“Save to drafts” implies that the order is actually being saved somewhere, whereas if you navigate away from the page it’s lost. (right?) How about “add to drafts” instead?
I’m not a doctor, but I would think you should show the dosing instructions from medication orders on the “order home page” without requiring an extra click to expand.
You mentioned making it easy to find common drugs, but you haven’t mocked this up. May I suggest copying what we did in the Ebola tablet app? (See B and C in Figure 1 in the JMIR article.)
Thanks for providing the mockups, however, one thing I did notice is that the way tests are added to the draft seem to differ a bit from the existing implementation, what we have currently models Bahmni’s implementation and the way that works is that the tests or panels are added to the draft once selected, and removed when unselected.
there is no Save To Draft button after selecting all your tests.
Personally, I feel the Save To Draft button is a bit redundant since that is the usual action the user would take as there is no any other obvious option other than that.
so I’d be proposing we stick with the current implementation.
We removed the dosing instructions from the initial display in an effort to clean up the UI for an orders list that contains many different types of orders. We could add them back in if people agree. Thoughts @burke, @jteich?
Yes, I’ve looked at the way meds are ordered in the Ebola tablet app. When we get back to iterating more on the drug orders, I’ll mock something up for everyone to review. I’m sure it will borrow from that design.
Thanks @efosa. Yes, I went back and forth on this. I think we changed it just to make it consistent with the drug ordering works, but maybe you are correct and it is better without “add to drafts”. Let’s leave it without that button (as it is currently being built) and we can change it later if people disagree with the usability.
The expansion arrows on the left edge of orders seem backwards or wrong at first impression. If this is already convention, so be it. But I was expecting the arrow to reflect the current state and not the “desired” state – i.e. I’m used to seeing arrows like: ► collapsed and ▼ expanded
The Type column seems unnecessary. I don’t think we need to dedicate a column to tell someone that Amoxicillin is a drug or that Hematocrit is a lab. If they don’t know that, then they have no business writing orders.
The Status of “Ordered” is confusing. If orders are active, aren’t they “ordered” too? It’s not immediately obvious why I cannot edit an “Ordered” order while I can edit an active order.
Add order
Eventually, I’d hope we could replace the “+Add Order” button with a text field that gets focus by default (at least for keyboard-based interactions). The current interface requires at least two clicks before I can even start specifying what I want to order. There could still be a widget at the end of the input field to pull up tools like common labs or order sets button-based screens. And the input field could be suppressed for non-keyboard based inputs (e.g., tablets). But when using a keyboard, I should be able to save dozens of clicks by simply typing the name of the orderable I want and hitting enter. For example, the current design requires two unnecessary clicks for every drug order.
I’m a little worried about your dividing things between panels and tests. The user should only be presented with orderables (i.e., those things that can be ordered) and we should not assume that all elements of panels will be individually orderable. How will the UI work when a test in a panel is not individually orderable? For example, a user can order a “Full hemogram” (panel containing hemoglobin, hematocrit, and several other indices) but cannot order the individual elements? On the Lab Order screen, if I click on the LDL in tests, I’m actually ordering something different than the LDL in the panel (in a lipid panel, the LDL is typically calculated from the other values and when you order just an LDL itself you are usually ordering a direct LDL, which uses a different method and would very likely be a different concept). If you insist on going this UI direction for labs, please please please do not assume that you simply fill the “TESTS” section with all components from the “PANELS” section (i.e., do not assume that you will be able to show users all components of a panel by selecting them in the TEST section). If you want to inform users of what components are in a panel, use a tooltip or clickthru to show them.
If at all possible, please approach the order forms as DIVs – i.e., don’t make assumptions about where they are in the page or the context around them. Ideally, we’d be able to take your order form screens (labs, drugs, order sets, etc.) and render them as modal dialogs instead of new pages.
Thanks @Burke! A lot of good feedback here. Before responding to all of this, I wanted to just touch base on your comment about Panels/Tests since it affects the in-progress implementation the most…
If I understand correctly, you are saying that only tests that are orderable should show in the tests list, right? We were planning on showing them all, but only the orderable ones would be clickable (this would be more clear by disabling the buttons of non-orderables). But we can certainly only show the orderable ones. The UI will still look similar - the panels automatically choose the components, but only if they are orderable on their own.
As a side note, is that how Bahmni works? It looks like every test in the Hemogram set are showing but maybe only the individually-orderable ones are set up on the demo instance I am looking at? If so, they must have a different way of knowing which results can be entered for a panel. @darius, @jteich
With only a dozen tests, showing all components (even non-orderable ones) in the TESTS panel can work, but it has two challenges: (1) users may be confused by having tests listed that are not-clickable and (2) it does not scale well.
