Twinlist (and more):
Novel User Interface Design for
Medication Reconciliation
A more complex case Aligned by diagnosis With selections
Maryland Participants
- Catherine Plaisant, (Co-PI) - Research Scientist, UMIACS, Associate Director of Research at HCIL
- Ben Shneiderman, (Co-PI) - Professor, Computer Science, Researcher (and Founding Director) at HCIL
- (past) Tiffany Chao, Graduate Student in the Department of Computer Science, University of Maryland
- (past) Johnny Wu, Graduate Student in the Department of Computer Science, University of Maryland
Other Participants
- University of Texas, Houston: Todd Johnson, Jorge Herskovic, Elmer V Bernstam, Eliz Markovitz (and many more providing feedback)
- Yale University: Seth Powsner
- Medstar Institute for Innovation: Zach Hettinger
NEWS
- June 2015: Story on our Twinlist prototype for medication reconciliation appears in User Experience, the Magazine of the User Experience Professionals Association.
- Nov. 2014: Twinlist evaluation paper accepted at JAMIA
- June 2014: New eBook Inspired EHRs: Designing for Clinicians , an eBook for developers of Electronic Health Record systems released. You will find clinical scenarios, designs, interactive prototypes, and introductory materials on human factors, design and usability. Includes a chapter on Medication reconciliation, which reviews Twinlist - and other designs
- >>>>Nov 2013: Twinlist paper received Distinguished Paper Award at AMIA 2013<<<<
CONTEXT: THE SHARP-C PROJECT
The University of Maryland is one of the nine institutions participating in the National Center for Cognitive Informatics and Decision Making in Healthcare (NCCD) led by The University of Texas Health Science Center at Houston. NCCD is funded by the Office of the National Coordinator for Health IT under the Strategic Health IT Advanced Research Projects (SHARP) Program. This program seeks to support improvements in the quality, safety and efficiency of health care through advanced information technology. The NCCD award was one of four presented by the Office of the National Coordinator for Health Information Technology (ONC) through the American Recovery and Reinvestment Act of 2009 to address key barriers to health information technology. NCCD's research focus area is Patient-Centered Cognitive Support.
For more information see:1) the NCCD website at the University of Texas in Houston (the main PI) OR
2) the Maryland webpage which provides a summary of all the SharpC projects HCIL participated in.
Project Description
Medication reconciliation is an important and complex task for which careful user interface design has the potential to help reduce errors and improve quality of care. In this project we focused on the inpatient situation: a clinician is in the process of discharging a patient from the hospital and needs to compare the list of home medications with the medications dispensed at the hospital and decide what the patient should take when he/she returns home.
The main output of this project is a novel interface called Twinlist, which illustrates the use of spatial layout and multi-step animation, to help medical providers see what is different and what is similar between the lists (e.g. intake and hospital lists), and rapidly select the drugs they want to include in the reconciled list.
Other prototypes were designed to present alternative user interfaces: variations on the Twinlist interface, and an interface called Medrec developed by our collaborators at Houston.
Those interfaces were built on the substratum of a novel medication reconciliation algorithm that computes the similarity between drugs. That similarity information can then be presented to the clinician by the user interface, and remove the tediousness of a fully manual reconciliation without diminishing the decision making power of the clinician.
The basic design of Twinlist can be adapted to other reconciliation tasks such as problem reconciliation or allergy reconciliation.
Papers-
Description of Twinlist and several of its variations:
Plaisant, C., Chao, T., Wu, J., Hettinger, A., Herskovic, J., Johnson, T., Bernstam, E., Markowitz, E., Powsner, S., Shneiderman, B.,
Twinlist: Novel User Interface Designs for Medication Reconciliation,
Proceedings of AMIA Annual Symposium (2013) 1150-1159
** Received Distinguished Paper Award **
(Tech report version)
-
Evaluation with 20 Physicians
Plaisant, C., Wu, J., Hettinger, AZ, Powsner, S., Shneiderman, B., Novel User Interface Design for Medication Reconciliation: An Evaluation of Twinlist
TO APPEAR IN JAMIA - contact ( Catherine Plaisant for personal copy) -
Discussion of the role of animation in Twinlist and other similar interfaces - with evaluation with students:
Plaisant, C., Chao, T., Liu, R., Norman, K., Shneiderman, B.
