information. Further, radio frequency identification (RFID) technology may replace bar codes on external packaging altogether, particularly in light of the growing problems with counterfeit drug imports entering the U.S. market. However, RFID will not replace the need for standardized bar code systems for patient care.

User Interface

The ability of clinicians to use a medical device or decision-support system successfully depends on how well the technologies have been designed at the level of the human–machine interaction (i.e., user interface). From the user’s perspective, the interface is the system (Shortliffe et al., 2001). When interacting with technology, clinicians aim to carry out tasks in which information is assessed, manipulated, or created (van Bemmel and Musen, 1997). The quality and style of the interface directly affect this processing of information. Well-organized information that is presented in a logical and meaningful way results in a higher degree of usability, whereas the display of information in a cluttered, illogical, or confusing manner leads to decreases in user performance and satisfaction (van Bemmel and Musen, 1997). Most important, a poorly designed user interface can even contribute to medication errors for all drug-related technologies (Patterson et al., 2002; Ash et al., 2004; Koppel et al., 2005).

As noted earlier, several studies have confirmed that many medication errors resulting in patient harm involve intravenous infusion devices, with the most common cause of the errors being incorrect programming (Kaushal et al., 2001; Taxis and Barber, 2003; Tourville, 2003). Several problems with the interface design for these devices in terms of programming keys, display screens, and menu structure have contributed to these high rates of ADEs. In an effort to simplify programming and reduce pump size, a limited number of programming keys are provided on the pumps. Each key serves multiple functions, and clinical protocol is selected through scroll menus. However, menu structures are so complex that even skilled users could easily get confused (Nemeth, 2003). Device programming is often further complicated by small display screens that are difficult to read and follow. As a result, the state of the infusion pump is not always obvious during each step of the process. Even small data entry errors can result in numerous unforeseen medical complications that cause patient harm. Clinicians frequently must power down the pumps and start over to clear programming mistakes. Device manufacturers have been working to improve the user interface by incorporating the principles of human factors engineering into the pumps’ design structure. Standards for human factors design have been established by the Association for the Advancement of Medical Instrumentation (AAMI) and approved by the American National



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