Keeping an Eye Towards the Future of EHR Design

How eye-tracking technologies can help create a more user-friendly EHR system

Eye tracking allows us to “see through our EHR users’ eyes.” We can observe what our clients visually attend to as they interact with EMA™. This is important in understanding user behavior, as often times someone is unaware of what he/she has actually seen. We can analyze eye movement patterns of large groups of people to look for trends in what information they pay attention to, what they did or did not notice and what actions they take based on what they see.

When speaking to one of our on-staff physicians on this topic, he shared, “Here at Modernizing Medicine we continually look to utilize the latest and greatest technology to improve the user experience. As part of this, I had the opportunity to use novel eye tracking hardware and software to validate workflows on the iPad. I expect that the results of the eye-tracking study will allow us to make our software even more user friendly and efficient,” Jonathan Criss, MD and Medical Director of Ophthalmology.

In the industry there’s been in depth research on this topic. One study, “Eye-tracking for clinical decision support: A method to capture automatically what physicians are viewing in the EMR,” discusses eye-tracking research as it relates to EMR systems in great detail.

At Modernizing Medicine, our user experience team utilizes eye-tracking research as part of our user-centered design process to help optimize the screen layout of our applications to be able to guide user’s attention, reduce distractions and increase overall efficiency. EHR systems are often times scrutinized for not designing their systems for the end-user. Instituting practices like eye tracking demonstrates how we work closely with our clients to help improve our products.

Vladimir Polyak, Senior UX Designer, uses our cutting-edge series eye tracker to track the eyes of a client while she interacts with our Practice Management interface.

Eye-tracking technology is also used in other areas of medicine, for example to study radiologic and electrocardiography interpretation, note reading and medication administration[1]. Eye tracking is specifically used by ophthalmologists to better understand eye movements and eye movement problems in order to develop a means to prevent, diagnose and treat abnormalities or ocular disease in clinical situations.

Providing Direction to Benefit EHR Users

Our eye-tracking research shows that predictable layouts help EHR users to complete their tasks more effectively. We can observe the eye movement patterns to ensure that users quickly and easily notice elements that would help them to complete a task. With the help of eye tracking we can evaluate the design of a screen’s visual hierarchy to determine where the users’ eyes go as they attempt to complete a task, such as the steps involved with faxing documentation to another provider. Also, too many fixations on one area may indicate that a user is confused or unsure how to proceed in order to complete their task.

screen shots from eye tracking in an EHR system

An effective visual hierarchy helps users notice the right visual cues at the right time. Beyond the aesthetic, our user experience team uses our knowledge of visual perception to guide the path your eyes follow based on visual elements, gestalt (means ‘unified whole’) principles and visual attributes that control focus.

Optimizing Efficiency for EHR Users

Our user experience team focuses on making the tasks performed while using EMA to be faster and easier to accomplish. Eye tracking helps us to identify opportunities where the user’s eyes tend to travel a distance to find the information that they seek. In the below visualization, this is evident by the long lines called “saccades” that connect each of the dots called “fixations.” We can then modify the designs to visually group the related information that users look for to reduce the distance that the eye needs to travel and to reduce eye fatigue.

eye tracking screenshot from EHR system

Our user experience team regularly obtains feedback from our customers to work to continually improve the usability and efficiency of our applications, and eye-tracking research is only one part of our user-centered design process at Modernizing Medicine.

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[1] Doberne JW, He Z, Mohan V, Gold JA, Marquard J, Chiang MF. Using High-Fidelity Simulation and Eye Tracking to Characterize EHR Workflow Patterns among Hospital Physicians. AMIA Annual Symposium Proceedings. 2015;2015:1881-1889.

Andrew Schall
Andrew Schall

Director of User Experience

As a user experience leader, he has a passion for combining research and design. Andrew has over 15 years of experience as a UX researcher and designer working with companies such as Facebook, Citibank and Southwest Airlines. He is a frequent speaker at international events on user-centered design. Andrew is co-author of the book "Eye Tracking in UX Design."

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