Toward intelligent display of health data: A qualitative study of use patterns

描述（由申请人提供）：随着存储和共享电子健康数据能力的扩展，对患者健康数据进行分类、优先排序和上下文链接变得越来越重要。使用电子健康记录的提供者抱怨说，他们很难迅速找到所需的信息，而且可能遗漏关键信息。不同数据的重要性取决于与患者、访问数据的临床医生以及访问数据的上下文相关的细节。在这个项目中，我们将采用知识启发的方法来研究临床医生的信息获取模式和优先级。我们的方法包括新颖地使用真实临床环境中记录的眼动追踪数据来支持信息访问的回顾性口头协议分析。具体来说，研究人员将采访提供者，并要求他们在观看提供者在患者护理背景下实际信息寻找过程中所看、所做和所说的视频时，描述他们在做什么和想什么。我们将使用定性数据分析方法（开放编码和轴向编码的持续比较分析）来确定在两个机构的重症监护背景下与信息寻求相关的新主题，这两个机构的存储和呈现电子健康数据的过程非常不同。我们的主要目标是利用这项工作的结果来制定原则，以改进电子健康记录中数据的组织和优先顺序。第二个目标是确定电子健康数据重要性排序的具体标准，以促进未来先进计算方法的发展，这些方法将支持替代显示技术，使护理人员能够轻松地快速查找和解释相关的重要信息。以前的研究主要集中在：(1)访谈或焦点小组形式的定性研究，强调提供者可以很容易地回忆起的信息，缺乏提供者如何在现场使用数据的现实表现；或(2)缺乏解释力的现场观察或技术，如按键数据捕获。结合现场观测数据和丰富的评论，通过回溯性的口头协议，在实际数据使用的眼动追踪视频记录的背景下，是一种利用两种方法优势的创新技术。电子健康记录的研究人员、设计人员和开发人员可以利用这项工作的结果，更好地组织和智能地显示患者数据，以支持临床决策。该研究项目具有重要意义，因为它有可能通过更快地访问和分析数据来提高患者护理效率，并通过减少关键信息被忽视或误解的机会来提高安全性。

DESCRIPTION (provided by applicant): As capabilities for storing and sharing electronic health data expand, it becomes increasingly important to classify, prioritize, and contextually link patient health data. Providers using electronic health records complain that it is difficult for them to rapidly find the information they need and that key information can be missed. Different data is important depending on details associated with the patient, the clinician who is accessing the data, and the context in which data are accessed. In this project we will employ knowledge elicitation methods to study information access patterns and priorities of clinicians. Our approach involves the novel use of recorded eye-tracking data from true clinical environments to support retrospective verbal protocol analysis of information access. Specifically, researchers will interview providers and ask them to describe what they were doing and thinking while watching video-playback of what the provider looked at, did, and said during actual information seeking in the context of patient care. We will use qualitative data analysis methods (constant comparative analysis with open and axial coding) to identify emerging themes related to information seeking in the context of intensive care at two institutions with very different processes for storing and presenting electronic health data. Our primary goal is to use the results of this effort to generate principles to improve the organization and prioritization of data in electronic health records. A secondary goal is to identify specific criteria for ranking the importance of electronic health data for future development of advanced computational methods that will support alternative display techniques to make it easy for caregivers to find and interpret relevant and important information quickly. Previous research has focused on either (1) qualitative research in the form of interviews or focus groups that emphasizes information that the provider can easily recall and lacks a realistic representation of how providers use data in the field, or (2) field observations or techniques such as key press data capture that lack explanatory power. Integrating field observation data and rich commentary through retrospective verbal protocol in the context of an eye-tracking video record of actual data use is an innovative technique to capitalize on strengths of both approaches. Researchers, designers, and developers of electronic health records can use the results of this effort toward better-organized and perhaps intelligent display of patient data to support clinical decisions. This research project is significant in its potential to increase efficiency in patient care through faster access and analysis of data and to improve safety by reducing the chances that critical information is overlooked or misinterpreted.