Human-centered development of an electronic health record-embedded, interactive information visualization in the emergency department using fast healthcare interoperability resources.
clinical decision support systems
health information exchange
health information interoperability
human-centered design
implementation science
Journal
Journal of the American Medical Informatics Association : JAMIA
ISSN: 1527-974X
Titre abrégé: J Am Med Inform Assoc
Pays: England
ID NLM: 9430800
Informations de publication
Date de publication:
14 07 2021
14 07 2021
Historique:
received:
15
08
2020
accepted:
21
01
2021
pubmed:
9
3
2021
medline:
25
11
2021
entrez:
8
3
2021
Statut:
ppublish
Résumé
Develop and evaluate an interactive information visualization embedded within the electronic health record (EHR) by following human-centered design (HCD) processes and leveraging modern health information exchange standards. We applied an HCD process to develop a Fast Healthcare Interoperability Resources (FHIR) application that displays a patient's asthma history to clinicians in a pediatric emergency department. We performed a preimplementation comparative system evaluation to measure time on task, number of screens, information retrieval accuracy, cognitive load, user satisfaction, and perceived utility and usefulness. Application usage and system functionality were assessed using application logs and a postimplementation survey of end users. Usability testing of the Asthma Timeline Application demonstrated a statistically significant reduction in time on task (P < .001), number of screens (P < .001), and cognitive load (P < .001) for clinicians when compared to base EHR functionality. Postimplementation evaluation demonstrated reliable functionality and high user satisfaction. Following HCD processes to develop an application in the context of clinical operations/quality improvement is feasible. Our work also highlights the potential benefits and challenges associated with using internationally recognized data exchange standards as currently implemented. Compared to standard EHR functionality, our visualization increased clinician efficiency when reviewing the charts of pediatric asthma patients. Application development efforts in an operational context should leverage existing health information exchange standards, such as FHIR, and evidence-based mixed methods approaches.
Identifiants
pubmed: 33682004
pii: 6157802
doi: 10.1093/jamia/ocab016
pmc: PMC8279791
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1401-1410Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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