For example, a lab with only three (3) very common panels (CBC, CMP, and urinalysis) could have the components (out of which maybe six are orderable):
WBC
RBC
HGB
HCT
MCV
MCH
MCHC
PLT
MPV
RDW
Basophil %
Basophil Absolute
Eosinophil %
Eosinophil Absolute
Lymphocyte %
Lymphocyte Absolute
Monocyte %
Monocyte Absolute
Neutrophil %
Neutrophil Absolute
Immature Granulocytes %
Immature Granolycytes Absolute
Nucleated RBC %
Nucleaeted Absolute
sodium
potassium
chloride
carbon dioxide
BUN
glucose
creatinine
GFR
calcium
total protein
albumin
total bilirubin
alkaline phosphatase
AST
ALT
anion gap
urine leukocytes
urine protein
urine glucose
urobilinogen
urine bilirubin
urine hgb
nitrite
pH
specific gravity
You can imagine that a site with dozens of panels along with many individual tests (not in a panel) would overwhelm your UI.
Your approach makes sense with a very finite number of panels & tests on a touch-based interface. I’d suggest that you could accomplish the same thing by:
Positioning your lab order screen as a tool for this simple use case and not “the” lab order screen (allowing for a lab order screen that uses a text field + quick links for common orders or favorites… more in line with your drug order screen)
Only showing orderables in the TESTS section and take another approach to informing users of panel components (e.g., tooltip or info button)
@burke - the only concern of yours we haven’t yet addressed is the ability for clinicians to more quickly order tests using keyboard entry (or whatever). This is something we can and should improve on. I just wanted to get these out there right away in order to get the Andela team working on the new design. If we do it right, there shouldn’t have to back-track on any functionality.
I would defer to @mogoodrich on how this is being built in terms of being able to use these in different contexts.
This round of mockups looks much better to me. Of course, I can still come up with some feedback (it never ends, does it?)…
What are the other possible statuses? If Patient Orders is a list of active orders and they will all have a status of active, then the Status column is unnecessary.
Do you imagine the Lab Order screen will evolve over time to support keyboard-based ordering and/or order forms for more complex ordering (e.g., repeating orders, including indication for test, etc.)? Or would you imagine text-based searching for lab orders and space for a lab test order form to be an additional/separate screen? If you envision the latter and there’s any situation where we might want to offer both options, then consider renaming “Lab Order” to “Quick Lab Order” or something along those lines.
Consider adding an info icon that can be clicked for the panel tooltip (since you can’t rely on hover on tablets).
The icon you’ve chosen for urgent labs (“!” in a triangle) looks like a warning to me. I’d expect to interact with it to discover some problem with the order. Would you be willing to use a red upward triangle instead (i.e., a red ▲)?
How about moving the urgent toggle to the left of the lab name? In the future, there will certainly be a need for an edit icon where you’ve currently placed the urgent icon (similar to meds), since lab orders will eventually support more than just urgency (e.g., frequency for repeating labs, indications, comments to lab, etc.).
It’s not clear to me how the “New” label is being used in the Unsaved Drafts. If the user navigates away from lab orders and then returns, will unsaved drafts still be populated, but the new label removed (i.e., only orders since arriving to the lab orders screen are labeled as “New”)? Or will every entry always have “New” in front of it?
Consider (or be prepared for later adding) checkboxes or radio buttons in front of items in the order sets screen. It’s common to allow providers to pick and choose what to include from an order set. Ultimately, the order set definition would control the default setting (selected or not) for each order as well as when a subset of orders supports multiple selection (checkbox) vs. single selection (radio button). These may not be features in 1.0, but they will come with time. Your current approach seems to present all orders in the order set ready to be ordered and allows the user to remove an item. This works for your examples, but does not allow an order set to suggest orders that will not be ordered by default. For example, “here’s an order for pre-treating with a steroid before chemo begins, but it’s not selected by default b/c it’s only needed 10-20% of the time” or “here are three antiemetic options for the patient with the most commonly used one already selected but you can switch to one of the others if you choose.”
This can be added later fairly easily by changing this:
into a [+] button at the end of a text field like this:
Focus defaults to the text input, where user can search against all orderables, and selecting any orderable would take them to the corresponding form (based on the type of orderable selected). Clicking on the [+] icon on the right would behave just like your “+ Add Order” button does now.
As far as the statuses, eventually I hope we would have statuses that closely reflect where the order is (are meds dispensed? have test results been reported on? Etc…). For now, it seems we will just use the methods currently built-in to orders to derive “statuses” (Active, Expired, Discontinued etc…).(@mogoodrich and @mseaton would know more) But the idea is to show all orders in this list and filter based on statuses. It would be easy to split the list up if we need to.
I like the idea of this first iteration to support “quick” orders and evolve it into something more robust and that maybe conveys more information with each order.
Good suggestion to replace the tooltip with a “?” icon. Same for moving the urgent icons to the orderables panel. This may not make it in the first phase since it’s already working the other way. Strangely there is no triangle icon including in font-awesome free license (except for a caret). Maybe use an up arrow?
The “new” in the draft list is a legacy of the drug ordering UI already built. If a user edited an active order, it would say “modified” and if one was removed it would say “discontinued” or something. I think the idea is that every change to orders (whether new, edited or removed) needs to go to the draft list and then Signed and Saved.
When we get into building order sets, we should re-present and review mockups. Your examples make sense to me and should be designed for.
