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

项目概要/摘要 重要性：电子健康记录（EHR）设计不当可能导致提供者忽视关键数据， 从而妨碍决策并不利地影响患者安全和护理质量。通常 每天使用EHR 3.3小时，ICU提供者每月监控250万个数据点， 可视化是一门将文本数据转换为可视化信息的科学。 显示.仪表板是一种新颖的信息可视化方法，用于组织数据， 减少信息和认知超载，从而通过增加供应商的决策能力， 高效可靠。 目的：探讨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EHR信息过载对护理质量的影响 规定供应商的性能，信息寻求负荷，信息处理负荷使用实时 实验室环境中Epic®和Cerner® EHR机构中的患者数据。 (2)评估信息可视化对供应商决策、绩效、效率的影响; 疲劳、工作量和满意度，通过随机对照试验中的真实的患者数据。 (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环境中进行实践，使用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®研究中心（ESTA，马约 诊所）和两个Cerner®研究中心（MedStar，匹兹堡大学）。第一项研究旨在描述 当前EHR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来提高决策、效率 通过随机试验将供应商的性能与其机构HER进行比较。第三，我们将开展 引导式访谈，以了解提供商对可视化实施和使用的看法 真实的ICU环境中的仪表板。 讨论：我们预计，完成这些目标将产生以下成果：1）增加新的 了解当前EHR中与信息过载相关的患者安全风险; 2）确定 与著名的EHR接口Epic®和Cerner®相比，可视化工具的有效性;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 可视化工具可以改善供应商的决策过程，我们预计其使用将增加 患者安全，减少医疗差错。

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.