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，他们很难快速找到他们需要的信息，而且关键信息可能会被遗漏。不同的数据很重要，这取决于与患者相关的详细信息、访问数据的临床医生以及访问数据的环境。在这个项目中，我们将使用知识启发方法来研究临床医生的信息获取模式和优先顺序。我们的方法包括从真实的临床环境中新颖地使用记录的眼球跟踪数据来支持信息获取的回溯性语言协议分析。具体地说，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正在做什么和在想什么-在病人护理的背景下，提供者在实际寻找信息的过程中看了什么，做了什么，说了什么。我们将使用定性数据分析方法(开放式和轴向编码的恒定比较分析)，在两个存储和呈现电子健康数据的流程截然不同的机构中，确定与重症监护背景下的信息寻求相关的新兴主题。我们的主要目标是利用这一努力的结果来制定原则，以改进电子健康记录中数据的组织和优先顺序。第二个目标是确定对电子健康数据的重要性进行排名的具体标准，以便未来开发先进的计算方法，这些方法将支持替代显示技术，使护理人员更容易快速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，并且缺乏提供者如何在现场使用数据的现实表示，或者(2)缺乏解释力的现场观察或技术，例如按键数据捕获。通过回溯性口头协议将实地观察数据和丰富的评论结合到实际数据使用的眼睛跟踪视频记录中，是一种利用这两种方法的长处的创新技术。电子健康记录的研究人员、设计师和开发人员可以利用这一努力的结果来更好地组织患者数据，甚至是智能地显示患者数据，以支持临床决策。这一研究项目的重要意义在于，它有可能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.