Quantifying Electronic Medical Record Usability to Improve Clinical Workflow

量化电子病历可用性以改善临床工作流程

• 批准号: 8665456
• 负责人: ZIA AGHA
• 金额: $ 46.45万
• 依托单位: VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8665456
• 关键词: Quantifying; Electronic; Medical; Record; Usability

DESCRIPTION (provided by applicant): We propose to conduct a prospective clinical study to understand how clinical work is actually done in outpatient clinics that use EMRs, and to explore associations between EMR usage, workflow, physician-patient communication, cognitive load, and user satisfaction. The proposed study will use an observational prospective design consistent with the knowledge discovery goals of the project. The study will be conducted in the outpatient clinics at VA San Diego and at University of California San Diego (UCSD) Healthcare System. Within the outpatient arena, we will study 2 use case scenarios (primary care clinics and medical specialty clinics). We propose to recruit and study 32 providers and 192 patients (6 unique patient visits/provider) across 2 sites. A multifaceted and complementary data collection schema is proposed to study EMR usability, workflow, communication, and cognitive load. EMR user-interface activity, including mouse-click events and screen activity, will be logged via usability software. Videos will be temporally coded for communication and workflow behaviors. Surveys will be used to measure satisfaction and cognitive load. The analysis consists of development of a range of process-level quantitative measures and indicators of EMR usage, clinical workflow, and provider-patient communication. We will link data on EMR use and clinical work to develop composite models of EMR usability, clinical workflow, and provider's cognitive load and will explore associations between these indicators across study sites (UCSD and VA), provider types (Primary and Specialty), patient visits, and EMRs (CPRS and EPIC) while accounting for important covariates. The present study will provide a comprehensive assessment of usability, workflow, communication, and cognitive load. This critical knowledge can inform the development of the next generation of user-centered EMRs, hence improving clinical performance and effectiveness.

描述（由申请人提供）：我们建议进行一项前瞻性临床研究，以了解在使用EMR的门诊诊所实际上如何完成临床工作，并探索EMR使用，工作流程，医师沟通，认知负载和用户满意度之间的EMR使用情况之间的关联。拟议的研究将使用与该项目的知识发现目标一致的观测前瞻性设计。该研究将在弗吉尼亚州圣地亚哥的门诊诊所和加利福尼亚大学圣地亚哥分校（UCSD）医疗保健系统进行。在门诊舞台上，我们将研究2个用例情景（初级保健诊所和医学专业诊所）。我们建议在2个站点招募和研究32名提供者和192名患者（6例独特的患者访问/提供者）。提出了一个多方面和互补的数据收集模式来研究EMR可用性，工作流，通信和认知负载。 EMR用户界面活动，包括鼠标单击事件和屏幕活动，将通过可用性软件记录。视频将在暂时地编码，以进行沟通和工作流程行为。调查将用于衡量满意度和认知负荷。该分析包括开发一系列过程级别的定量度量以及EMR使用，临床工作流程和提供者与患者通信的指标。我们将链接有关EMR使用和临床工作的数据，以开发EMR可用性，临床工作流程以及提供商的认知负载的复合模型，并将探索研究站点（UCSD和VA），提供商类型（主要和专业），患者访问和EMR和EMR（CPRS和EPIC）的这些指标之间的关联。本研究将对可用性，工作流，沟通和认知负荷进行全面评估。这种批判性知识可以为下一代以用户为中心的EMR的发展提供信息，从而提高临床性能和有效性。