Table 3 Representative verbalizations about the timeline visual for patient history of colorectal cancer screening

"This [timeline] is really useful - they had an outside colonoscopy in 2006, there were multiple polyps removed. ... I like the design of it. I like to be able to look at a glance, especially the one that said hemocult, hemocult, hemocult [gesturing to different points in time]."

"Yeah I'd probably use it I think it's an easier, visual way to see than the notes. And it's more reliable than patient memory. I would definitely be more likely to use something like that [timeline]. I think the timeline is easy to follow since it goes from left to right and easily highlights when it [CRC screening] was done."

"So this is nice, I can see that he did have his colonoscopy - 2006 multiple polyps, which was abnormal. So it looks like he'll need a repeat. And that's good that this is all in one place, so I know where to go."

Negative

"You know - past information...I prefer text to anything graphical. We're just used to seeing text. I would just want to see it as a list in consecutive order."

Further Improvements

[Currently] you have all the procedures listed together on one line [in the timeline - FOBT, flex sig, colonoscopy]. I'd like to see the FOBTs separated on different line...or maybe in a different color or smaller or below the bars instead of all on the same horizontal line because in my mind I have to separate those things out because they mean different things to me in terms of what needs to be done next. So if those were separated for me in advance, it would speed my mental processing."

"The other thing that would speed things up slightly is if the computer just calculates how many years it's been since those things have been done and throws that on there - maybe just enter the procedure that's like 2005 and it could say, 'the flex sig, 4 years ago'. And that way I won't have to do the subtraction for every item that appears there - the subtraction is already done for me."

Reliability and Accuracy

"The thing I worry about is how is that data...is it accurate? I mean how does it get in there? You know what I mean? Like one of these is an outside report and if it's an outside report, how does it get into CPRS? But assuming it was magically accurate, it would be good. I like the design of it."

"The only thing would be you'd have to have a sense that that would be something that is very reliable so that you wouldn't have to... if it missed something somewhere for instance that would prompt me to have to go look for things on my own again. As long as it's a reliable system. Because it really just takes one episode of something like this missing something and then from then on out you're not using the tool because if it's going to miss stuff I'll just look it all up myself."