A user-oriented computer interface for health professionals

One of the characteristics of medical information systems, which have been most successful in being integrated into the patient care process, is a cordial type of human interface that embodies a form of input/output generator software coupled with a terminal device that facilitates the selection of input data elements from lists or “menus.” This paper reviews the nature of this involvement in patient care and describes this interface in greater detail, illustrating its intrinsic value as an appropriate human-computer interface for use by medical professionals. As with any successful management information system, a medical information system's use will ultimately be a function of the ease with which it can be incorporated into the decision-maker's (manager's) daily activity. Watson has shown that physicians, after a long orientation period, are willing to use a CRT device that presents information in a convenient manner and allows the input of new data by means of selections from tree-structured lists instead of typing. A technique more natural than the use of a light pen is to simply touch a selection with one's finger. For this reason, our hardware terminal device consists of a 15-inch diagonal CRT with 24 80-character lines activated by the touch of a finger, which passes a direct digital signal to the controlling software for appropriate action. The accompanying software described is best characterized as a nonprocedural “higher level language,” or a “meta language”, designed specifically to process frames of CRT information in such a way as to eliminate much of the inevitable programming modification process. Such a capability takes on the characteristics of a “tool” by which the non-computer-oriented professional actually creates application programs that best serve his own needs. The user is able to concentrate on thewhat of using the computer rather than thehow. The software automatically determines thehow. Its use is not limited to just the presentation of the frames but also involves a method of allowing the user to link these with each other, and with parameter tables in a user-logical fashion. In addition, the frames can be readily modified. The selected parameter becomes data that the application program processes. By means of such an optimum combination of software and hardware, the user exerts significant control over that portion of the system that he interfaces with most directly. This approach also offers considerable flexibility in the design of a system so that it can be changed as the user's needs and expectations grow. The need to reflect the user's requirements in input sequence and method of presentation has been shown to be of particular importance in the design of systems that are expected to be used by health professionals. The details of the software supporting such a technique have been described.