Appl Clin Inform - Impact of a prototype visualization tool for new information in EHR clinical documents.

Tópicos

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Resumo

CKGROUND: EHR clinical document synthesis by clinicians may be time-consuming and error-prone due to the complex organization of narratives, excessive redundancy within documents, and, at times, inadvertent proliferation of data inconsistencies. Development of EHR systems that are easily adaptable to the user's work processes requires research into visualization techniques that can optimize information synthesis at the point of care.OBJECTIVE: To evaluate the effect of a prototype visualization tool for clinically relevant new information on clinicians' synthesis of EHR clinical documents and to understand how the tool may support future designs of clinical document user interfaces.METHODS: A mixed methods approach to analyze the impact of the visualization tool was used with a sample of eight medical interns as they synthesized EHR clinical documents to accomplish a set of four pre-formed clinical scenarios using a think-aloud protocol.RESULTS: Differences in the missing (unretrieved) patient information (2.3?1.2 [with the visualization tool] vs. 6.8?1.2 [without the visualization tool], p = 0.08) and accurate inferences (1.3?0.3 vs 2.3?0.3, p = 0.09) were not statistically significant but suggest some improvement with the new information visualization tool. Despite the non-significant difference in total times to task completion (43?4 mins vs 36?4 mins, p = 0.35) we observed shorter times for two scenarios with the visualization tool, suggesting that the time-saving benefits may be more evident with certain clinical processes. Other observed effects of the tool include more intuitive navigation between patient details and increased efforts towards methodical synthesis of clinical documents.CONCLUSION: Our study provides some evidence that new information visualization in clinical notes may positively influence synthesis of patient information from EHR clinical documents. Our findings provide groundwork towards a more effective display of EHR clinical documents using advanced visualization applications.

Resumo Limpo

ckground ehr clinic document synthesi clinician may timeconsum errorpron due complex organ narrat excess redund within document time inadvert prolifer data inconsist develop ehr system easili adapt user work process requir research visual techniqu can optim inform synthesi point careobject evalu effect prototyp visual tool clinic relev new inform clinician synthesi ehr clinic document understand tool may support futur design clinic document user interfacesmethod mix method approach analyz impact visual tool use sampl eight medic intern synthes ehr clinic document accomplish set four preform clinic scenario use thinkaloud protocolresult differ miss unretriev patient inform visual tool vs without visual tool p accur infer vs p statist signific suggest improv new inform visual tool despit nonsignific differ total time task complet min vs min p observ shorter time two scenario visual tool suggest timesav benefit may evid certain clinic process observ effect tool includ intuit navig patient detail increas effort toward method synthesi clinic documentsconclus studi provid evid new inform visual clinic note may posit influenc synthesi patient inform ehr clinic document find provid groundwork toward effect display ehr clinic document use advanc visual applic

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