Leveraging the PIIM Process to Advance Health IT · Leveraging the PIIM Process to Advance Health IT (W81XWH-09-1-0456): Web Services and Infrastructure Volume Version 2 Document

Web Services and Infrastructure Volume: Version 2 Page 1 of 72

Leveraging the PIIM Process to Advance Health IT

Web Services and Infrastructure Volume: Version 2

December 10, 2009


Leveraging the PIIM Process to Advance Health IT (W81XWH-09-1-0456): Web Services and Infrastructure Volume Version 2

Table of Contents

1. INTRODUCTION .................................................................................................................... 4 2. APPROACH TO THIS QUARTERLY DELIVERABLE ................................................................. 4 3. TECHNICAL ANALYSIS OF EXISTING TECHNOLOGY ............................................................ 4 4. PIIM VISUALIZATION TOOLKIT (PVT) ................................................................................. 4

4.1 Introduction to PVT ........................................................................................................... 4 4.2 PVT Use in the PIIM AHLTA GUI Prototype .......................................................................... 6 4.3 Overview of Frameworks Integrated In PVT ......................................................................... 6 4.4 PVT Namespaces and Loading Examples .............................................................................. 8

5. HESSIAN BINARY WEB SERVICE (HBWS) ............................................................................ 9

5.1 Introduction to HBWS ........................................................................................................ 9 5.2 HBWS Java Example ........................................................................................................ 10

6. SUBVERSION AND ENGINEERING REPOSITORY SYSTEM ................................................. 11 7. PIIM GUI DEMONSTRATION PORTAL ................................................................................ 11 8. IDENTIFICATION OF NECESSARY WEB SERVICES ............................................................ 11

8.1 Overview ........................................................................................................................ 11 8.2 PAWS API to Usability Study Matrix ................................................................................... 12 8.3 PAWS and PVT APIs to Visualization Models ....................................................................... 49

9. REQUIRED TECHNICAL DOCUMENTATION – MEETING DODAF ........................................ 63 10. DODAF DOCUMENTATION .................................................................................................. 64

10.1 All View .......................................................................................................................... 64 10.1.1 AV-1: Overview and Summary Information ........................................................................ 64 10.1.2 AV-2: Integrated Dictionary .............................................................................................. 65 10.2 Operational ..................................................................................................................... 67 10.2.1 OV-1: High Level Operational Concept Graphic ................................................................... 67 10.2.2 OV-2: Operational Node Connectivity Description ............................................................... 67 10.3 Systems and Services....................................................................................................... 69 10.3.1 SV-1: Systems/Services Interface Description ..................................................................... 69 10.3.2 SV-3: Systems-Systems, Services-Systems, Services-Services Matrices ................................. 69 10.3.3 SV-4a (Class)/SV-4b (Activity): Systems/Services Functionality Description ........................... 70 10.3.4 SV-8: Systems/Services Evolution Description .................................................................... 70 10.3.5 SV-11: Physical Schema ................................................................................................... 70



Document Version History

Version Date Approved By Sections Affected Remarks

1.0 September 11, 2009 B. Willison All None

2.0 December 10, 2009 B. Willison 1-2, 4-7, 8-10 Updated from version 1.0 for second quarter

delivery



1. INTRODUCTION The Parsons Institute for Information Mapping (PIIM) is currently working on Graphic User Interface (GUI) redesign efforts for the Armed Forces Health Longitudinal Technology Application (AHLTA). This effort is split into three distinct yet collaborative categories:

1) GUI / Visualization: analyzing areas of improvement and designing enhanced GUI elements for the AHLTA system (version 3.3 is being assessed);

2) Usability: analyzing existing usability studies of AHLTA v3.3 and assessing PIIM designed GUI enhancements throughout the project

3) Engineering: developing prototype technologies that will drive the GUI redesign elements. This report is the second of four quarterly deliverables PIIM will provide to the Telemedicine & Advanced Technology Research Center (TATRC) towards the Web Services and Technology Development portion of this project. This report accompanies the “Detailed GUI Design Volume” also developed by PIIM for this project. As a second iteration/version, this document contains new sections and utilizes the previous deliverable’s content as a basis. 2. APPROACH TO THIS QUARTERLY DELIVERABLE PIIM approached developing this quarterly deliverable with a focus on developing a technical strategy for the GUI framework technology and accomplishing initial tasks to lay a foundation to build upon towards that strategy. In addition to this long-range planning, the PIIM Technical team began to test this strategy through the development and deployment of a first iteration, semi-functional prototype utilizing the visualization models delivered in the first quarter’s work. The PIIM Technical team built upon the work and technology assessments conducted in the previous quarter’s efforts. Details on this quarter’s efforts are contained in the sections that follow this section. 3. TECHNICAL ANALYSIS OF EXISTING TECHNOLOGY The PIIM Engineering Team conducted an initial technical review of the AHLTA v3.3 workstation/client software suite based upon the AHLTA v3.3 training system provided by TATRC. This initial review assessed the major, visible, and user-accessible components of the AHLTA v3.3 system. This review accompanied additional discussions and conference calls from members of TATRC with experience in the technical components of AHLTA. This review enabled PIIM to develop an initial understanding of the complexities and technical environment in which AHLTA v3.3 was developed and deployed. This understanding supported PIIM’s assumed assessment of LOE for technical and GUI design modifications presented in the “Detailed GUI Design Volume” delivered alongside this technical report and was a key determining factor of which GUI assets/elements would be addressed in this first set of deliverables. 4. PIIM VISUALIZATION TOOLKIT (PVT) 4.1 Introduction to PVT The PVT is a collection of tools, technology, source code, programs and a custom Application Programming Interface (API) that enables the utilization, creation, rapid development and information analysis for Knowledge Visualization tools built by PIIM. The methodology behind the PVT leverages the precedence’s from Service-Orientated Architecture (SOA), Rich Internet Applications (RIA) and Web 2.0 principles. The PVT is divided into 6 categories: Mapping, Portlet, Server Side/Protocol, UI/Widget



Framework, Visualization and IDE. These areas provide a well-rounded foundation for rapid prototyping and development following open standards. A detailed matrix of these areas follows: Package Category Language

OpenLayers Mapping JavaScript

Google Maps API Mapping JavaScript

OpenGIS Standards Mapping Multiple/Standards

ESRI - Arc Web Mapping Multiple/Standards

Java Portlets Portlet Java

Hessian Binary Web Service Server Side/Protocol Multiple/Standards

Apache Pluto Server Side/Protocol Java/Server

AJILE UI/Widget Framework JavaScript

Blueprint CSS UI/Widget Framework CSS

prototype.js UI/Widget Framework JavaScript

netscape.javascript UI/Widget Framework JaveScript

UIZE UI/Widget Framework JavaScript

vegUI UI/Widget Framework JavaScript

RICO UI/Widget Framework JavaScript

Flare Visualization Flex/ActionScript

Processing Visualization Java

SMILE - Timeline Visualization JavaScript

SMILE - TimePlot Visualization JavaScript

SMILE - Exhibit Visualization JavaScript

SMILE - AJAX Library Visualization JavaScript

Lib GD Visualization Multiple

Eclipse/Flex Builder IDE

The PVT is a living set of tools that will evolve over time based on technological advances and needs. It is currently under development with the focus on fast, efficient, portable and expandable UI and Widget functionality for Web 2.0 using AJAX. The concept of the PVT Framework is to combine the best of tools and technologies that enhance the rapid development of applications and visualizations. The PVT allows for several important key rapid prototype and development advantages.

1. Taking advantage of tools without the need to reinvent or recode well established code bases. 2. The PVT promotes and exploits the use of function chaining which allows the development of

applications with less custom code, more functionality and leverage the wealth of open source frameworks.

3. Frameworks are built to be fast and efficient. PVT utilizes these features by using the best methods and functions from the included frameworks when needed for a specific application.

4. PVT along with its included frameworks humanize the code so it is human-readable and not cryptic or hard to understand making development more efficient.

5. Unified API and universal web browser compatible.



4.2 PVT Use in the PIIM AHLTA GUI Prototype PVT is chosen as the GUI framework technology that will be implemented into the PIIM AHLTA GUI prototype being developed for this project. As an aggregator of cutting-edge and open-source GUI and visualization packages, PVT will enable the PIIM Engineering and GUI/Visualization teams the best opportunities to rapidly deploy the redesign AHLTA GUI in the web-based environment being prototyped in this project. With integration into the Hessian Binary Web Service (HBWS, detailed later in this document), the PIIM AHLTA GUI will provide a JavaScript- and Ajax-based data transfer mechanism that is tightly integrated to GUI assets and user experience/workflow aspects of the AHLTA GUI. 4.3 Overview of Frameworks Integrated In PVT The PVT is an integration framework composed of a collection of technologies and services that enable the utilization, creation and rapid development of Web 2.0 applications utilizing the latest AJAX and web based technologies. The TATRC GUI redesign project primarily utilizes UI and widget JavaScript frameworks UIZE, Prototype, RICO, and VegUI. AJILE (Advanced JavaScript Importing & Loading Extension), is used to simplify and enhances the PVT by supporting efficient, interoperable, and unobtrusive usage of the frameworks included in the PVT, so that you only load what you are using, not the entire library. AJILE allows for protecting proprietary source code through runtime source-code cloaking. AJILE AJILE, the Advanced JavaScript Importing and Loading Extension allows support for load, import, include and namespace to a wide variety of JavaScript-enabled browsers. AJILE simplifies and enhances web development by supporting efficient, interoperable, and unobtrusive JavaScript. AJILE protects intellectual property via configurable runtime source-code cloaking. AJILE can be used to make web sites and applications fast and responsive via highly interoperable scripts capable of loading and importing functionality as needed. AJILE features: Asynchronous script loading from any location, unobtrusive scripting via MVC-styled page/script separation, configurable auto-loading of site and per-page scripts, namespace support to encapsulate and uniquely identify functionality, namespace and module including for full-name access, namespace and module importing for short-name access, namespace and module importing with aliases, namespace and module importing with versioning, automatic path resolution for namespaced modules, dependency definition with runtime enforcement, import notification via event listening, flexible packaging via namespaced files and/or structured directories, load-time and runtime cache management, load-time and runtime name collision management, load-time and runtime source code cloaking, and target environment. AJILE is standard compliant and currently works in the latest versions of Mozilla Firefox, Mozilla based browsers, Internet Explorer, Opera and Safari. vegUI vegUI is a JavaScript AJAX framework and widget-collection that allows you to build dynamic web applications that are also fast and flexible. The concept of vegUI was originally developed to serve as a foundation for the online browser-based mmorpg Lands of Kazram. So it was developed with 4 core features in mind: speed, compact design, total control over appearance, flexibility and modular design.



