Enhancing Clinical Information Display to Improve Patient Encounters: Human-Centered Design and Evaluation of the Parkinson Disease-BRIDGE Platform.
Enhancing Clinical Information Display to Improve Patient Encounters: Human-Centered Design and Evaluation of the Parkinson Disease-BRIDGE Platform.
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DOI：
10.2196/33967
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发表时间：
2022-05-06
影响因子：
2.7
通讯作者：
Bove, Riley
中科院分区：
文献类型：
--
作者：
Brown, Ethan G.;Schleimer, Erica;Bledsoe, Ian O.;Rowles, William;Miller, Nicolette A.;Sanders, Stephan J.;Rankin, Katherine P.;Ostrem, Jill L.;Tanner, Caroline M.;Bove, Riley
关键词：
帕金森病 (PD) 患者有各种复杂的医疗问题，需要在每次临床遇到时进行详细审查，以进行适当的治疗。其他复杂病症的护理受益于有效整合不同临床信息的数字健康解决方案。尽管已经开发了各种数字方法用于帕金森病的研究和护理，但还没有现成的数字解决方案可以在临床治疗中实现个性化和改善沟通。我们打算通过开发一个平台 (PD-BRIDGE)，利用来自电子健康记录 (EHR) 和患者报告结果 (PRO) 数据的个性化临床信息，提高 PD 患者临床治疗的功效和效率。使用以人为本的设计 (HCD) 流程，我们让临床医生和患者利益相关者通过三个阶段开发 PD-BRIDGE：灵感阶段涉及焦点小组并与 PD 患者进行讨论，构思阶段生成初步模型以获取反馈，以及实施阶段测试平台。为了定性评估该平台，运动障碍神经科医生和 PD 患者在遇到 PD-BRIDGE 后收到了调查问卷，询问其技术有效性、可用性和临床相关性。 HCD 流程产生了一个包含 4 个模块的平台。其中，从 EHR 中提取数据的 3 个模块包括显示随时间变化的运动评级的纵向模块、显示最近收集的临床评级量表的显示模块以及显示相关实验室值和诊断的另一个显示模块；第四个模块根据家庭日记显示运动症状波动。在实施阶段，PD-BRIDGE 在 17 次临床诊疗中使用，患者由 11 名运动障碍神经科医生中的 1 名护理。大多数患者认为 PD-BRIDGE 促进了与临床医生的沟通 (n=14, 83%)，并帮助他们了解自己的疾病轨迹 (n=11, 65%) 和临床医生的建议 (n=11, 65%)。神经科医生认为 PD-BRIDGE 提高了他们了解患者病程的能力（n=13，占就诊次数的 75%），支持临床护理建议（n=15，占 87%），并帮助他们与患者沟通（n=14，占 81%）。在改进方面，神经学家指出，PD-BRIDGE 中的数据在 62% (n=11) 的遭遇中并不详尽。将 EHR 和 PRO 数据中的临床相关信息集成到可视化高效平台 (PD-BRIDGE) 中可以促进与 PD 患者的临床接触。开发具有更多不同信息的新模块可以进一步改善这些复杂的遭遇。
People with Parkinson disease (PD) have a variety of complex medical problems that require detailed review at each clinical encounter for appropriate management. Care of other complex conditions has benefited from digital health solutions that efficiently integrate disparate clinical information. Although various digital approaches have been developed for research and care in PD, no digital solution to personalize and improve communication in a clinical encounter is readily available. We intend to improve the efficacy and efficiency of clinical encounters with people with PD through the development of a platform (PD-BRIDGE) with personalized clinical information from the electronic health record (EHR) and patient-reported outcome (PRO) data. Using human-centered design (HCD) processes, we engaged clinician and patient stakeholders in developing PD-BRIDGE through three phases: an inspiration phase involving focus groups and discussions with people having PD, an ideation phase generating preliminary mock-ups for feedback, and an implementation phase testing the platform. To qualitatively evaluate the platform, movement disorders neurologists and people with PD were sent questionnaires asking about the technical validity, usability, and clinical relevance of PD-BRIDGE after their encounter. The HCD process led to a platform with 4 modules. Among these, 3 modules that pulled data from the EHR include a longitudinal module showing motor ratings over time, a display module showing the most recently collected clinical rating scales, and another display module showing relevant laboratory values and diagnoses; the fourth module displays motor symptom fluctuation based on an at-home diary. In the implementation phase, PD-BRIDGE was used in 17 clinical encounters for patients cared for by 1 of 11 movement disorders neurologists. Most patients felt that PD-BRIDGE facilitated communication with their clinician (n=14, 83%) and helped them understand their disease trajectory (n=11, 65%) and their clinician’s recommendations (n=11, 65%). Neurologists felt that PD-BRIDGE improved their ability to understand the patients’ disease course (n=13, 75% of encounters), supported clinical care recommendations (n=15, 87%), and helped them communicate with their patients (n=14, 81%). In terms of improvements, neurologists noted that data in PD-BRIDGE were not exhaustive in 62% (n=11) of the encounters. Integrating clinically relevant information from EHR and PRO data into a visually efficient platform (PD-BRIDGE) can facilitate clinical encounters with people with PD. Developing new modules with more disparate information could improve these complex encounters even further.
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DOI：
10.1093/intqhc/mzaa127
发表时间：
2021-01-12
期刊：
International journal for quality in health care : journal of the International Society for Quality in Health Care
影响因子：
--
作者：
Melles M;Albayrak A;Goossens R
通讯作者：
Goossens R
影响因子：
4.1
作者：
Hill EJ;Mangleburg CG;Alfradique-Dunham I;Ripperger B;Stillwell A;Saade H;Rao S;Fagbongbe O;von Coelln R;Tarakad A;Hunter C;Dawe RJ;Jankovic J;Shulman LM;Buchman AS;Shulman JM
通讯作者：
Shulman JM
影响因子：
4.4
作者：
Arndt, Brian G.;Beasley, John W.;Gilchrist, Valerie J.
通讯作者：
Gilchrist, Valerie J.
DOI：
10.1093/jamia/ocv189
发表时间：
2016-09
期刊：
Journal of the American Medical Informatics Association : JAMIA
影响因子：
--
作者：
Mandel JC;Kreda DA;Mandl KD;Kohane IS;Ramoni RB
通讯作者：
Ramoni RB
影响因子：
81.5
作者：
Poewe, Werner;Seppi, Klaus;Lang, Anthony E.
通讯作者：
Lang, Anthony E.