Improving Providers’ Decision-Making and Reducing Information Overload Using Information Visualization in Electronic Health Records

使用电子健康记录中的信息可视化改进提供商的决策并减少信息过载

• 批准号: 10180237
• 负责人: Saif Khairat
• 金额: $ 34.6万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-03 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10180237
• 关键词: Academic Medical Centers; Address; Affect; Area; Clinic; Clinical Data; Cognitive; Complex; Computer Systems; Consumption; Control Groups; Critical Illness; Data; Data Analyses; Decision Making; Diagnostic; Electronic Health Record; Environment; Eye; Fatigue; Frequencies; Goals; Guidelines; Hour; Individual; Intensive Care Units; Interview; Intuition; Knowledge; Laboratories; Leadership; Measures; Medical Errors; Medical center; Methods; Monitor; Mus; Nurse Practitioners; Outcome; Patients; Perception; Performance; Physician Assistants; Physicians; Process; Provider; Pupil; Quality of Care; Questionnaires; Randomized; Randomized Controlled Trials; Research; Research Design; Risk; Science; Severities; Site; Surveys; System; Time; United States National Aeronautics and Space Administration; Universities; Visit; Visual; Visualization; Visualization software; Workload; base; constriction; control trial; dashboard; design; efficacy testing; experience; group intervention; heterogenous data; improved; indexing; information processing; novel; patient safety; randomized trial; recruit; response; sample fixation; satisfaction; simulation; tool; trial comparing; usability; visual tracking

Project Summary/Abstract Importance: Poor design of electronic health records (EHR) can cause providers to overlook crucial data, consequently impeding decision-making and adversely affecting patient safety and quality of care. Typically spending 3.3 hours per day using the EHR, ICU providers monitor 2.5 million data points per month and respond to 187 alerts per patient per day Visualization is the science of transforming textual data into a visual display. Dashboards are novel information visualization methods to organize data and hold the potential to reduce information and cognitive overload, thereby improving providers' decision-making through increased efficiency and reliability. Objective: Our goal is to investigate the efficacy of novel information visualization methods to improve ICU providers' decision-making, efficiency, and satisfaction. Specific aims: (1) Characterize the effect of EHR information overload on the quality of care by measuring prescribing providers' performance, information seeking load, information processing load using real-time patient data in institutional Epic® and Cerner® EHR in a laboratory setting. (2) Evaluate the effect of information visualization on providers' decision making; performance; efficiency; fatigue; workload; and satisfaction through real patient data in a randomized controlled trial. (3) Determine the acceptability, ease of use, and barriers to implementing information visualization dashboards into practice in an ICU setting, using guided interviews with ICU providers. Study Design: We will recruit ICU providers from four academic medical centers: two Epic® sites (UNC, Mayo Clinic) and two Cerner® sites (MedStar, University of Pittsburgh). The first study will aim to characterize the effect of current EHR information overload on providers' information processing abilities. Second, we will test the efficacy using an information visualization dashboard to improve the decision-making, efficiency, performance of providers compared to their institutional HER through a randomized trial. Third, we will conduct guided interviews to understand provider's perceptions around the implementation and use of visualization dashboard in real ICU settings. Discussion: We anticipate that completion of these aims will yield the following outcomes: 1) to add new knowledge around information overload-related patient safety risks in current EHRs; 2) to determine the efficacy of a visualization tool compared to prominent EHR interfaces Epic® and Cerner®; and 3) to create new knowledge around visualization implementation guidelines and usability best-practices. Because the visualization tool may improve the decision-making process for providers, we expect its use will increase patient safety and decrease the number of medical errors.

项目概要/摘要 重要性：电子健康记录 (EHR) 的设计不当可能会导致提供者忽视关键数据， 因此，通常会阻碍决策并对患者安全和护理质量产生不利影响。 ICU 提供者每天花费 3.3 小时使用 EHR，每月监控 250 万个数据点， 每位患者每天响应 187 个警报 可视化是将文本数据转换为视觉数据的科学 仪表板是一种新颖的信息可视化方法，用于组织数据并具有潜力。 减少信息和认知超载，从而通过增加 效率和可靠性。 目的：我们的目标是研究新型信息可视化方法对改善 ICU 的有​​效性 供应商的决策、效率和满意度。 具体目标： (1) 通过测量来表征 EHR 信息过载对护理质量的影响 实时规定提供商的性能、信息搜索负载、信息处理负载 实验室环境中机构 Epic® 和 Cerner® EHR 中的患者数据。 (2) 评估信息可视化对提供商决策绩效的影响； 疲劳；工作量；以及随机对照试验中真实患者数据的满意度。 (3) 确定实施信息可视化仪表板的可接受性、易用性和障碍 通过与 ICU 提供者的指导访谈，在 ICU 环境中进行实践。 研究设计：我们将从四个学术医疗中心招募 ICU 提供者：两个 Epic® 中心（北卡罗来纳大学、梅奥 诊所）和两个 Cerner® 站点（MedStar，匹兹堡大学）。 第一项研究旨在描述该研究的特征。 当前 EHR 信息过载对提供者信息处理能力的影响 其次，我们将测试。 使用信息可视化仪表板提高决策、效率、 第三，我们将通过一项随机试验将提供者的表现与其机构 HER 进行比较。 引导访谈，以了解提供商对可视化实施和使用的看法 真实 ICU 设置中的仪表板。 讨论：我们预计这些目标的完成将产生以下结果：1）添加新的 了解当前 EHR 中与信息超载相关的患者安全风险；2) 确定 与著名的 EHR 界面 Epic® 和 Cerner® 相比，可视化工具的功效；以及 3) 创建； 围绕可视化指南和可用性最佳实践的新知识。 可视化工具可以改善提供商的决策过程，我们预计其使用将会增加 患者安全并减少医疗错误的数量。