vegUI's speed is due to the fact that vegUI uses a template system, that allows you to define any vegUI element/widget as a template. Templates can then be used to clone as many duplicates as you want. This saves time and space while writing the code and also speeds up the loading process of the scripts. vegUI is also able to load and build modules at "runtime", so instead of loading in everything at once - which would result in some longer waiting times on big applications - vegUI can load and build modules as they are needed even after the page has already been loaded. vegUI’s compact design, compared to most of the other window managers and widget collections vegUI is fairly small. The package comes with a commented and a compressed library. And while the commented library nearly reaches 200 KB the compressed libraries - with comments removed - is only 75 KB big. VegUI’s control over appearance is due to its modular design and the template engine you have total control over the way your widgets look. In the end vegUI is made up of a lot of HTML nodes, and you can style those html nodes in whichever ways JavaScript and CSS provide. vegUI was built to be modular from the beginning, and it has really paid off. It is simple to add new widgets or elements to vegUI. vegUI is standard compliant and currently works in the latest versions of Mozilla Firefox, Mozilla based browsers, Internet Explorer, Opera and Safari. UIZE UIZE is a powerful, open source, object oriented JavaScript framework - supporting widgets, AJAX, DOM, templates, and more. The UIZE JavaScript Framework is an open source, object-oriented JavaScript framework designed to facilitate development of JavaScript based applications for a range of computing platforms and a range of host environments, including Rich Internet Applications built on Web standards supported by contemporary web browsers, build script applications written for Microsoft's Windows Script Host technology, and applications for other host environments that support the ECMA-262 standard upon which JavaScript is based, such as Adobe Photoshop with its ExtendScript system. UIZE does not extend native objects, and supports interoperability with other libraries that adhere to this principle. UIZE implements systems for JavaScript Inheritance, JavaScript Events, JavaScript Modules, JavaScript Libraries, JavaScript Templates, JavaScript Widgets, JavaScript Localization, JavaScript Documentation, JavaScript Code Compression, JavaScript Build Scripts, and many more powerful capabilities. The UIZE JavaScript Framework comes packed with a good number of ready-to-go widgets. Built-in widgets include: the slider, progress bar, color picker, date picker, draggable and resizable window, marquee / resizer, image wipe with advanced fades / transitions, tabs, table sorter, thumbnail zoom, tree list, tree menu / drop down menu, egg timer, button, collection, collection item, image port, options selection, stretchy, and more. The widgets are being added to all the time. The Framework has been designed making full use of the object orientation features of the JavaScript language. The APIs of the various modules have been carefully thought out so that they are comprehensive, sensible and consistent. The UIZE JavaScript Framework is developed as a purely client framework and is, therefore, server language and server platform agnostic. UIZE is standard compliant and currently works in the latest versions of Mozilla Firefox, Mozilla based browsers, Internet Explorer, Opera and Safari.



Prototype Prototype is a JavaScript Framework that eases development of dynamic web applications. Featuring a unique, easy-to-use toolkit for class-driven development and the nicest Ajax library around, Prototype is quickly becoming the codebase of choice for web application developers everywhere. The Prototype framework enables you to deal with Ajax calls in a very easy way that is also safe (cross-browser). Besides simple requests, this module also deals in a smart way with JavaScript code returned from a server and provides helper classes for polling. The biggest part of the Prototype framework is its DOM extensions. Prototype adds many convenience methods to elements returned by the $() function: for instance, you can write $('comments').addClassName('active').show() to get the element with the ID 'comments', add a class name to it and show it (if it was previously hidden). The 'comments' element didn't have those methods in native JavaScript; how is this possible? This document reveals some clever hacks found in Prototype. Prototype utilizes JSON (JavaScript Object Notation) a lightweight data-interchange format (if you are new to JSON, you can read more about it on the JSON website). It is notably used by APIs all over the web and is a fast alternative to XML in Ajax requests. Prototype 1.5.1 features JSON encoding and parsing support. Prototype is standard compliant and currently works in the latest versions of Mozilla Firefox, Mozilla based browsers, Internet Explorer, Opera and Safari. RICO Rico 2.0 extends the component set from the previous versions. The LiveGrid has been expanded to include filtering, column resizing, and many more features. The core of Rico 2.0 has been designed to enable custom components to be more easily built. Rico 2.0 provides responsive animation for smooth effects and transitions that that can communicate change in richer ways than traditional web applications have explored before. Unlike most effects, Rico 2.0 animation can be interrupted, paused, resumed, or have other effects applied to it to enable responsive interaction that the user does not have to wait on. Rico provides one of the simplest interfaces for enabling your web application to support drag and drop. Just register any HTML element or JavaScript object as a draggable and any other HTML element or JavaScript object as a drop zone and Rico handles the rest. Rico you can easily build an Accordion component like those found in Macromedia Flex and Laszlo. Rico provides several cinematic effects as well as some simple visual style effects in a very simple interface. Rico provides a very simple interface for registering Ajax request handlers as well as HTML elements or JavaScript objects as Ajax response objects. Multiple elements and/or objects may be updated as the result of one Ajax request. Rico is standard compliant and currently works in the latest versions of Mozilla Firefox, Mozilla based browsers, Internet Explorer, Opera and Safari. 4.4 PVT Namespaces and Loading Examples Embedding PVT into HTML:



<head> <script type="text/javascript" src="pvt_index.js" /> </head>

Creating a PVT Namespace with AJILE in pvt_index.js: Namespace ("pvt.newschool.piim"); Loading PVT framework libraries into the pvt.newschool.piim namespace: Load("PVT/PIIM_tools/js/lib/Uize.js"); Load("PVT/PIIM_tools/js/lib/prototype.js"); Load("PVT/PIIM_tools/js/lib/vegUI.js"); Load("PVT/PIIM_tools/js/lib/RICO.js");

Creating a UI Environment using a vegUI object in the PVT namespace: var Environment = new PVTUIManager(‘Environment'); Environment.set(1024, 768, 0, 0); Environment.T.w = 1024; Environment.T.h = 768; Environment.T.x = 0; Environment.T.y = 0; Environment.T.Css.backgroundColor = '#000000; Environment.build(document.body);

The Environment keeps track of all elements spawned and handles certain mouse and keyboard events for the elements. 5. HESSIAN BINARY WEB SERVICE (HBWS) 5.1 Introduction to HBWS The HBWS protocol makes web services usable without requiring a large framework, and without learning yet another alphabet soup of protocols. Because it is a binary protocol, it is well-suited to sending binary data without any need to extend the protocol with attachments. HBWS is a simple binary protocol for connecting web services. The com.caucho.hessian.client and com.caucho.hessian.server packages do not require any other Resin classes, so can be used in smaller clients, like applets. The HBWS can provide a messaging service layered on top of its RPC call. The messaging service itself is based on the standard Hessian RPC call, so HBWS itself has no need to become more complicated. HBWS is a dynamically-typed, binary serialization and Web Services protocol designed for object-oriented transmission, and portable across languages. The HBWS protocol has the following design goals:



It must self-describe the serialized types, i.e. not require external schema or interface definitions. It must be language-independent, including supporting scripting languages.

It must be readable or writable in a single pass.

It must be as compact as possible.

It must be simple so it can be effectively tested and implemented.

It must be as fast as possible.

It must support Unicode strings.

It must support 8-bit binary data without escaping or using attachments.

It must support encryption, compression, signature, and transaction context envelopes. The integration of HBWS in the PVT framework allows for easy control and transfer of different types data between different programming languages and acts as a middleware to enable integration of web services, systems and applications. This is especially useful when client applications that are coded in different languages need to connect to the same web service or passes through a similar middleware layer to an external web service using HBWS as a proxy. HBWS solves the problem by constructing a middleware for the types of applications that typically cannot communicate with one another in order to share data by allowing the applications to use a consistent API and HBWS as an integration module. 5.2 HBWS Java Example Creating a HBWS service using Java has four steps:

1. Create a Java interface as the public API

2. Create a client using HessianProxyFactory

3. Create the Service implementation class

4. Configure the service in your servlet engine. The Service API public interface basicData { public String sendData() }

Service Implementation public class BasicService extends HessianServlet implements basicDataI { private String _data = "123456789"; public void setData(String data) { _data = data; }



public String sendData() { return _data; } }

Client Implementation String url = "http://127.0.0.1/test_data"; HessianProxyFactory factory = new HessianProxyFactory(); basicData basic = (basicData) factory.create(basicData.class, url); System.out.println("sendData(): " + basic.sendData());

6. SUBVERSION AND ENGINEERING REPOSITORY SYSTEM PIIM has established a Trac, web-based project management and bug-tracking tool and the Subversion (SVN) version control system to for the TATRC GUI redesign project and the PVT. Access to the web-based source code repository and bug-tracking tool can be found at: http://clients.piim.newschool.edu/trac Login to Trac and SVN is password protected. The username is TATRC and the password is AHLTA. To access only the SVN repository use one of the SVN clients available through http://subversion.tigris.org. TATRC SVN repository: http://clients.piim.newschool.edu/repos/piim/TATRC PVT SVN repository: http://clients.piim.newschool.edu/repos/piim/PVT For help accessing the Trac or the SVN repositories, e-mail: [email protected]. 7. PIIM GUI DEMONSTRATION PORTAL Access to the TATRC GUI and technology demo is password protected. The username is TATRC and the password is AHLTA. To access the TATRC GUI and technology demo navigate your browser to: http://clients.piim.newschool.edu/TATRC For help accessing the Trac or the SVN repositories, e-mail: [email protected]. 8. IDENTIFICATION OF NECESSARY WEB SERVICES 8.1 Overview



Working alongside PIIM’s GUI / Visualization Team, PIIM engineers developed two matrices as a foundation for its future development work. These matrices included:

1) A first iteration matrix which maps usability concerns defined in the AHLTA v3.3 Usability Study to PAWS API entities; and

2) A first iteration matrix which maps PAWS API entities (e.g. services, classes, methods, etc.) to PIIM designed GUI modifications to the AHLTA v3.3 system.

