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

项目摘要/摘要 重要性：糟糕的电子健康记录(EHR)设计可能会导致提供者忽略关键数据， 从而阻碍决策，并对患者的安全和护理质量产生不利影响。通常 ICU提供商每天使用EHR 3.3小时，每月监控250万个数据点， 对每位患者每天187次警报做出响应可视化是将文本数据转换为可视数据的科学 展示。仪表板是一种新颖的信息可视化方法，用于组织数据并保持以下潜力 减少信息和认知过载，从而通过增加 效率和可靠性。 目的：研究新的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)通过测量来表征电子病历信息过载对护理质量的影响 使用实时来规定提供商的性能、信息搜索负载、信息处理负载 实验室环境中的机构Epic®和Cerner®EHR中的患者数据。 (2)评价信息可视化对提供者决策的影响；绩效；效率； 在一项随机对照试验中，通过真实的患者数据进行疲劳、工作量和满意度。 (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环境中实践，使用与ICU提供者的指导性访谈。 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®站点(北卡罗来纳州大学、梅奥大学 诊所)和两个Cerner®网站(匹兹堡大学的MedStar)。第一项研究的目的是描述 当前电子病历信息过载对提供者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提高决策、效率、 通过随机试验将提供者的表现与他们的机构HER进行比较。第三，我们将进行 引导式访谈，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)增加新的 了解当前电子病历中与信息过载相关的患者安全风险；2)确定 可视化工具与突出的EHR界面Epic®和Cerner®相比的效率；以及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 可视化工具可能会改善提供商的决策过程，我们预计其使用量将会增加 保障患者安全，减少医疗差错的发生。

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.