Performance vs Clinical Risk

The complexity of creating usable solutions in healthcare 

The productivity that a user can get with a tool depends, among other things, on the usability of the interface used to work. In the context of healthcare applications, the interface design solutions can supose in certain situations a number of hazards that result in clinical risk. A productive solution is incompatible with clinical risk free solution? In an effort to provide a broad view of the problems, in this article we offer solutions addressing the most common design patterns used to increase productivity in user interfaces.

For the analysis, we propose two specific usage modes: data entry (interaction with the system) and data output (representation of information and data management interactions) in a health system.

Data Entry (garbage-in)

Help to complete the information

  • Problem: Help may be decontextualized
  • Solution: The help that is offered to the user should not contextualize only normal activity but the content and the information required.


  • Problem:The autocomplete action may end up in the selection of an unwanted value
  • Solution: Actions should allow the end user to overwrite the value and warn you that you are entering a value outside the catalog.

Validation and error feedback

  • Problem: The errors reported are partial
  • Solution: Inform the user about the possible existence of more errors and the need for revision


  • Problem: Default values ​​may be based on faulty assumptions
  • Solution: Report existing defaults and even offer the possibility of removing.


  • Problem: Loss of visual feedback on what you are doing.
  • Solution: Inform the user with a message of the action to be executed.

Commands (actions, undo, massive actions)

  • Problem: The command may cause a failure in the integrity of the data.
  • Solution: Run command to complete mock confirmation by the user and inform the local view of the result.

Data Output (garbage-out)

Indexes and data summaries

  • Problem: The data are not updated
  • Solution: Inform the user of the last update of the data and provide the ability to update it in context.


  • Problem: The search is hidding results.
  • Solution: Reporting results of existence visible and hidden results either paging issues as matching with the search.


  • Problem: Notifications are not prioritized.
  • Solution: Offer a prioritization system and allow customization of alert priority one by one or by type.


  • Problem: It was considered an alert something that is not.
  • Solution: Associate clinical alerts to static domains consistently identifiable
  • Problem: An unintuituve icon has been associated to an alert
  • Solution: Tagged alerts with short terms  and / or group them under predefined domains

The healthcare scenario

We should note that in the health context, the tasks that a user must perform that require a computer system can account for up to 30% of their time and therefore there is a clear need to improve the efficiency and productivity in their daily use.

At the same time it is important to consider that during the working day there are many and frequent changes of tasks, activities and contexts, for instance, a doctor in the emergency room in a 10’ frame has been triaging two patients, be consulted by the nursing team 3 times on matters of different nature, it has been lifted from his seat 6 times for different tests of material, information, etc.

Therefore, although the task itself requires a high concentration effort, attention span is reduced by the high number of interruptions. In this context, the user controls what he does but is subjected to a high load of stress and distractions in almost any of its activities. A medical error could pose a risk to the health of their patients.

From the most simplified view of a computer system as a mere representation of the information model, the most basic interface is build up with forms to fill available data and views for display them. Even with this formula, the application would not be free of clinical risks. Any solution applicable for the simplest interface is not incompatible with richer and more usable interfaces. For this we consider that not only is not incompatible to have solutions which can enhance productivity and usability, but it is also necessary.