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.

项目摘要/摘要 重要性：电子健康记录（EHR）的设计差会导致提供商忽略关键数据， 因此，阻碍了决策，并对患者的安全和护理质量产生不利影响。通常 ICU提供商每天花费3.3个小时，每月监视250万个数据点，并且 对每天每天可视化的187个警报做出响应是将文本数据转换为视觉的科学 展示。仪表板是组织数据并保持潜力的新型信息可视化方法 减少信息和认知超负荷，从而改善提供商的决策 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的效率以改善ICU 提供者的决策，效率和满意度。 具体目的：（1）通过测量来表征EHR信息过载对护理质量的影响 开处方提供者的绩效，寻求负载的信息，使用实时的信息处理负载 在实验室环境中，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的影响；表现;效率; 疲劳;工作量；在随机对照试验中通过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 在ICU环境中练习，使用与ICU提供商的有指导性访谈。 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®网站（UNC，Mayo 诊所）和两个Cerner®地点（匹兹堡大学Medstar）。第一个研究将旨在表征 当前EHR信息超载对提供商信息处理能力的影响。第二，我们将测试 使用信息可视化仪表板的效率来提高决策，效率， 通过随机试验，提供者的绩效与她的机构相比。第三，我们将进行 指导访谈以了解提供者对实施和使用可视化的看法 实际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）添加新的结果 当前EHR中，有关信息过度相关的患者安全风险的知识； 2）确定 与突出的EHR接口EPIC®和Cerner®相比，可视化工具的功效； 3）创建 有关可视化实施指南和可用性最佳实践的新知识。因为 可视化工具可以改善提供商的决策过程，我们预计其使用将增加 患者安全并减少医疗错误的数量。