Novel user interface design for medication reconciliation: an evaluation of Twinlist

J Am Med Inform Assoc. 2015 Mar;22(2):340-9. doi: 10.1093/jamia/ocu021. Epub 2015 Feb 8.


Objective: The primary objective was to evaluate time, number of interface actions, and accuracy on medication reconciliation tasks using a novel user interface (Twinlist, which lays out the medications in five columns based on similarity and uses animation to introduce the grouping - compared to a Control interface (where medications are presented side by side in two columns). A secondary objective was to assess participant agreement with statements regarding clarity and utility and to elicit comparisons.

Material and methods: A 1 × 2 within-subjects experimental design was used with interface (Twinlist or Control) as an independent variable; time, number of clicks, scrolls, and errors were used as dependent variables. Participants were practicing medical providers with experience performing medication reconciliation but no experience with Twinlist. They reconciled two cases in each interface (in a counterbalanced order), then provided feedback on the design of the interface.

Results: Twenty medical providers participated in the study for a total of 80 trials. The trials using Twinlist were statistically significantly faster (18%), with fewer clicks (40%) and scrolls (60%). Serious errors were noted 12 and 31 times in Twinlist and Control trials, respectively.

Discussion: Trials using Twinlist were faster and more accurate. Subjectively, participants rated Twinlist more favorably than Control. They valued the novel layout of the drugs, but indicated that the included animation would be valuable for novices, but not necessarily for advanced users. Additional feedback from participants provides guidance for further development and clinical implementations.

Conclusions: Cognitive support of medication reconciliation through interface design can significantly improve performance and safety.

Keywords: human factors; medication reconciliation; user-computer interface.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude to Computers
  • Audiovisual Aids*
  • Data Display
  • Databases as Topic
  • Drug Therapy, Computer-Assisted*
  • Efficiency*
  • Humans
  • Medication Reconciliation / methods*
  • Surveys and Questionnaires
  • User-Computer Interface*