Does user-centred design affect the efficiency, usability and safety of CPOE order sets

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First Review

This is a review of the article by Chan, et al., Does user-centred design affect the efficiency, usability and safety of CPOE order sets? [1].


Despite the potential importance of user centered design on successful Computerized Provider Order Entry (CPOE) implementation, there are limited quantitative data on the role of user centered design in CPOE design and implementation. One barrier to successful implementation is poor usability of CPOE systems. Usability refers to the level of ease with which a user is able to complete tasks. CPOE usability plays a significant role in CPOE acceptance by providers.


The authors conducted a randomized trial at Sunnybrook Health Sciences Centre, an academic hospital in Toronto, Canada, where 27 staff physicians, residents and medical students, completed four simulated order set tasks with three order set formats (two CPOE Test tasks, one User Centered Design, and one Paper). Order of presentation of order set formats and tasks was randomized. Users received individual training for the CPOE Test format only.


27 study participants completed 108 order sets. Mean task times were: User Centered Design, Paper format, and CPOE Test format. Users requested assistance in 31% of the CPOE Test format tasks, whereas no assistance was needed for the other formats. There were no significant differences in number of errors between formats.


The User Centered Design format was more efficient and usable than the CPOE Test format even though training was provided for the latter. The authors concluded that application of user-centered design principles can enhance task efficiency and usability, increasing the likelihood of successful implementation.


The user-centered design of this study was more efficient and more usable for participants and will ultimately result in less medical errors and better patient care, however, a serious limitation of the study is that only one CPOE system was evaluated.

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Second Review

Add next review here.


  1. Julie Chan, Kaveh G Shojania, Anthony C Easty, Edward E Etchells (2011). Journal of the American Medical Informatics Association May 2011, 18 (3) 276-281; DOI: 10.1136/amiajnl-2010-000026