These matrices – following PIIM processes utilizing its Visualization Driven Rapid Prototyping method –are living documents that ultimately provide traceability between GUI elements and technical components. As such, these matrices allow leadership, stakeholders, designers, usability professionals, engineers, and integrators the ability to clearly trace GUI elements to the technical services and components that deliver those GUI elements. When connected and viewed alongside the visualization models contained in the current (and future) Detailed GUI Design Volumes, this matrix enables a central “picture” of both Information Technology (IT) and GUI and design assets. Ultimately, these matrices will be utilized within and incorporated into the pixel-level, detailed GUI Design Volumes to clearly map each AHLTA GUI elements (in visual documentation form) to its corresponding technology service. 8.2 PAWS API to Usability Study Matrix The matrix below documents relationships between usability concerns highlighted in Dr. Zhang’s AHLTA Usability Study and the PAWS API references. This matrix was developed to initialize a traceability between usability concerns and the available technologies which will be utilized (in the AHLTA redesign) to resolve those usability concerns. Additionally, when the “ID #” field is mapped between this matrix and the Matrix of Usability and GUI Concerns, a full traceability between usability concerns (e.g. the “cause”), GUI redesign elements (e.g. the “implementation”), and technical components (e.g. the “deployment”) is documented.



ID # LOCATION OF OCCURANCE USABILITY PROBLEM PAWS API Reference ENGINEERING DIFFICULTY

(P: problem; S: solution)

Problems found by PIIM Problems found by Dr. Zhang's team

1 = less difficult;5 = more difficult)

1 Main screen (entire GUI) DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

1.0.1 Main screen (entire GUI) P: Lack of effective workflow from all patients to specific patients, and thence down to specific encounters and patient details. S: Interface should permit full utility of space when working under specific clients.

3

1.0.2 Main screen (entire GUI) P: All text functions as black on illuminated base of varying value; close values make for poor readability for sight challenged; opportunity exists for reverse luminance. S: Workflow advantage may be gained by utilizing light on dark ground for heads (and other text) or for single main purpose, such as selected patient record.

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.PatientService 2

1.0.3 Main screen (entire GUI) P: Letters appearing on the top main menus, tabs, titles for object, and text for various health record are handled with the same or similar type treatment. S: Typeface, size, weight, or italicization should be applied to create visual distinctions for classified contents.

2

1.0.4 Main screen (entire GUI) P: There is no visual distinction which helps clarify AHLTA's production flow. The current AHLTA GUI uses the same color for the fields where users view records and for the fields where they enter records. S: A simple workflow improvement would be to apply a unique color to fill in the field: where users can only view the record without modification; where users are required to enter records; and, where users have an option to enter records.

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.PatientService

3

1.0.5 Main screen (entire GUI) P: Icons are composed of random and low contrast color sets, richness of selection creates overall bland, non-distinctive color-balanced iconography, this also applies to overall GUI. S: Rethink color of icons, limit palette of color, create consistency and color distinction, create color set for overall interface and limit random (default) colorization, unless under user preferences.

2







1.0.6 Main screen (entire GUI) P: Color serves only on two levels; default and highlighted. S: Create multiple levels (at least three) to provide intuitive advantages to workflow, such as critical, needs attention, and general specification and information.

2

1.0.7 Main screen (entire GUI) P: Text and labels require entry panels to be randomly placed, I.e., forced placement by length of text. S: Use worst-case planning to equalize tab lengths and better place entry labels.

3

1.0.8 Main screen (entire GUI) P: Inappropriate arrangement of space, and poor logic of pull down window options. S: Re-order Fill-in and Drop-down entry panels with improved logic and spatial considerations.

2

1.0.9 Main screen (entire GUI) P: No functional, organizational, or aesthetic advantage is realized when user selects between Minimize and Maximize window. S: Create benefit to utilize maximize window option by allowing additional entry options to become available (reorganize and distinguish between these views).

3

1.0.10 Main screen (entire GUI) P: When users click on certain descriptors (such as "provider search") inconsistently titled windows are launched, (such as "clinician search"). P: Use consistent language between requested window and titled window.

DoD.TATRC.PAWS.Services.ProviderService

3

1.0.11 Main screen (entire GUI) P: There are FIVE possible control entry points (1 conditional and 4 optionally set) to view the same data list. S: Rethink the logic of such redundancy, for example: warnings can simply be highlighted control icons, etc. Reduce number of options so space of overall GUI may be better utilized.

3

1.0.12 Main screen (entire GUI) P: Reports and Tools sections can be moved and logically featured outside of the folders list. S: Reports and Tools sections can be given "premium branding" within site by utilizing wasted space of redundant control functions.

DoD.TATRC.PAWS.Services.DocumentService

3

1.0.13 Main screen (entire GUI) P: Type choice for detailed (specific) entries within the forms creates very poor spacing, and resultantly poor readability . S: Test multiple resident and systems fonts to determine font with best possible spacing parameters.

2







1.0.14 Main screen (entire GUI) P: Inconsistency and lost opportunity to match selected patients (and other topical matches) between called out areas such as headers) and files and sub information). S: Match colors between selected patients and files and sub information.

DoD.TATRC.PAWS.Services.PatientService

2

1.1.1 Patient Information Bar (green bar below the menu bar)

P: The selected patient's name in all cap should have increased letter space for better readability. The type treatment for displaying patient's profile makes the section look disorganized. S: Apply better typography to this section.


2

1.1.2 Patient Information Bar (green bar below the menu bar)

P: When the selected patient has allergies, an icon appears on the left edge. This is not obvious enough to alert users. Also, it is difficult to recognize the graphic. S: Remove the nose image which hardly represents allergies. Find a new way to alert the user when a selected patient has allergies.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.AllergiesService

2

2 Top Menu Bar DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

2.0.1 Top Menu Bar (overall) P: Icons are not appealing visually; they seem old-fashioned (early Windows icons), and pixilated. Icons for "New Results," "Consult Log," "Demographics" and "Health History" are hard to recall because the images do not represent the items logically. S: Redesign the icon set entirely.

DoD.TATRC.PAWS.Services.HistoryServiceDoD.TATRC.PAWS.Services.PatientService DoD.TATRC.PAWS.Services.DocumentService 2

2.0.2 Top Menu Bar (overall) P: "Remove" and "Close" buttons are too similar. Images for "History" and "SF513" are not communicating well. S: Redesign the icon set entirely. Also review whether keeping all four buttons is necessary.

DoD.TATRC.PAWS.Services.HistoryServiceDoD.TATRC.PAWS.Services.PatientService 2

2.0.3 Top Menu Bar (overall) P: The arrangement of icons on the second bar changes based on the selected menu. However it is difficult to tell which icons belong to "Desktop" or "Patient." S: Icons can be separated by lines or different background colors.

2

2.0.4 Top Menu Bar (overall) P: The "Allergy" icon is placed too far right. S: Relocate the "Allergy" icon to the left of the "Patient's Name" tab.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.AllergiesService 2







2.1 Bar on the left column (3rd row) P: This menu set is secondary; it belongs to the menu selected under "Folder List," and it changes icons according to the selected menus. It is confusing because the menu set is located next to the primary menus. S: Consider fining better location for the icon set.

2

2.2 View Option menu (3rd row on the left)

P: Without having the cursor pulled down this menu, it is extremely difficult to know how this menu functions. S: Label the menu.

2

2.3 New Task P: In "encounter" list, the items are not sorted by time.S: sort the tasks in an appropriate way.

DoD.TATRC.PAWS.Services.EncounterServiceDoD.TATRC.PAWS.Services.PatientService 3

2.4 DD2766 P: Always print the Flowsheet of a certain patient, not the current display S: print the content which is displayed as user click this button.

DoD.TATRC.PAWS.Services.HistoryServiceDoD.TATRC.PAWS.Services.PatientService 3

2.5 Lock P: There should be a window to customize the "lock" function. E.g. how many minutes should the system get automatically locked when there's no move to the system. S: add this function to automatically lock the system if no operation in a certain time.

3

2.6 Spell check P: When is it activated? 3

3 Folder List DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.0.1 Folder List (overall) P: Some of the titles of menu items including the main menus do not present objects/functions clearly. For example, it difficult to understand what the "Desktop" menu does until users select the menu. S: Rename some of the unclear menu items such as "Desktop," and "Tasking."

2

3.0.2 Folder List (overall) P: The tree map of directories and sub-directories is ineffective. When every directories are opened, the list displays too many items at once. It also requires a scroll bar to access the list. S: Simplify the main directories with tabs. The tabs can be a set of "Desktop (should be renamed)," "Tools," "Selected Patient (or "Patient)."


4







3.0.3 Folder List (overall) P: Too many icons are used. Some icons are repeated twice (e.g. apple image), and some are unclear. S: Remove all icons. Keep icons for only top menus.

2

3.0.4 Folder List (overall) P: A pushpin image is used to automatically hide "Folder List" window. A pushpin image and "auto hide" are unrelated. S: Redesign the icon (both active and inactive) for "Auto Hide."

2

3.0.5 Folder List (overall) P: When a user clicks a "pushpin" icon, the window collapses and a tab appears on the left. S: Omit side tag and avoid redundancy.

4

3.0.6 Folder List (overall) P: Folder List's title bar is orange, and Reminder is blue. S: Keep the menu bars in one consistent color. 2

3.0.7 Folder List (overall) P: The type treatment of applying bold type for menus with active items, and bold type in red for menus with many active items is not elegant. S: Create emphasis with subtlety.

2

3.0.8 Folder List (overall) P: Window close button is placed too far right. S: Include the close button on the same tab. 2

3.0.9 Folder List (overall) P: Once a patient is chosen, the "Patient" folder appears under "Folder List". The list becomes longer and a user has to scroll down or expand the window to select menu from the "Patient" menu set. S: Rename "Folder List" to "Management", and create a separate window for "Patient". Also tabs can be colored differently.


3

3.0.10 Folder List (overall) P: Nothing happens when a mouse hovers over different windows. S: Change the color of the tab of a window. 3

3.1 Notifications DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.1.1 Notifications P: Cannot sort only by patient name. S: put patient name on a separate column so that it could be more readable and sortable.

DoD.TATRC.PAWS.Services.PatientService3







3.1.2 Notifications P: What is the meaning of the number here? Could not find in Help. S: either use words or color or make full length explanation available when mouse cursor points on the number.

3

3.1.3 Notifications P: Almost the same content as the main page of notifications. S: reduce redundancy.

2

3.1.4 Notifications P: Same as double click. After this, the message will be gone from the notification lists and could not find a place to undo. S: give a warn message saying this notification will be removed from the list and give an option to undo this action. Also let the user know whether this address action has been recorded or not.

