Developing Design Principles to Integrate PROs into clinical practice through HIT: Data, user experience, and workflow requirements for PRO Dashboards

制定设计原则，通过 HIT 将 PRO 集成到临床实践中：PRO 仪表板的数据、用户体验和工作流程要求

• 批准号: 8858203
• 负责人: David R Flum
• 金额: $ 48.7万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8858203
• 关键词: Developing; Design; Principles; Integrate; PROs

 DESCRIPTION (provided by applicant): Incorporating Patient-Reported Outcomes (PROs) into clinical assessments and decision making improves patient-provider communication, patient satisfaction, and treatment monitoring. Although PRO data is starting to be included in health information technology (HIT) platforms, most healthcare providers have little experience using PRO displays or incorporating PRO data into health care activities. As part of the Agency for Healthcare Research and Quality-sponsored Washington State Comparative Effectiveness Research Translation Network (CERTAIN), we began a process of sharing PRO data with healthcare providers in clinics across Washington State in 2012. We developed a prototype web-based PRO platform (PROs in Practice) for collecting and presenting PROs to healthcare teams. Focusing on the presentation of PROs through a dashboard, we recruited physicians, nurses, and other members of healthcare teams to provide feedback about the platform's form and function. This pilot work uncovered large gaps in evidence about the needs of those users for integrating PROs into their practice. We found that simply adding PRO metrics to structured medical records led to unintended consequences. Healthcare practitioners and staff raised concerns about the negative impact of using PRO dashboards on clinic workflow, the need to tailor visual displays to the needs of different types of healthcare team members, and uncertainties related to missing data and validity. To more effectively integrate PROs into clinical care, a set of evidence-based design principles related to workflow, user-experience, and validity/interpretability specific to PROs needs to be developed. To address this gap we plan to work across CERTAIN's clinical sites and employ systems engineering methods, human-centered design, and mixed-research methods to develop design principles that will ultimately enable more effective integration of PRO data into patient care activities through HIT. We propose three aims: (1) Evaluate the information needs and healthcare decision making processes regarding the integration and interpretability of PRO data; (2) Specify healthcare practitioner user requirements for interactive PRO visualizations through human-centered methods; and (3) Characterize clinical workflow needs and impact associated with integration of PROs into clinical care activities through HIT platforms. There is broad interest in incorporating PRO data into clinical care, but important questions remain about how these data can be most effectively used without a negative impact. The proposed studies address fundamental issues for HIT related to PROs and will inform design principles related to workflow, optimal user experience, and data comprehension and interpretation. Since they are being developed in a diverse statewide network, these design principles are likely to be relevant to others across the nation who are, or will soon be, working on effective integration of PROs into clinical care.

 描述（由应用程序提供）：将患者报告的结果（PRO）纳入临床评估和决策，可改善患者提供者的沟通，患者满意度和治疗监测。尽管PRO数据开始包含在健康信息技术（HIT）平台中，但大多数医疗保健提供者使用Pro展示或将PRO数据纳入医疗保健活动的经验很少。作为医疗保健研究机构和质量赞助的华盛顿州比较有效性研究翻译网络（某些）的一部分，我们于2012年开始与华盛顿州诊所的医疗保健提供者共享PRO数据。我们开发了一个基于Web的Protype Pro Pro平台（实践中的ProS），用于收集和向医疗团队收集和呈现。我们专注于通过仪表板来展示专业人士，我们招募了医生，护士和医疗团队的其他成员，以提供有关平台形式和功能的反馈。这项飞行员工作发现了有关这些用户将专业人士纳入实践的需求的巨大差距。我们发现，仅将专业指标添加到结构化的医疗记录中，就会导致意想不到的后果。医疗保健实践者和员工对使用专业仪表板在诊所工作流程上的负面影响，对不同类型的医疗团队成员的需求进行量身定制的不利影响以及与缺失数据和有效性有关的不确定性的不利影响提出了担忧。要更有效地将专业人士整合到临床护理中，这是一系列与工作流，用户体验以及特定于PRO的有效性/解释性有关的基于证据的设计原则。为了解决这一差距，我们计划在某些临床站点和员工系统工程方法，以人为中心的设计以及混合研究方法来制定设计原理，以最终使Pro数据通过HIT纳入患者护理活动。我们提出三个目标：（1）评估有关PRO数据集成和解释性的信息需求和医疗保健决策过程； （2）通过以人为本的方法指定医疗保健从业人员用户的需求； （3）表征了通过HIT平台将专业人士集成到临床护理活动中相关的临床工作流程需求和影响。人们对将Pro数据纳入临床护理有广泛的兴趣，但是关于如何最有效地使用这些数据而不会产生负面影响的重要问题。拟议的研究涉及与专业人士有关的HIT的基本问题，并将为与工作流，最佳用户体验以及数据理解和解释有关的设计原则提供信息。由于它们是在全州潜水员网络中开发的，因此这些设计原则可能与全国其他人有关，或者很快就会有效地将Pros整合到临床护理中。