Keep no secrets and tell no lies: computer interfaces in clinical care

Physicians are accountable for the decisions they make on behalf of their patients. Likewise, computer interface designers must assume accountability for assumptions, limitations, and other unseen deficiencies that impact on the quantity, validity, integrity, and timeliness of data made accessible through their interfaces. During the development of a Web-based clinical workstation, extensive usability testing showed physicians exhibiting bewildering and conflicting simultaneous demands for both more and less information on their patients. A closer examination of these results highlighted the need for visual “accountability cues” visual indicators which allow physicians to assess the quantity and quality of data made available through the user interface. Interface designers must develop new methods for showing only needed information and must highlight where data integrity compromises have been made -where there are secrets and maybe even lies.