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的能力扩展，对患者健康数据进行分类、优先级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，而且可能会遗漏关键信息。根据与患者、访问数据的临床医生以及访问数据的上下文相关的详细信息，不同的数据很重要。在这个项目中，我们将采用知识启发的方法来研究信息的访问模式和优先级的临床医生。我们的方法涉及新的使用记录的眼动跟踪数据从真实的临床环境，以支持回顾性的口头协议分析的信息访问。具体来说，研究人员将采访提供者，并要求他们描述他们在观看视频回放时所做的事情和想法，这些视频播放了提供者在患者护理背景下寻求实际信息时所看到的，所做的和所说的。我们将使用定性数据分析方法（开放式和轴向编码的持续比较分析），以确定与重症监护背景下的信息寻求相关的新兴主题，这两个机构具有非常不同的存储和呈现电子健康数据的过程。我们的主要目标是利用这项工作的结果来制定原则，以改善电子健康记录中数据的组织和优先级。第二个目标是确定对电子健康数据重要性进行排名的具体标准，以便将来开发先进的计算方法，支持替代显示技术，使护理人员能够轻松快速地找到和解释相关和重要的信息。以前的研究集中在（1）以访谈或焦点小组的形式进行的定性研究，强调提供者可以轻松回忆的信息，缺乏提供者如何在现场使用数据的现实表示，或（2）现场观察或技术，如缺乏解释力的按键数据捕获。在实际数据使用的眼动跟踪视频记录的背景下，通过回顾性口头协议将现场观察数据和丰富的评论整合在一起，是一种利用这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一努力的结果，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的潜力，可以通过更快地访问和分析数据来提高患者护理的效率，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.