Multi-Step Animation to Facilitate the Understanding of Spatial Groupings: the Case of List Comparisons
HCIL Tech Report
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Additional prototype description for potential implementers (February 2014, updated from January 2012 version):
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Early work:
- Early prototype description
(Infovis class project):
Claudino, L., Khamis, S., Liu, R., London, B., Pujara, J., Plaisant, C., Shneiderman, B., Facilitating Medication Reconciliation with Animation and Spatial layout Proceedings of the Workshop on Interactive Healthcare Systems (WISH2011) - Markowitz, E., Bernstam, E., Herskovic, J., Zhang, J., Shneiderman, B., Plaisant, C., Johnson, T., Medication Reconciliation: Work Domain Ontology, Prototype Development, and a Predictive Model (AMIA Fall 2011)
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Early Description of Twinlist:
Chao, T., Visual techniques for medication reconciliation: spatial metaphor, animated explanation, and flexible decision-making (Undergrad Honor Project report - Dec 2011)
Videos
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INTRODUCTION TO TWINLIST (visual layout and animation help users see similarities, simple interaction allows rapid selection):
Start by watching this
Watch it on YouTube: URL: http://www.youtube.com/watch?v=YXkq9hQppOw
or stream/download our mp4 version (22.6 MB, 1024 x 768 resolution, 2:11 min.) - ADVANCED FEATURES AND ALTERNATE LAYOUTS
Watch it on YouTube: URL:www.youtube.com/watch?v=dABfksDvOiw
or stream/download our mp4 version the video (35.3 MB, 1024 x 700 resolution, 9:18 min.) - HOW WE EVALUATED TWINLIST WITH A BASELINE INTERFACE
See exactly what participants used with Twinlist with a baseline interface (for the results see our paper above)
Stream/download our mp4 version (18.8 MB, 1280x800 resolution, 5:41 min.) - ALTERNATIVE INTERFACE: MEDREC - from U. of Texas Houston
(example with mobile device, with drag and drop interaction)
[From our SharpC Project 4 partners] Contact: Jorge R. Herskovic.Watch it on YouTube:
- MANYLISTS
(or HOW ANOTHER PROJECT EXPANDED THE IDEA OF TWINLIST TO THE COMPARISON OF MANY PRODUCTS)
Watch it on YouTube:
For more info see the MANYLISTS project page
Open Source Software
- The SIMILARITY ALGORITHM computing similarity between drugs is available for download at https://github.com/jherskovic/MedRec PLEASE Contact: Jorge R. Herskovic for possible updates.
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Try the direct link to a LIVE DEMO of TWINLIST with a simple case (use Chrome or Safari, with a window that is not too large - IE will not work properly)
OR: you can find the Twinlist interface source CODE and more LIVE DEMOScan be HERE (as a "playground" to tryout different designs and test cases) PLEASE PLEASE PLEASE Let us know if you use it :) - Contact Catherine Plaisant, and give credit to the University of Maryland. - Jorge Herskovic's alternative MEDREC INTERFACE source code is also available. See https://github.com/jherskovic/MedRecUI. Contact: Jorge R. Herskovic.
- Jorge Herskovic also led the PanSHARP project and developed a SMART Platform version of Twinlist for this integration demonstration project.
Lectures Slides (sample)
-
AMIA Conference, November 2013,
Twinlist: Novel User Interface Designs for Medication Reconciliation and pptx (presentation of our AMIA 2013 paper - see above) -
HCIL Symposium, May 2012,
Animated Interfaces for List Matching: Medication reconciliation and product comparison (Tiffany Chao, Ran Liu, Catherine Plaisant, Ben Shneiderman)
Related projects
- Inspired EHRs: Designing for Clinicians , an eBook for developers of Electronic Health Record systems is now released. You will find clinical scenarios, designs, interactive prototypes, and introductory materials on human factors, design and usability.
- See all our other Maryland SHARP projects
- Better EHR: Usability, workflow and cognitive support in electronic health records
Acknowledgements
This work is supported in part by Grant No. 10510592 for Patient-Centered Cognitive Support under the Strategic Health IT Advanced Research Projects Program (SHARP) from the Office of the National Coordinator for Health Information Technology.