3

3.1.5 Notifications P: No warn message and no way to undo. S: give a warn message before it is deleted and an option to undo.

3

3.1.6 Notifications P: When no message on the list, folder list on the left hand still shows "Notifications(2)." S: make it match the content.

3

3.1.7 Notifications P: Could not figure out how to add a notification. It seems notification can only be added automatically by the system. S: give users the flexibility to add a notification manually.

3

3.2 Appointments DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.2.1 Appointments P: "My Appointments in This Clinic for Today Plus All Incomplete Back 1 days" Not concise. S: use phrases for key information instead of a long sentence.

DoD.TATRC.PAWS.Services.EncounterService

2

3.2.2 Appointments: FMP/SSN, home phone, work phone, FM/Col/LCDR/Ret/VADM/CAPTLT

P: Not sure how relevant to doctor's work. S: minimize infrequently needed information in the main window to enhance efficiency. 2







3.2.3 Appointments: date of birth (on the green bar)

P: Same usage as age, less direct info than age for a doctor. S: minimize infrequently needed info.

DoD.TATRC.PAWS.Services.EncounterService2

3.2.4 Appointments: encounter status P: Automatically change to "checkedIn" after the appt is opened. Then automatically change to "waiting" when the "screen" and "vitals" are opened. Then "Inprogress" when "O/P" is opened. S: let user choose whether to change encounter status or not. Also make the terms of encounter status match the real workflow.


4

3.2.5 Appointments: check-in time, classification

P: Not sure how relevant to doctor's work. S: minimize infrequently needed info.


3.2.6 Appointments: encounter P: What does it mean? Could not find in Help. S: give full explanation when mouse cursor points there.


3.2.7 Appointments: check-out time P: Not sure how relevant to doctor's work. S: minimize infrequently needed info.


3.2.8 Appointments: set/restore column order defaults

P: Why put this in irrelevant "Change Selections"? S: move this action to the right click menu of the column. 3

3.2.9 Appointments: right click appt record

P: Right click menu shows up wherever you right click on that window, but only means actions about the record which was previously selected (highlighted). S: highlight the record when right click it so that the right click menu can always be about the record where users right click.


3

3.2.10 Appointments: view comments P: Not just view, also can edit, delete, when delete there is no warn against loss and no way to recover the loss, no patient and appt relevant info on the comment window. S: name it as “comments” and give warn message when irreversible change is made and an option to undo. Add patient and appointment relevant info available on this window so that users do not have to check from other places to make sure the comments are added on the right patient’s record.

DoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.DocumentService

3

3.2.11 Appointments: undo cancel P: When I try to undo cancel on my cancelled appt, it shows "You cannot restore cancelled appt in the past". S: make a functioning undo button.








3.2.12 Appointments: open appt P: Actually opens "Current Encounter". S: consistent naming.


3.2.13 Appointments: options P: actually is "change selection criteria", same as the other button. S: reduce redundancy or use consistent names.


3.2.14 Appointments: sign encounter P: What is the function? Does not tell me what I am signing on and the regulatory meaning of this signature. Especially in the appointment list, what needs to be signed on? S: match the signature regulation in the real workflow and give clear explanation when mouse cursor points this button.


3

3.2.15 Appointments: action bar on the top

P: No notes are implied to tell users which information must be provided until submission. This may bother users again and again until all required blanks are filled. S: Put a star mark before each blank implying this is required.

3

3.3 Telephone Consults DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.3.1 Telephone Consults: provider P: Is this provider the person who sent out the request for telcon appts or the one who is supposed to receive the request and then finish the telcon appts? S: clarify the direction in a referral or consult process among providers to match the real situation.


2

3.3.2 Telephone Consults: home phone, work phone, FMP/SSN, FM/Col/LCDR/Ret/VADM/CAPTLT



2

3.3.3 Telephone Consults: date of birth

P: Same usage as age, less direct info than age for a doctor. S: minimize infrequently needed info.


3.3.4 Telephone Consults: status P: Automatically change to "Inprogress" once you double click the record. S: give users the flexibility to change the status.








3.3.5 Telephone Consults: encounter P: What does it mean? Could not find in Help. S: give full explanation when mouse cursor points there.


3.3.6 Telephone Consults: set/restore column order defaults

P: Why put this in irrelevant "Change Selections"? S: move this action to the right click menu of the column.


3.3.7 Telephone Consults: view notes, notes

P: Not just view, also can edit, delete, when delete there is no warn against loss and no way to recover the loss, no patient and telephone consult relevant info on the comment window. S: name it consistently and give warn message when irreversible change is made and an option to undo. Add patient and telcon relevant info available on this window so that users do not have to check from other places to make sure the notes are added on the right patient’s record.


2

3.3.8 Telephone Consults: Telcon Entry — note

P: Open telcon appt leads to this one. After save, note box return empty. Not sure how to undo and edit the notes just saved. The note just saved is actually in the SO Note (not in the note button which is in fact the comments column) in the bottom half window on the telcon list page. S: consistent naming. If the “note” in different places means different thing, use different names. If what is added through the “note” button on the action bar is actually saved into the “comments” column in the telcon list, change the button name to “comments”. Give the users an option to edit or undo the SO Note.


2

3.3.9 Telephone Consults: cancel telcon, cancel

P: Could not figure out how to undo this cancellation. S: add a functioning undo feature.


3.3.10 Telephone Consults: change phone number, edit phone#

P: It says to change CallBack Phone number. Whose side is the callback side? It seems we are sending out requests for telcon appts instead of receiving requests of telcon appts from others. But it is not self-evident. S: clarify the direction in a referral or consult among providers to match the real situation.


2

3.3.11 Telephone Consults: options P: actually is "change selection criteria", same as the other button. S: reduce redundancy and use consistent naming.








3.3.12 Telephone Consults: right click telcon record

P: Right click menu shows up wherever you right click on that window, but only means actions about the record which was previously selected (highlighted). S: highlight the record when right click it so that the right click menu can always be about the record where users right click.


3

3.3.13 Telephone Consults: visible info P: What does "provider" mean? S: provide corresponding descriptions for important items.

DoD.TATRC.PAWS.Services.ProviderService2

3.3.14 Telephone Consults: Telcon Entry

P: Users cannot revise the notes that have been saved through Tasking Detail; There is no information in Note History blank. S: If it's allowed to edit the content here, add this function.

DoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.DocumentService 3

3.4 Search (patient search) DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.4.1 Search (patient search) P: name differently, can not make the window bigger, horizontal bar, cannot open Help at the same time. S: consistent naming and put this window back into the main frame to enlarge the window and avoid horizontal bar problem.


3

3.4.2 Search (patient search): all patients, patient details

P: horizontal bar. S: minimize infrequently needed info.


3.4.3 Search (patient search): SSN, FMP/sponsor SSN, home phone, work phone, address



4

3.4.4 Search (patient search) P: There is no instructive message until an inappropriate input is given. S: facilitate search function with more intelligent support.


3.4.5 Search (patient search): visible info

P: Unspecified formats when input keywords, Like DOB. This reduces the efficiency. S: Use controlled format and GUI tools like a drop list, and users could click the button and choose the numbers of month, date and year. So as to other criteria.


4







3.5 Patient List DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.5.1 Patient List: add P: Cannot add more than one patient at the same time. S: make it possible to add more than one patient at one time.


3.5.2 Patient List: visible info P: Too little information is provided in this list. S: provide more relevant information from certain patient.


3.6 Consult Log DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.6.1 Consult Log P: Cannot link to a window where user could type in consulting record for each consult on the log. S: add a place for consult receivers to enter consult record to match the real situation.

DoD.TATRC.PAWS.Services.EncounterServiceDoD.TATRC.PAWS.Services.DocumentService DoD.TATRC.PAWS.Services.HistoryService 3

3.6.2 Consult Log: PCM P: Layout option or selection criterion? If I uncheck PCM, no records show up in the list any more. Obviously SSN and Specialty are layout options, not filters. But PCM functions differently. S: make sure PCM is a layout option but not a filter to be consistent with the other two items at the same place.


3.6.3 Consult Log: options P: actually is "change selection criteria", same as the other button. S: consistent naming or reduce redundancy.

DoD.TATRC.PAWS.Services.EncounterServiceDoD.TATRC.PAWS.Services.DocumentService DoD.TATRC.PAWS.Services.HistoryService

3

3.6.4 Consult Log: shortcut selection (filter)

P: This filter does not function consistently as you switch among the options on the list. S: make sure the item shown on the filter is the filter used to select the records.


3.6.5 Consult Log: action bar on the top

P: No detailed history information is linked through the History button and window. S: connect the button to the corresponding window for users' convenience.








3.7 Co-signs DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.7.1 Co-signs: append narrative P: the window opened is called "encounter note", so many terms mean the same thing. S: consistent naming.

DoD.TATRC.PAWS.Services.EncounterServiceDoD.TATRC.PAWS.Services.DocumentService 3

3.7.2 Co-signs: amend encounter P: opens "current encounter" and shows changes I made but my changes are not shown in the lower half window until I signed the encounter. S: give sufficient feedback of each action the users achieve and enough hints about what to do next.

DoD.TATRC.PAWS.Services.EncounterServiceDoD.TATRC.PAWS.Services.DocumentService

4

3.7.3 Co-signs: sign encounter P: after signature, this cosign record disappears from cosign list and no way to undo the previous signing nor warn of this non-undoable action. Have to search the patient by name or use the patient on the folder list before you click other patient's co-sign item and find among the previous encounters in order to get the record which I just signed, still no way to undo my signing. S: give sufficient feedback about what happens in the system and warn message and undo option.


4

3.7.4 Co-signs: sign encounter P: in the co-signed document, the part of AP I amended is recorded as the right date and my name, but the original part of AP which I did not amend is recorded as my name also. S: only change the name for the part the person changed on the record.


3

3.7.5 Co-signs: actions P: When "amend encounter", there appears the "Reminder" of "A/P". Go to 2.2.16.2 (Line 1313)

DoD.TATRC.PAWS.Services.EncounterServiceDoD.TATRC.PAWS.Services.DocumentService 3

3.7.6 Co-signs: action bar on the top P: When sign note through Append Narrative, signature loading function from local machine should be provided in case of the inconvenience of signing with a mouse. S: Allow signers to load their previously saved signature in picture formats.


