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Journal of Healthcare Engineering
Volume 4, Issue 3, Pages 427-451
Research Article

Design of Electronic Medical Record User Interfaces: A Matrix-Based Method for Improving Usability

Kushtrim Kuqi,1 Tim Eveleigh,1 Thomas Holzer,1 Shahryar Sarkani,1 James E. Levin,2 and Rebecca S. Crowley3

1Department of Engineering Management and Systems Engineering, The George Washington University, Washington DC, USA
2Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
3Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

Received 1 December 2012; Accepted 1 April 2013

Copyright © 2013 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study examines a new approach of using the Design Structure Matrix (DSM) modeling technique to improve the design of Electronic Medical Record (EMR) user interfaces. The usability of an EMR medication dosage calculator used for placing orders in an academic hospital setting was investigated. The proposed method captures and analyzes the interactions between user interface elements of the EMR system and groups elements based on information exchange, spatial adjacency, and similarity to improve screen density and time-on-task. Medication dose adjustment task time was recorded for the existing and new designs using a cognitive simulation model that predicts user performance. We estimate that the design improvement could reduce time-on-task by saving an average of 21 hours of hospital physicians’ time over the course of a month. The study suggests that the application of DSM can improve the usability of an EMR user interface.