Right Place, Right Time: Information Design to Support Decisions in Acute Care

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 DESCRIPTION (provided by applicant): Improving electronic health care information organization, prioritization, and presentation to support patient care is a crucial patient safety priority. Each year tens of thousands of patients are harmed because important information is missed, misunderstood, or identified too late. Providers complain that it is difficult for them to find the information they need quickly and that key information can be missed. Technological advances intended to help providers detect important patient changes or follow through with evidence-based care activities are underway in the form of intelligent surveillance and decision support tools. However, these tools are often perceived as simply adding more to the information load. The primary objective of this project is to implement a user-centered design process to establish design guidelines and evaluate design concepts to better organize, prioritize, and present acute care electronic patient information. Our approach begins by conducting knowledge elicitation activities including interviews, card sorting, and ranking to capture the way acute care information is organized and prioritized in the minds of critical care providers. To account for the importance of context and complexity in health care information organization and prioritization, we will conduct our activities in the context of realistic patientuse cases. We will use the findings from these activities to inform an iterative user-centered design process to create and evaluate conceptual designs for smarter, more effective patient information displays. In our recent qualitative study of information use in critical care settings, we identified a need to design information presentation to support prioritizing patients and tasks, monitoring patients for impending crises or risks, tracking patient status and progress toward goals, and rapid directed information access of dynamic patient data. Thus, our conceptual designs will have these goals as a primary focus. We will conduct interviews, implement heuristic inspection methods, and apply usability testing of design concepts to develop a functioning design prototype. Finally, we will use the findings of this effort to generate knowledge in the form of design guidelines for healthcare information presentation. We expect our work to result in highly effective critical care patient information presentation. In particula, we expect our work to inform: presentation of dynamic patient data, presentation of information generated or interpreted by intelligent systems, and means of identifying and conveying clinical relevance and urgency. Our innovative approach includes the use of rigorous user-centered design methods to identify meaningful schemes for organizing patient data. We will integrate these findings with novel techniques of conveying valuable data characteristics such as urgency and change over time. The results of this project can be applied to the design of future electronic health records so that important data are not missed and can be accessed easily and quickly. In intensive care units as well as other care settings, we expect the results of this effot to significantly reduce clinician workload and preventable adverse events.