Have you ever started a survey only to quit mid-way due to the sheer number of questions you have to answer? Or have you ever clicked the same answer choice just to make it through to the end?
These are some of the concerns that BeaconLBS navigates when presenting evidence-based guidelines through Physician Decision Support (PDS). Combining PDS with a modern design has allowed BeaconLBS to make lab test ordering efficient by reducing extra clicks and non-pertinent clinical questions.
The BeaconLBS experience compared to major EHR and lab ordering systems.
The number of questions that a healthcare provider has to answer is important. While not necessarily related to clinical care, Survey Monkey evaluated the impact of long question surveys by analyzing a sample of 100,000 surveys that varied in length from 1 to 30 questions. The study looked at the median amount of time that respondents took to complete the questions. The study assumed that the average time to answer a question would not vary based on the length of the survey, so a linear relationship would exist. However, it found that the relationship was not linear and the more questions asked resulted in less time spent on answering them. The study stated that one cannot assume that longer surveys contain less thorough answers. But, the Survey Monkey data showed that this was not the case. This study also noted that as surveys grew in length, abandon rates increased.
Similarly, electronic health records (EHRs) have many benefits for care providers; however EHRs are linked to being an administrative burden and the cause of “click fatigue.” Both EHR providers and health care institutions are working to reduce inefficiencies to save time and reduce the number of keyboard-and-mouse interactions. One study determined that the quality of documentation by residents decreased as the number of dialog boxes for information entry increased. The authors attributed this to “click fatigue” and may be associated with safety hazards.
Question abandonment, click fatigue, and cumbersome documentation create systems with poor usability and inefficient data entry. BeaconLBS strives to create a process by which a health care provider can navigate through PDS with the fewest number of questions. Intelligent design can allow users to save most commonly used diagnosis codes and frequently ordered labs and tests. If a provider orders a test within PDS, the system will automatically prepopulate certain fields thereby only leaving those items that need specific clinical criteria. By integrating age, sex, and frequently used diagnosis codes into the smart technology, the correct path can be initiated and the provider can answer on relevant clinical questions. Also, the BeaconLBS format presents questions in an interactive way so that they are dynamically generated due to branch logic.
The BeaconLBS platform, which is deployed at the point of care through participating EHRs, lab ordering systems or the BeaconLBS portal aims to reduce the burden on health care providers. Through user feedback and intelligent design, PDS can be intuitively navigated with only relevant questions and few keyboard-to-mouse interactions.
Chudoba B. How much time are respondents willing to spend on your survey? Survey Monkey. Available at: https://www.surveymonkey.com/curiosity/survey_completion_times/
Collier R. Rethinking EHR interfaces to reduce click fatigue and physician burnout. CMAJ. 2018;190(33):E994-E995.
Rodriguez Torres Y, Huang J, Mihlstin M, et al. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine. PLOS One. Published: September 21, 2017. https://doi.org/10.1371/journal.pone.0185052