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

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This article compares the effectiveness between Twinlist and Control Interface in performing medication reconciliation. [1]


Medication Reconciliation is a very important part of meaningful use. It is a multistep process that is frequently complicated by the involvement of multiple providers in the patient’s care over the course of a hospital stay. During the discharge process, clinicians must obtain a list of home medications (usually created during the admission process) and one of current medications used during the hospital stay. Getting this information as accurate as possible is vital in patient care and a simple mistake could lead to medication errors that could cause death. This study is looking at the effectiveness of Twinlist compared to a Control Interface.


Twenty participants, both emergency and Internal Medicine residents and attending physicians, with no experience with Twinlist were used in this study. They used both Control Interface and Twinlist.

Image of Twinlist user interface


Participants completed both reconciliation tasks significantly faster (P = 0.006) using Twinlist (M = 211.4 s, SD = 54.5 s) compared to using Control (M = 293.2 s, SD = 133.3 s). The mean improvement was 81.8 s, an 18% improvement.


This study evaluated the effectiveness of a novel interface (Twinlist), which uses a spatial layout to reveal similarities and differences, staged animation, and carefully designed interaction to facilitate medication reconciliation in a medical provider population. Twinlist reduced reconciliation time by 18% and the number of clicks and scrolls by 40% and 60%, respectively. Overall, three times as many errors were made with the Control interface than with Twinlist, driven by dramatic improvements observed for three participants. These results suggest that cognitive support through interface design can have a significant impact on patient safety.


Due to the constant issues that we encounter with medication reconciliation, this article was very interesting. I believe that making the user experience better is one very important step in making this process as accurate as possible to prevent medication errors and better patient care. Human factors design is one area of study that strives to improve the user experience as described above. It is beginning to gain a presence in EHR design discussions.


  1. Catherine Plaisant , Johnny Wu , A. Zach Hettinger , Seth Powsner , Ben Shneiderman DOI: First published online: 9 February 2015.