AJava-based ToolforEntryofaMedical Problem List, WhichAccesses aRemoteLargeScale Enterprise Vocabulary Server

TheMayoClinic hasbeendeveloping arefined interface designtofacilitate theentryof controlled diagnoses into amedical problem list. Therefinements havebeenbasedonasetof successive Usability experiments.12 These experiments haveyielded principles whichwe believe mustembodyasuccessful attempt at controlled entry ofmedical problem lists. The first lesson isthatthis function encompasses subtleties ofdesign notpreviously published. Thesecomplexities include interaction between historical problems andpresent problems, the relationship between thelevel ofgranularity necessary toencode theclinical detail which describes thepatient's condition andthatare necessary tobill fortheencounter. Inaddition, designers mustconfront theprecision andrecall question. Thatis, iftheclinician toooften does notfind theproblem onthelist presented bythe system, thesystem becomes unusable. Atthe sametime, iftheclinician cannotquickly navigate through averylonglist ofproblems they will find thesystem unwieldy andtherefore unusable. Thisiscompounded bythefact that these problems mustbesolved within thesame application, whichmeansthat fromacomputing standpoint there isconsiderable overlap. This causesdesigncompetition betweenthese varying agendas, whichisfurther compounded bythefact that there exists limited screen real estate. Thesecond lesson learned wasthat with a complexscreen design (onedesigned to maximize flexibility) onemustkeepvisual pointers onthescreen tominimize Cognitive Overhead andDisorientation.34