).

In case of a complicated EMR, the pharmacist must be able to place the Vitalink medication scheme on a 'to do' list so that it can be analyzed in detail later and then uploaded to Vitalink. So a 'validate later' button must be present.

The combined overview of the medication scheme is always accessible with one click (eg via switching between 2 tabs) and is therefore never closed.

The pharmacist receives feedback on the upload of the Vitalink medication scheme when the patient's EMR is closed.

It must be possible at all times to be able to open the EMR, and consequently the Vitalink medication scheme of different patients at the same time (eg telephone contact with another patient during a consultation).

If the pharmacist does not want the medication scheme (now, will have to do it later) to be uploaded to Vitalink, he should have the option to validate later (put on a 'to do' list) or to not validate it yet.

If the pharmacist decides, at a later date, to validate this medication scheme, Vitalink must check whether the Vitalink medication scheme in the EMR is the latest version.

• This means that when opening an item from the 'to do' list, the relevant Vitalink medication scheme must be re-loaded.
• If applicable, a message should be shown that a more recent Vitalink medication scheme will be shown.
• The medication schemes that are 'to be validated later' must also be removed from the 'to do' list.

A medication scheme can not 'to be validated' for more than x number of days. This number of days must be parametrisable. Afterwards, the pharmacist is obliged by a notification to validate the medication scheme (and is uploaded to Vitalink) or take another action (not validate).

Recommendations

• It is important that the 'to do' list for later validation of medication schemes and uploading to Vitalink can be managed efficiently.

  • Provide the pharmacist with a reminder functionality in which he / she can set up to be reminded within x time to validate the medication scheme on the 'to do' list and send it to Vitalink.

Visualization of the print version of the Vitalink medication scheme

Mandatory

It should be taken into account that the print version of the medication scheme for the patient may evolve in the future.

Depending on the needs of the patient, different types of displays may be necessary.

Each view will be built on the same dataset. This view should be able to be viewed on the screen by the pharmacist & possibly the patient during the consultation, or be printed to give to the patient.

• A display type can be selected on the combined overview of the medication scheme.
• It must be easy to alternate between the different types of view so that the pharmacist can decide in consultation with the patient which visualization of the medication scheme is best suited for the patient.

An exact implementation of this representation(s) will have to be offered by the software supplier.

Recommendations

• Ensure that the pharmacist can easily switch between the different display types.

• Keep the preference for a specific type of display for each patient, so that the pharmacist can know which type he / she should select during a subsequent consultation.

How to handle mistakes

x

Miscellaneous

x