4







3.8 Patient Registries DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

Could not figure out how to create a new registry, where is registry setup as the Help says? Could not figure out how to add a patient to a registry as the Help says. Doubt this version is complete?

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.DocumentService 4

3.8.1 Patient Registries: patient list, registry list

P: These two buttons are actually switching between two subpages within patient registries, but the name of the subpages is not shown on the main window. S: make “patient list” and “registry list” as two tabs on the “patient registry” page.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.DocumentService

4

3.8.2 Patient Registries: select columns

P: window default setting is too small, even though you could make it bigger. S: enlarge the default size of this window.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.DocumentService 3

3.8.3 Patient Registries P: In "Pregnant Indicator" column, the markers for each row are displayed as check boxes, which are always used for Boolean selection. S: Change the indicator in a more proper style with no misleading

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.DocumentService DoD.TATRC.PAWS.Services.VitalsService DoD.TATRC.PAWS.Services.HDDService.PickListEnum

3

3.9 New Results DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.9.1 New Results P: horizontal bar. S: minimize infrequently needed info and freeze the key identifier on the left side so that even when you have to move the horizontal bar you will still be able to see the key identifier.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.DocumentService DoD.TATRC.PAWS.Services.LabsService DoD.TATRC.PAWS.Services.HDDService.PickListEnum

4

3.9.2 New Results: sign/remove P: only has a function as "remove from the list". Also the result will only be removed from new result list. It will still be in the patient's lab record. S: give users enough hints and feedback about what this action is about and give a concise and accurate name.


4







3.9.3 New Results: forward P: Help says "No notification dialog box will display. The results are forwarded to the provider" and it is true. S: put this feedback available right after users click this button.


4

3.9.4 New Results: forward P: As default, all new results are displayed in an order of date regardless of different patients. This may cause a mismatch when reviewing the results with certain patient. Moreover, this is not good for a whole understanding of the results for a certain patient. S: Group the results as patients for the first priority.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.DocumentService DoD.TATRC.PAWS.Services.LabsService DoD.TATRC.PAWS.Services.HDDService.PickListEnum 4

3.9.5 New Results: patient relevant P: In the table of laboratory results. The test name is far from result value which may cause a visual mistake. S: Put two columns together after “Site/Specimen”.


4

3.9.6 New Results: patient relevant P: In the table of laboratory results. The Ref Range/Units is hidden as default. These important references may be ignored. S: Show Ref Range/Units as default, right next to the individual’s result values.


4

3.10. Reports DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.10.1 Reports P: A menu item "Reports" is located under the "Reports" directory. This item is the only item found. S: Relocate "Reports" under other main directory such as "Desktop."

DoD.TATRC.PAWS.Services.DocumentService4

3.10.1 Reports P: "+" node is redundant. S: reduce redundancy.


3.10.2 Reports P: small window to review the report but big empty space below it. S: do not waste space on the screen.


3.10.3 Reports: report on P: Only on Appointment? S: if possible, enrich the content of the report, like med, vital, lab results, etc..








3.11 Tools DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.11.1 Tools: Template Management P: cannot undo on deletion or edits. S: give users an option to undo. 4

3.11.2 Tools: new/edit template P: cannot rename the template. Have to save as another name and delete the current template. S: enable direct renaming on the template name list.

4

3.11.3 Tools: new/edit template P: no guidance on how to make a new template or edit one. Hardly find in the Help. S: give users guidance step by step.

4

3.11.4 Tools: List Management P: no definition of "list" in Help and no explanation about the function of "list". S: give clear definition of terms used in the system interface.

3

3.11.5 Tools: List Management P: cannot group related items in one category. S: give users the flexibility to organize multiple items on the “list” by grouping into several categories.

4

3.11.6 Tools: Delete P: no warn message and cannot undo the deletion. S: give warn message before the deletion action happens and an option to undo.

4

3.11.7 Tools: move up/down P: the column can be sorted, but once it has been sorted, the previous order is broken and irreversible. Cannot store the order as default. S: enable users to store the order and change back to this manually set order no matter how it is sorted.

4

3.11.8 Tools: Questionnaire Setup P: window layout inconsistent. S: consistent window border. 3

3.11.9 Tools: comment P: look like a blank to be filled, but cannot type in anything. S: gray out things that can not be typed in. Do not make it misleading to users.

3

3.11.10. Tools: List Management P: What is the "list"? S: add more explanation in help document. 3







3.11.11 Tools: actions P: While change the switchs on the top, sometimes the "Adequate Calcium Counseling Comment" might appear as "LOADING DATA..." and no further response any more. This may confuse users. S: Show the data, or reply a message to show no data or time out.

4

3.12 Tasking DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.12.1 Tasking: Delete P: no warn message and cannot undo the deletion. S: give warn message before the deletion action happens and an option to undo.

4

3.12.2 Tasking: Options (change selection criteria)

P: different names with the same meaning. S: consistent naming. 3

3.12.3 Tasking: change selection criteria

P: Incorrect meaning for "Options"; S: use more appropriate word. 3

3.12.4 Tasking: change selection criteria

P: Sometimes the "OK" button could NOT be clicked after changing criteria. S: Debug the mistake in this table.

3

3.12.5 Tasking: action bar on the top P: The “Assignee” selection could be input both by free text and selection from a user list. This increase a risk of unclear input. S: Generate revision on input text, like “Patient”.


3

3.13 Sign Orders DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.13.1 Sign Orders P: cannot sort by clicking the column. Cannot change layout order by dragging the column either. S: enable sorting and dragging column.


3.13.2 Sign Orders: expand/collapse P: expanded info is mostly repetitive. S: reduce redundancy.








3.13.3 Sign Orders: cancel selected orders

P: even though there is a warn message, but here "cancel" means to remove. S: consistent naming.


3.13.4 Sign Orders: sign selected orders, sign all shown orders

P: after signature, this order disappears from this list and no way to undo the previous signing nor any warn message of this non-undoable action. S: give sufficient feedback about what happens in the system and warn message and undo option.


4

3.13.5 Sign Orders: visible info P: What is the order in the order list? How to sort items? S: defaut order should be start time of orders. And add the sort function


3.13.6 Sign Orders: action bar on the top

P: 1. "Cancel selected orders" will completely delete selected orders, which is too easy a function for such essential order manipulation; S: change the expression to remind users to delete the orders selected. P: 2. "Sign all orders" will sign all the orders without a notice and undo function, which may lead to error. S: add the message and undo function.


4

3.14 Immunization Admin DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.14.1 Immunization Admin P: small window to review the report but big empty space below it. S: do not waste space on the screen.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.ImmunizationService 3

3.14.2 Immunization Admin: delete P: no warn message and cannot undo the deletion. S: give warn message before the deletion action happens and an option to undo.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.ImmunizationService 4

3.15 Patient Full Record DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService







3.15.1 Patient Full Record P: multiple steps to switch between patients and no place to check the patients' names of the records which I just checked. S: a small shortcut patient list as the reminder window, always on the left hand side.


4

3.16 Demographics DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.16.1 Demographics: patient category, religion, records maintianed at

P: layout inconsistent, the window frame and drop down button are useless and misleading. S: consistent layout.


3.16.2 Demographics: insurance information

P: horizontal bar. S: freeze the key identifier on the left side and minimize infrequently needed info.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.ProviderService 4

3.16.3 Demographics: primary care manager information

P: The "specialty" and "facility" are both displayed in code without descriptions. Users may get confused on their meanings. S: Translate the codes into words

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.ProviderService 4

3.16.4 Demographics: DEERS eligibility P: What's "DEERS"? S: add more explanation in help document.


3.17 Health History DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.17.1.1 Summary (disappear when mouse is not on)

P: show up in a very short time when mouse cursor is not on the window unless you click the pin to make it constantly show up in the bottom. S: let the users to close the window when they want.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.HistoryService

3

3.17.1.2 Summary (disappear when mouse is not on): refresh

P: actually functions as "go back to default setting". S: consistent naming.

DoD.TATRC.PAWS.Services.PatientServiceDoD.TATRC.PAWS.Services.HistoryService 3

3.17.2.1 Problems P: Why "surgical history","social history","other PMH", "family history", and others things are all included in this section?








S: match the real medical record structure and workflow.

3.17.2.2 Problems: Save P: does not change to active status even after changes are made. S: make it function consistently.


3.17.2.3 Problems: Delete P: no warn message, but if you see the activated "cancel" button, to click cancel could cancel the delete action which actually function as a warn message. No undo. S: pop up a warn message right after delete button is clicked and give an option to undo.


4

3.17.2.4 Problems: comment P: no warn message when I delete/change the existing comments. S: give warn message of irreversible changes and options to undo.


3.17.2.5 Problems: chronicity, status, date onset

P: when a new problem is entered, these three items are automatically entered as the default setting. For such key information, why not ask the user to input one by one instead of putting a default value there and waiting for the user to change on it? S: ask users step by step to enter value in these items instead of putting a default value there.


4

3.17.2.6 Problems: encounter comment P: cannot type in anything although looks like could be able to type in. S: use consistent layout to avoid misleading.


3.17.2.7 Problems: Copy to P: "copy to" where? No feedback to tell me where it is copied to. S: give users feedback about what has been done and what to do next.


3.17.2.8 Problems P: many bugs and easy to get frozen. S: make it function consistently.


3.17.2.9 Problems P: Users cannot input by free text. S: add this function.


3.17.2.10. Problems P: Users couldn't print the problem list. S: add this function.








3.17.2.11 Problems P: When "Problem" menu is selected under the "Patient" folder, first a user select type of the problem and check problems from a list. A user has to go back and forth between "Problem Type" window and "Problem List" window below. S: Separate the window into 2 columns and display side by side.


4

3.18 Meds DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.18.1 Meds: Modify P: after modification/renew, have to click submit instead of save and then close OE and then need to click refresh in order to make it show up on the list. The med record which has just been changed is not highlighted either. You have to memorize which one you just changed and look through and then find out whether you have successfully made the change or not. S: give users immediate feedback about what has just been changed.

DoD.TATRC.PAWS.Services.MedicationsServiceDoD.TATRC.PAWS.Services.HDDService.PickListEnum

4

3.18.2 Meds: Renew P: cannot function before current encounter is open. Warn message only says this but does not give a button to open current encounter or automatically open a current encounter. For patient has no current encounter, meds cannot be modified or renewed? S: to modify or renew meds could happen on previous encounters. Features need to match the real situation. Give a link to open whatever needed on the message.


