On FOCUS

by Michelle Schneider

I have really been diving into MEDITECH’s 6.0 Clinical Panels.  This is, after all, the latest MEDITECH has to offer for patient chart review and support for clinical decision making.   I find it very frustrating though, because it’s difficult to get a good flow of data evaluation.  In MEDITECH’s demonstrations, the data is all perfectly placed in these narrow columns so that the user gets a wonderful vibe of an easy, relaxed chart review.  However, as soon as reality strikes, users realize that all responses are not less than 15 characters.  A user is notified of a longer response with an ellipsis after a truncated entry.  In order to see the  longer response, he must click once to open an additional screen, move the mouse to the bottom right of the screen, click close and then continue the chart review.  In the assessment below, which certainly represents a very limited assessment, the user cannot easily glean the patient’s status.  There are so many entries with the ellipsis after them that the user is forced to click on each to see the response.

This results in a very clunky workflow.  If you count the keystrokes required to view the first (and shortest) entry in this example, the user would have to use 10 keystrokes.  This may irritate users and in some cases, the user may think the beginning of the entry is intuitive and assume the remainder of the response in order to save time. However, this represents bad practice and could result in compromised patient safety.  For instance, the “Gastrointestinal” entry has two responses, which are both truncated with an ellipsis.  They are “Bowel Soun…” and “Abdomen D…”  Upon clicking on the row, the user sees that the entry is “Bowel Sounds Hypoactive” and “Abdomen Distended.”  The user can then sweep the mouse to the bottom right of the screen, click close and return to the assessment.  To see all of the entries on this screen, the user will have to click 40 times.  That is not a typo.  FORTY clicks!  Wow.  There is no apparent method to widen the columns and no apparent method to use that blue space to the right of my last column.  It’s just sitting there, teasing me.  Sure would be a good place for the rest of my results.  Hmmmmm.

How do you think your clinicians will react to this method of chart review?  Can this, will this meet their needs?

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• December 4, 2009 -- All Show and No Go (1)
• November 17, 2009 -- Please Pass the Ketchup (2)
• November 9, 2009 -- FOCUS: When/Where (1)