4

3.18.3 Meds: Renew P: once the OE module is opened, the highlighted med record is automatically jumping back to the first one on the list. S: keep highlighting the record which is being edited to avoid misleading.


3

3.18.4 Meds: Renew P: once submitted, cannot be changed. S: give an option to double check before irreversible change happens.

DoD.TATRC.PAWS.Services.MedicationsServiceDoD.TATRC.PAWS.Services.HDDService.PickListEnum 4

3.18.5 Meds: comment P: seems a place able to type in, but not. S: use consistent layout.








3.18.6 Meds: refresh P: actually functions as "go back to default setting". S: consistent naming.


3.18.7 Meds: Options P: actually is to set the default filter. S: use self-evident naming.


3.18.8 Meds P: 1. There's no information to specify the route of the orders. E.g. IV/oral. S: If route of the order is important here, add this row in the database. P: 2. What about the orders that have been taken only once? I mean I could only see the long-term (or continuous) orders, what about one-time ones? S: specify whether it's a long-term order or once.


4

3.18.9 Meds: visible info P: Confusing display style on "Comment". S: revise the style of this box.


3.18.10. Meds: action bar on the top P: Printing leads to a summary report with the meds order changed into alphabetical one. S: Print the content as it is displayed and customized in the main window by users.


3

3.19 Allergy DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.19.1 Allergy P: cannot change the size of the frames. S: give users the flexibility to organize the window.

DoD.TATRC.PAWS.Services.AllergiesService3

3.19.2 Allergy P: many bugs and easy to get frozen. S: make sure it functions consistently.


3.19.3 Allergy: Options P: it shows as "properties", "categorized items". Actually it functions to set up the default allergen in the dropdown menu. S: use self-evident naming.

DoD.TATRC.PAWS.Services.AllergiesService

3

3.19.4 Allergy: double click to edit P: When search for Reaction from the window, it's hard to input all by users without any hints. S: facilitate search function with more intelligent support.








3.19.5 Allergy: action bar on the top P: After click the "Verify", there is no response. What is expected?


3.20. Wellness DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.20.1 Wellness P: this is actually about “reminders”. S: consistent naming. 3

3.20.2 Wellness: coded P: choose "completed" or "ordered", the item will disappear from the list but come back as "addressed" status after refresh and cannot undo that action. S: give immediate feedback about what has been changed and use consistent naming.

4

3.20.3 Wellness: details P: shows up in a separate window after click this button rather than showing up directly in the big empty space below. S: reduce redundancy and do not waste space on the screen.

3

3.20.4 Wellness P: Users cannot print wellness information. S: add this function. 4

3.21 Immunization DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.21.1 Immunization P: cannot change the size of the frames. S: do not waste space on the screen and make it more readable.

DoD.TATRC.PAWS.Services.ImmunizationServiceDoD.TATRC.PAWS.Services.HDDService.PickListEnum 3

3.21.2 Immunization: vaccine history P: horizontal bar. S: minimize infrequently needed info or freeze the key identifier on the left side.


3.21.3 Immunization: individual immunizations

P: Usually allergies are displayed in red as emphasized, why here in blue? S: If it's not following the right rule, change it.








3.22 Vital signs review DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.22.1 Vital signs review P: in the main window, all values are gray, hardly readable. S: make the words and numbers readable.

DoD.TATRC.PAWS.Services.VitalsService3

3.22.2 Vital signs review P: cannot change the width of each column. The right end column is very wide. S: give users the flexibility to organize the window.


3.22.3 Vital signs review P: smaller bottom window only has the entry person which is not shown up on the main window. S: put the entry person in a parallel column in the main window to save space in the bottom.

DoD.TATRC.PAWS.Services.VitalsService

3

3.22.4 Vital signs review: search type P: to select time filter. Use different words to mean the same thing. S: consistent naming.


3.22.5 Vital signs review: vital signs review

P: There is no graphic view of vital summary for a certain patient. S: It's important to embed this function.


3.22.6 Vital signs review: visible info P: The table is too sparse and the display style is not efficient enough to figure out the data. S: revise the display style.


3.22.7 Vital signs review: temp unit P: Changing the unit between Celsius and Fahrenheit has no impact in the note window below. S: automatically calculate and change into the right unit.


3.22.8 Vital signs review: PKC couplers P: Could the assessment information in the new session be displayed in the same session? S: If it's allowed, add this function.


3.22.9 Vital signs review: perform new assessment

P: Why list all items in the middle of the blank? S: On the left?


3.22.10. Vital signs review: lab tests P: There is no distinct display style on the abnormal ones. S: change the style of the abnormal results and make them notable.

DoD.TATRC.PAWS.Services.VitalsServiceDoD.TATRC.PAWS.Services.LabsService DoD.TATRC.PAWS.Services.HDDService.PickListEnum

3







3.22.11 Vital signs review: lab P: It's hard to do the search without any hints like droplist. S: facilitate search function with more intelligent support.


3.22.12 Vital signs review: display criteria

P: The results cannot be printed. S: add this function.


3.22.13 Vital signs review: radiology P: Users cannot print nor export the results. S: add these functions.

DoD.TATRC.PAWS.Services.VitalsServiceDoD.TATRC.PAWS.Services.RadiologyService DoD.TATRC.PAWS.Services.HDDService.PickListEnum

4

3.22.14 Vital signs review: visible info P: Is there a way to see the graphic result? S: add graphic display for users' convenience.


3.22.15 Vital signs review: result code P: No noticeable mark in the context. S: add marks to make them notable


3.22.16 Vital signs review: action bar on the top 2 (new/edit)

P: Users could easily change the note date and clinicians without any authorization. Is this allowed? S: If it's not allowed, restrict this function.


3.22.17 Vital signs review: view last four/all

P: Why last four? S: expand to more items, not only last four.


3.23 Current Encounter DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.23.1 Current Encounter P: reminders jump out every time the current encounter is opened. Only one current encounter of one patient can be open at one time. But doctors may need to work with several patients at the same time and thus need to switch among patients' current encounters back and forth. This one current encounter at one time feature and automatical popup of reminders are not efficient. On the other hand, almost all things on the reminders are not actually the doctors' job, instead, nurses or health promotion personnels are the workforce dealing with those. S: Easy and quick to switch among patients and reduce memory load about which patient's record has just been checked. Let the reminder only automatically jump-out for those who are responsible to accomplish the relevant services.


4







3.23.2 Current Encounter P: to switch between several "open encounters" of the same patient, the only way is to close the opened current encounter and click "current encounter" on the folder list in order to see the "select an open encounter" window with the list of other "open encounters". S: make the list of "open encounters" obvious to be seen.


4

3.23.3 Current Encounter P: "open encounter" and "current encounter" have different meanings? S: consistent wording.


3.23.4 Current Encounter: select an open encounter

P: although each column is sortable, there is no sign to show that. S: use a small triangle on the column title to show the column is sortable.


2

3.23.5 Current Encounter: primary diagnosis

P: not every patient visit could have "primary diagnosis" concluded at the time the patient visits the provider. S: "reason for visit" is apparent at the time the patient visits and could be used to replace.


2

3.23.6 Current Encounter: reminders P: after one reminded service is submitted, the submitted service is added as another diagnosis on the selected open encounter. S: reminded service could be "reason for visit", but does not make sense to be a diagnosis.


2

3.23.7 Current Encounter: reminders P: After clicking either box of "Select" or "Modify" column for each row, if click in the grey part below, it could still control the last box that users have just clicked. This is a serious bug which may lead to mistake without users' attention. S: Debug the mistake in this table.


4

3.23.8 Current Encounter: reminder name

P: "Registries","Wellness",and "Immunizations" are the categories of services which are supposed to be easily seen, but it is hard to see these categories. S: different fonts for category headings.


2

3.23.9 Current Encounter: due P: this column is not sortable. S: make it sortable.


3.23.10. Current Encounter: encounter summary

P: Cannot sort by time across all components. S: make it sortable by time.








3.23.11 Current Encounter: encounter summary

P: Big empty space left on the right hand side. Titles of sections are not obvious enough to see. Words are very close to each other and the format is hardly readable, even contents with different meanings are next to each other in one big paragraph. S: use different fonts aiming at easy readability and do not waste space on the screen.


2

3.23.12 Current Encounter: encounter summary

P: No feedback when each section has information entered or changed. S: let users know what content has just been changed as feedback of users actions.


4

3.23.13 Current Encounter: status P: any "current encounter" is not supposed to be in the status of "in progress"? Why documents in "previous encounter" could be directed into the sheet of "current encounter" with the status of "updating or need co-sign" after click "amend"? S: "previous encounter" should always be previous encounter no matter it is being edited or co-signed. Use meaningful wording to show the status of "current encounter" such as "in triage nurse", "in VS nurse", "waiting for physician", "in physician office", "in blood-drawing nurse","waiting for lab results", "in CT room", etc.


2

3.23.14 Current Encounter: providers P: What's the grey box on the right used for? S: revise this interface.


3.23.15 Current Encounter: template Mgt, save as template

P: these two buttons are relevant, but far away from each other on the action bar. S: use one button called "template".


3.23.16 Current Encounter: reminder P: In order to see detailed information about "Reminders", a user has to activate "Current Encounter" menu. The order of the list is not consistent in the two windows. S: Keep the order consistent. Also add status color to the list in "Reminder" window.


2

3.23.17 Current Encounter: reminder P: The list of "Immunizations" is not included in "Reminder" menu. S: Add the list of "Immunizations" to the "Reminder" list.


3.24 Screening







3.24.1 Screening P: big empty space but small window, weird scroll bar. S: do not waste space on screen.


3.24.2 Screening: reason for visit P: What is the difference between "reason for appointment" and "reason for visit (chief complaint)"? Why these reasons are entered in the section of "screening"? S: consistent wording for the same meaning. "reason for visit" should be an independent section instead of existing in the "screening" section.


2

3.24.3 Screening: reason for visit P: Not enough instruction on how to add a reason for visit via "search". Under "selected reason for visit", column is sortable but no sign, and no sign to show that users can change "new" or "follow up" by click on the default "new" and select from dropdown menu, no sign to show that users can click on the row at "comment" column to type in comments of that reason for visit directly. S: Guide users step by step to enter all key items of "reason for visit" instead of using default setting.


3

3.24.4 Screening: due reminders P: "reminders" again? S: pick one place for reminder handling--- either here or CPOE.


3.24.5 Screening: due reminders P: reminded services are all underlined but require double click. S: use standard layout.


3.24.6 Screening: options P: the window opens after click this button is "encounter summary properties". S: remove this button because this window is not relevant to "screening".


2

3.24.7 Screening P: When adding certain problems to list error warning comes up S: fix the bug


3.25 Vital Sign Entry DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService







3.25.1 Vital Sign Entry P: to enter vital sign has to go through reminder. S: Give users the flexibility of setting reminder jump-out automatic or not.


3.25.2 Vital Sign Entry P: the "cancel" button on the bottom of vital entry page functions the same as "close" action. No reminding message to ask whether need to save the input data or not before that page is closed. S: either change the function of "cancel" button or remove "cancel" button.


4

3.25.3 Vital Sign Entry: entry P: There are some button named "...", which may make users puzzled. What are they for? And the information customized inside these functions may not be visible after close the functions. S: name these buttons with appropriate hints


2

3.25.4 Vital Sign Entry: BP, HR, Temp, height, weight

P: "…" button contains parameters or "modifiers" of the associated measurement, But it is not straightforward on the vital sign page unless the button is clicked and another window is opened. There is no reminding message about the "modifier" setup feature of "..." button. No feedback after the "modifiers" have been changed. S: Show the parameters or "modifiers" directly on the vital sign page.


3

3.25.5 Vital Sign Entry: pain severity P: the "…" button contains almost the same content for adult. S: reduce redundancy.


3.25.6 Vital Sign Entry: save vitals P: no feedback after click "save vitals" button except all the inputs have been cleared. Also the "save" action on "vitals" page does not have to be named as "save vitals". S: "save" is clear enough to be the name of this button and give feedback about what has been saved and give hint about what is the next possible operation.


3

3.25.7 Vital Sign Entry: options P: the window called "Properties" contains "units preference" for height and weight. However, there are no units appearing in the vital sign review page. S: add units on the data chart and let units changeable on the column of the data chart. Remove units preference from this window.


3







3.25.8 Vital Sign Entry: adult/pediatric P: whether this patient needs to use "adult" vital chart or "pediatric" vital chart should already be very clear once this appointment is made. Why need the vital sign entry person to select again? S: move this dropdown item to the step of making appointment.


3

3.25.9 Vital Sign Entry: review P: No units and normal ranges on the data chart. S: add units and normal ranges.


3.25.10. Vital Sign Entry: review P: There is no graphic view of vital summary for a certain patient. S: add graphic display for users' convenience.


3.25.11 Vital Sign Entry: search type P: the window called "Time Search" which is the same as the button "Default Time" in the "Time Options" on the window "Properties" after clicking "Options". S: consistent wording.


2

3.25.12 Vital Sign Entry: date P: year is much less frequently read compared with date and time. S: group results by year and month.


3.25.13 Vital Sign Entry: edit vitals, delete vitals

P: "Can only edit/delete vitals from the current encounter." However, there is no info showing which row of vitals is from the current encounter. S: should not give the chance to change vitals no matter in "current encounter" or not.


4

3.25.14 Vital Sign Entry: graph vitals P: only graph the vitals from one specific day, which does not make much sense, esp when BP and HR and RR and T and height are plotted in the same coordinate. S: to compare same vital item across different time is more informative.


4

3.25.15 Vital Sign Entry P: Extra questions on important information hidden eg -alcohol & smoking questions, BP,HR, Ht & lb must click small box to see more questions S: once click on or fill in VS - ex tra box of questions should pop up


4

3.25.16 Vital Sign Entry: chart P: Both axis use the same black color, which may result in errors to users. S: differentiate the colors of axis








3.25.17 Vital Sign Entry: action bar on the top

P: Why there is still the button "Clear Vitals"? It's only for Entry tag. S: hide this function in this window.


3.26 S/O DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.26.1 S/O: add/edit S/O note P: Why "Edit this note as a new user (take over note in my name)" is the only option to edit a previous note? Is it possible to just change part of others' note with my name but the parts that I do not change are still with the original name? S: leave my name only for the parts that I have changed if changing notes is allowed by regulations.


3

3.26.2 S/O: S/O sheet P: No button to clear the information back to the default status. S: add this function.


3.26.3 S/O: autoNeg P: can not clear "AutoNeg" entry at one step. In addition, "Pain can not be controlled" is not a negative symptom description. S: enable users to "unselect" "AutoNeg". "Pain can not be controlled" should be removed from "AutoNeg".


4

3.26.4 S/O: input P: "Unit" button has no unit list to use.S: enrich the list with multiple regular units.

DoD.TATRC.PAWS.Services.DocumentService 4

3.26.5 S/O: modifier P: can only search by the initial letter. S: more flexible search method.


3.26.6 S/O: HPI, PMH, ROS, PE, Tests, Browse

P: Must only browse by tree. No search function?S: facilitate search function with more intelligent support.


3.26.7 S/O: cancel P: function similar as "close". S: reduce redundancy.


3.26.8 S/O P: Confusing message when pressing certain buttons -prompting - meaning? S: properly defining message and its implications








3.27 Drawing DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.27.1 Drawing: visible info P: How to zoom in and zoom out?S: add this function.


3.27.2 Drawing: double click to edit comments

P: What's the meaning of each button around the picture? No annotate. S: enrich the instruction for pictures.


3.27.3 Drawing P: Select drawing annotate - message comes up and freezes the window - must restart program S: Debug


3.28 A/P DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.28.1 A/P P: Home icon appears to be dysfunctional. Also it is unclear why this is even needed S: Remove Home Icon

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.HDDService 2

3.28.2 A/P P: On right hand side there is lots of empty space to the right of the box with the tabs S: Expand the tabbed interface to fit whole horizontal space


3.28.3 A/P P: A procedure needs to be associated with a particular diagnosis. If it the 5th diagnoses then an error message is displayed


3.28.4 A/P P: Procedure ordering and signing is difficult to understand DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.HDDService 3

3.28.5 A/P P: unable to resize search result boxesS: Allow boxes to be resized


3.28.6 A/P P: Any added orders appear to have to be linked to a diagnosis. However, the space between diagnoses in the top box and the actual order entry screens in the bottom half is great. Therefore users are likely to forget, and orders are likely to be added to the selected diagnoses (which may or may not be correct)

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.HDDService

4







3.28.7 A/P P: Right clicking does not bring up a menu of possible functionality S: Provide flexibility by adding a context sensitive right click menu


3.28.8 A/P: action bar on the top P: Users cannot print separately items from the following perspectives. S: enrich the function of printing.


3.28.9 A/P: delete P: no warn message about this deletion and no way to undo this deletion. S: add undo function and warn message before this deletion action is accomplished.


3.28.10. A/P: upper half window P: All items are displayed in same black color and font, which is easy to make mistakes. S: differentiate the colors and fonts.


3.28.11 A/P: upper half window P: No keyboard shortcuts to explode a node (such as by clicking enter) S: Provide keyboard shortcuts


3.28.12 A/P: upper half window P: When you click a procedure in the top viewing window another box opens up S: Do no open box unless double clicked as this is unexpected


3.28.13 A/P: chronic/acute P: When a diagnosis is selected it automatically defaults either Acute or Chronic. This appears to be based on previous selections. S: Rather than a default value of chronic or acute, this should be based on the condition itself or user selectable with a default to blank

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.HDDService 2

3.28.14 A/P: <> button P: Removing a procedure is done by clicking this item. The icon is confusing S: Provide another more meaningful icon for removing a procedure


3.28.15 A/P: orders & procedures P: It is unclear how the items in the Orders and Procedures box are ordered S: Provide a logical ordering for these items

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.HDDService

2

3.28.16 A/P: orders & procedures P: Cannot view the full items names of orders that are longer than the viewing width S: Increase viewing width, or at the very at least allow


3







scrolling etc

3.28.17 A/P: search P: Able to search and retrieval items that are not diagnoses in the search box. Example search for "ECG". However, on trying to add it brings up an error S: Restrict search to only those items that are diagnoses


3.28.18 A/P: encounter order sets P: There does not appear to be a way to search for an order set S: As order sets increase, there needs to be a more efficient way to retrieve information. Add a search facility


3.28.19 A/P: encounter order sets P: Previous and next icons appear to be another way to select items in the drop down box S: Remove these icons as these are non-standard ways to select


3.28.20. A/P: order entry consults P: Data Validation alert box has a spelling error: "Please include a reason" S: Correct spelling


4

3.28.21 A/P: reason for request P: Reason for request is free text. Coded items may be more efficient S: Consider using coded items with option to add free text notes


3.28.22 A/P: save to queue P: Once an order has been Saved to Queue, it is unclear how this can be edited again S: Allow order to be edited


4

3.28.23 A/P: save as draft P: Once an order has been Saves as Draft it appears in the Active Consults section. However, it is unclear how this can then be edited and submitted?


3

3.28.24 A/P: active consults (?) P: Active Consults box is too small and is difficult to view more than one consult S: Enlarge this box both horizontally and vertically


3

3.28.25 A/P: active consults (?) P: It is unclear what fields are required on this form. S: Indicate required fields


3

3.28.26 A/P: order entry lab P: Upon searching a lab order the results appear in a drop down list S: Use a more standard way to display the search results

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.LabsService

4







such as a list of items DoD.TATRC.PAWS.Services.HDDService

3.28.27 A/P: order entry lab

P: After selecting some types of a lab order, a new window pops up with details to complete. However, this is unexpected as the original form indicates that more information will be collected on the original screen. In some cases this pop-up screen does not occur. S: Although the specific fields to collect for each type of order may differ, they should appear in a consistent manner. For example use a pop-up for all orders, or have a dynamic form be generated underneath the selection of a lab test name.

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.LabsService DoD.TATRC.PAWS.Services.HDDService

4

3.28.28 A/P: order entry lab

P: The action buttons: Save to Queue, submit are above the more detail fields making it difficult to see how to compete a submission S: Action buttons related to form submission should be after the fields.


2

3.28.29 A/P: lab orders

P: When more details is selected, the laboratory orders rows are not visible anymore S: Make Laboratory Orders viewable


4

3.28.30. A/P: search P: No intelligent item suggestion when a new letter is input. It's not convenient to search. S: facilitate search function with more intelligent support.


3.28.31 A/P: modify P: After editing an existing Rad order, a duplicate order screen appears. After overriding, there does not appear to be a duplicate order as this was a modification of an existing order S: Duplicate Order alert should not be displayed

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.RadiologyService DoD.TATRC.PAWS.Services.HDDService

3

3.28.32 A/P: order entry med P: Unclear how to edit a medication entryS: Allow medication entry to be edited

DoD.TATRC.PAWS.Services.DocumentServiceDoD.TATRC.PAWS.Services.EncounterService DoD.TATRC.PAWS.Services.MedicationsService DoD.TATRC.PAWS.Services.HDDService

4

3.28.33 A/P: search P: Search results appear in a combo boxS: For consistency search results are normally presented in a list


4







3.28.34 A/P: item name P: Listing of medication items are in all CAPS. To ease readability they should not be in all caps. S: Use upper case for beginning of words. Alternatively use upper caps to distinguish the generic and brand name medications


2

3.28.35 A/P: max P: Field always seems to be inactive. S: Remove if this field is always inactive or allow data input when appropriate


4

3.28.36 A/P: days supply P: Field always seems to be inactive. S: Remove if this field is always inactive or allow data input when appropriate


4

3.28.37 A/P: expanded sig P: Expand Sig button and More Detail button appear to do the same thing S: Use one button instead of 2


2

3.28.38 A/P: start date P: Start date can be selected as in the past (for example in 1990) S: Build in some logic checks to prevent errors


4

3.28.39 A/P: notes to provider P: This box is grayed out however, cursor flashes when clicked although nothing can be entered in S: Make clear that nothing can be inputted by preventing cursor from flashing when clicking inside when inactive


3

3.28.40. A/P: comments P: There appears to be a limit on the number of characters allowed in the comments field S: Remove limit or increase character limit


3

3.28.41 A/P: current outpatient med P: Current Outpatient Medication box not visibleS: Expand the box so info can be visible


3

3.28.42 A/P: search P: Normally a user cannot input anything into a combo box but it is used for selection of items. The search box looks like a combo box and it is not immediately clear than anything can be inputted S: Do not have a drop down feature in the search box








3.28.43 A/P: search P: The word "Find Now" on the action button may be improved S: Use "Search" to quickly communicate meaning to users


4

3.28.44 A/P: search P: The search function does not seem to be very sophisticated and appears to bring up an alphabetical list whenever the search keyword appears in the item name. Some results appear to be totally irrelevant. For example a search for "corn" brings up an item "Anticipatory Guidance: Child Proofing the House"


3.28.45 A/P: order consults P: print preview doesn’t show consult order S: once all orders are written - should be able to preview b before it prints


4

3.28.46 A/P: order med P: need to scroll up and down to see all of pt's med S: all meds prescribed should be seen all at once to prevent contraindications


4

3.29 Disposition DoD.TATRC.PAWS.Services.BaseWebServiceDoD.TATRC.PAWS.Services.ConfigurationService DoD.TATRC.PAWS.Services.EnumDocumentFormat DoD.TATRC.PAWS.Services.NetworkCredentialHeader DoD.TATRC.PAWS.Services.SecurityService

3.29.1 Disposition P: big empty space and crowded words. I do not feel this is relevant to doctor's role. S: do not waste space on the screen and give users flexibility to choose relevant sections.


3.29.2 Disposition: cancel P: same function as "close". S: reduce redundancy.


3

3.29.3 Disposition: billing chief complaint

P: When select diagnosis, it's easy to abnormally terminate the system S: Debug the mistake.


4



8.3 PAWS and PVT APIs to Visualization Models The diagrams below document relationships between the PAWS API references and the intended PVT implementation to the visualization models developed by PIIM during this quarter’s and last quarter’s GUI/Visualization deliverables. In conjunction with the PAWS API to Usability Concerns Matrix (above) and the Matrix of Usability and GUI Concerns (contained in the Detailed GUI Design Volume delivered alongside this document), these diagrams provide full traceability between usability, GUI redesign, and technical components of this AHLTA redesign project. This section has been updated from the previous quarter’s Web Services and Infrastructure Volume as specific emphasis has been placed to integrate PAWS with the most up-to-date visualization models developed in this quarter’s work. The diagrams below document the following components of the PIIM AHLTA GUI:

1) Overall IA/wireframe 2) Appointments 3) Telephone Consult 4) Patient Search



Information Architecture: Top Level Block Groups



Folder List



Appointment Screen: Day (Patient Not Selected)



Appointment Screen: Day (Patient Selected)



Appointment Screen: Week (Patient Selected)



Appointment Screen: Month (Patient Selected)



Telephone Consults: Day (Patient Not Selected)



Telephone Consults: Day (Patient Selected)



Telephone Consults: Week (Patient Selected)



Telephone Consults: Month (Patient Selected)



Patient Search



Patient Search By “All Patients”



Patient Search By “Patient’s Details”



9. REQUIRED TECHNICAL DOCUMENTATION – MEETING DODAF An analysis of the engineering aspects of this program was completed to determine the appropriate level of technical documentation to complete in order to correctly describe the prototype system being developed. The PIIM Engineering team believes the following artifacts – following the Department of Defense Architecture Framework (DoDAF) version 1.5 – will be required at this stage of the program to successfully communicate the scope and nature of this program’s technology deliverables: All View

AV-1: Overview and Summary Information AV-2: Integrated Dictionary

Operational

OV-1: High Level Operational Concept Graphic OV-2: Operational Node Connectivity Description

Systems and Services

SV-1: Systems/Services Interface Description SV-3: Systems-Systems, Services-Systems, Services-Services Matrices SV-4a/SV-4b: Systems/Services Functionality Description SV-8: Systems/Services Evolution Description SV-11: Physical Schema

These diagrams will evolve throughout the course of this program as additional functionalities are integrated and clarity of associated systems is present. These diagrams are contained in the next section.



10. DODAF DOCUMENTATION 10.1 All View 10.1.1 AV-1: Overview and Summary Information AV-1: Overview and Summary Information

1. Architecture Project Identification

Name AHLTA GUI Redesign Architect Brian Willison Organization Developing the Architecture

Parsons Institute for Information Mapping (PIIM)

Assumptions and Constraints TBD Approval Authority TBD Date Completed December 10, 2009 Level of Effort and Projected and Actual Costs to Develop the Architecture

TBD

2. Scope: Architecture View(s) and Products Identification

Views and products developed AV-1: Overview and Summary Information AV-2: Integrated Dictionary OV-1: High Level Operational Concept Graphic OV-2: Operational Node Connectivity Description\ SV-1: Systems/Services Interface Description SV-3: Systems-Systems, Services-Systems, Services-Services Matrices SV-4a (Class)/SV-4b (Activity): Systems/Services Functionality Description SV-8: Systems/Services Evolution Description SV-11: Physical Schema

Time frames addressed July 1, 2009 – December 10, 2009 Organizations involved Parsons Institute for Information Mapping (PIIM); Telemedicine and Advanced Technology



AV-1: Overview and Summary Information

Research Center (TATRC) 3. Purpose and Viewpoint The purpose of this architecture is to define a Graphic User Interface (GUI) technology framework built in HTML/CSS/Ajax/JavaScript that will drive the AHLTA system within a web-based context. This architecture is being developed from the viewpoint of the Parsons Institute for Information Mapping (PIIM) with a focus on the GUI technology framework utilizing the Patient Ancillary Web Services (PAWS) system and definitions. 4. Context

Mission Supporting the redesign of the AHLTA GUI and establishing a web-based technology framework for its deployment.

Doctrine, goals, and vision This architecture seeks to provide a foundation for the design and engineering work to deploy a web-based version of AHLTA.

Rules, criteria, and conventions followed

TBD

Tasking for architecture project and linkages to other architectures

TBD

5. Tools and File Formats Used Microsoft Office Suite (Outlook, Excel, Visio, Word) 6. Findings

Analysis results TBD Recommendations TBD

10.1.2 AV-2: Integrated Dictionary A



AHLTA: Armed Forces Health Longitudinal Technology Application Ajax: Asynchronous JavaScript and XML C CSS: Cascading Style Sheet D DOD/DoD: Department of Defense H HTML: Hypertext Markup Language J JS: JavaScript M MHS: Military Health System P PAWS: Patient Ancillary Web Service PIIM: Parsons Institute for Information Mapping T TATRC: Telemedicine and Advanced Technology Research Center



10.2 Operational 10.2.1 OV-1: High Level Operational Concept Graphic

Note: The OV-1 diagram has been simplified to illustrate only the components at their highest-state that are relevant to the GUI prototype being developed in this program. 10.2.2 OV-2: Operational Node Connectivity Description



Note: The OV-2 diagram has been simplified to illustrate only the highest-level nodes accessing the AHLTA GUI.



10.3 Systems and Services 10.3.1 SV-1: Systems/Services Interface Description

Note: The SV-1 diagram has been simplified to illustrate only the highest-level nodes accessing the AHLTA GUI with a subsystem breakdown within the AHLTA GUI being prototyped in this project. 10.3.2 SV-3: Systems-Systems, Services-Systems, Services-Services Matrices Note: This diagram will be provided in the next quarter’s deliverable as it is heavily dependent on technology interfaces between the components of the AHLTA GUI and the PAWS system.



10.3.3 SV-4a (Class)/SV-4b (Activity): Systems/Services Functionality Description

Note: This diagram only discusses the PIIM AHLTA GUI being prototyped in this project and the highest-level description of its subsystems. 10.3.4 SV-8: Systems/Services Evolution Description

Note: This diagram describes the evolution of the PIIM AHLTA GUI during the time period of this project only. 10.3.5 SV-11: Physical Schema System Administration Portal



/var/www/html/{version number} /admin /media /css /global /{module-specific-name} /images /global /{module-specific-name} /js /global /{module-specific-name} /templates {global} /modules /{module-specific-name} /templates

Public/Clinician Portal /var/www/html/{version number} /public /media /css /global /{module-specific-name} /images /global /{module-specific-name} /js /global /{module-specific-name} /templates {global} /modules /{module-specific-name} /templates



JavaScript/Ajax Services /var/www/html/{version number} /javascript-services /pvt /version_x /vegui /version_x /uize /version_x /prototype /version_x /ajile /version_x

Web Services (Non-PAWS) /var/www/html/{version number} /web-services /global /{module-specific-name}

Portal Configuration /var/www/html/{version number} /config /admin /{module-specific-name} /web /{module-specific-name} /global

Documents

Leveraging the PIIM Process to Advance Health IT · Leveraging the PIIM Process to Advance Health IT (W81XWH-09-1-0456): Web Services and Infrastructure Volume Version 2 Document