Human-centered development of an electronic health record-embedded, interactive information visualization in the emergency department using fast healthcare interoperability resources

Thayer, Jeritt G.; Ferro, Daria F.; Miller, Jeffrey M.; Karavite, Dean; Grundmeier, Robert W.; Utidjian, Levon; Zorc, Joseph J.

doi:10.1093/jamia/ocab016

Cited by 19 publications

(29 citation statements)

References 40 publications

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“…26 In addition, the display of data in a structured, problem-oriented format, such as Health Dart's chief complaint view, improves efficiency of data retrieval and user satisfaction. 28,45,46 Contrary to our prediction, the effect of the app's implementation on INPC use was not as strong in encounters that occurred after UI enhancements. The UI enhancements appeared to The results of the COVID-19 modeling should be interpreted with caution as the lower volume of patients and higher rate of infectious diseases and respiratory conditions in encounters during the pandemic increase the potential for confounding.…”

Section: Estimating the Probability Of Inpc Usecontrasting

confidence: 99%

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Does directly integrating health information exchange (HIE) data with the electronic health record increase HIE use by clinicians in the emergency department?

Hosler

Jang

Schaffer

et al. 2022

Preprint

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Objective: Develop and evaluate the effect of a Fast Healthcare Interoperability Resources (FHIR) app, Health Dart, integrating information from Indianas community health information exchange (HIE), the Indiana Network for Patient Care (INPC), directly with Cerner, an electronic health record (EHR) Materials and Methods: Health Dart was implemented in 14 Indiana University Health emergency departments (ED) using a stepped-wedge study design. We analyzed rates of INPC use in 286,175 ED encounters between October 1, 2019 and December 31, 2020. Logistic regression was used to model the probability of INPC use given the implementation context, such as user interface (UI) enhancements and the COVID-19 pandemic. Results: INPC use increased by 131% across all encounters (from 3.6% to 8.3%; p<0.001) after Health Dart implementation. INPC use increased by144% (from 3.6% to 8.8%; p<0.001) more than two months post-implementation. After UI enhancements, post-implementation INPC use increased 123% (from 3.5% to 7.8%) compared to 181% (from 3.6% to 10.1%; p<0.001) in post-implementation encounters that occurred before UI enhancements. During the pandemic, post-implementation INPC use increased by 135% (from 3.4% to 8.0%; p<0.001) compared to 178% (from 3.6% to 10%; p<0.001) in post-implementation encounters that occurred before the pandemic. Statistical significance was determined using 95% confidence intervals (α=0.05). Discussion: Direct integration of HIE information into an EHR substantially increased frequency of HIE use, but the effect was weakened by the UI enhancements and pandemic. Conclusion: HIE information integrated into EHRs in the form of dashboards can potentially make information retrieval more efficient and effective for clinicians.

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Section: Estimating the Probability Of Inpc Usecontrasting

confidence: 99%

“…26 In addition, the display of data in a structured, problem-oriented format, such as Health Dart ’s chief complaint view, improves efficiency of data retrieval and user satisfaction. 28,45,46…”

Section: Discussionmentioning

confidence: 99%

Does directly integrating health information exchange (HIE) data with the electronic health record increase HIE use by clinicians in the emergency department?

Hosler

Jang

Schaffer

et al. 2022

Preprint

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“…The paper of Thayer et al, [3] is an exemplary exposition of a project to integrate and visualize urgently needed patient information for a pediatric emergency department. The emergency room at the Children's Hospital of Philadelphia, a highly regarded tertiary care health system, treats more than 7,000 acute asthma cases each year, with an admission rate of 30%.…”

Section: Resultsmentioning

confidence: 99%

Best Papers in Human Factors and Sociotechnical Development

Senathirajah

Solomonides

2022

Yearb Med Inform

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Objectives: To select the best papers that made original and high impact contributions in human factors and organizational issues in biomedical informatics in 2021. Methods: A rigorous extraction process based on queries from Web of Science® and PubMed/Medline was conducted to identify the scientific contributions published in 2021 that address human factors and organizational issues in biomedical informatics. The screening of papers on titles and abstracts independently by the two section editors led to a total of 3,206 papers. These papers were discussed for a selection of 12 finalist papers, which were then reviewed by the two section editors, two chief editors, and by three external reviewers from internationally renowned research teams. Results: The query process resulted in 12 papers that reveal interesting and rigorous methods and important studies in human factors that move the field forward, particularly in clinical informatics and emerging technologies such as brain-computer interfaces and mobile health. This year three papers were clearly outstanding and help advance in the field. They provide examples of examining novel and important topics such as the nature of human-machine interaction behavior and norms, use of social-media based design for an electronic health record, and emerging topics such as brain-computer interfaces. thematic development of electronic health records and usability techniques, and condition-focused patient facing tools. Those concerning the Corona Virus Disease 2019 (COVID-19) were included as part of that section. Conclusion: The selected papers make important contributions to human factors and organizational issues, expanding and deepening our knowledge of how to apply theory and applications of new technologies in health.

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“…26 27 28 29 30 31 HCD approaches have been shown to help ensure that technology is easy-to-use and, thus, more consistently and effectively used. 27 28 30 32 While HCD approaches provide a methodological foundation for developing effective CDS and have been used to develop smoking cessation CDS system in adult care settings, 33 34 they have not been rigorously applied to systems focused on tobacco use treatment in pediatric settings. This critical gap in the application of HCD to smoking cessation efforts in pediatric settings has limited the effectiveness of efforts to reduce parent smoking.…”

Section: Background and Significancementioning

confidence: 99%

Electronic Health Record-Embedded, Behavioral Science-Informed System for Smoking Cessation for the Parents of Pediatric Patients

et al. 2022

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Background Helping parents quit smoking is a public health priority. However, parents are rarely, if ever, offered tobacco use treatment through pediatric settings. Clinical decision support (CDS) systems developed for the workflows of pediatric primary care may support consistent screening, treatment, and referral. Objectives This study aimed to develop a CDS system by using human-centered design (HCD) that identifies parents who smoke, provides motivational messages to quit smoking (informed by behavioral science), and supports delivery of evidence-based tobacco treatment. Methods Our multidisciplinary team applied a rigorous HCD process involving analysis of the work environment, user involvement in formative design, iterative improvements, and evaluation of the system's use in context with the following three cohorts: (1) parents who smoke, (2) pediatric clinicians, and (3) clinic staff. Participants from each cohort were presented with scenario-based, high-fidelity mockups of system components and then provided input related to their role in using the CDS system. Results We engaged 70 representative participants including 30 parents, 30 clinicians, and 10 clinic staff. A key theme of the design review sessions across all cohorts was the need to automate functions of the system. Parents emphasized a system that presented information in a simple way, highlighted benefits of quitting smoking, and allowed direct connection to treatment. Pediatric clinicians emphasized automating tobacco treatment. Clinical staff emphasized screening for parent smoking via several modalities prior to the patient's visit. Once the system was developed, most parents (80%) reported that it was easy to use, and the majority of pediatricians reported that they would use the system (97%) and were satisfied with it (97%). Conclusion A CDS system to support parental tobacco cessation in pediatric primary care, developed through an HCD process, proved easy to use and acceptable to parents, clinicians, and office staff. This preliminary work justifies evaluating the impact of the system on helping parents quit smoking.

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Human-centered development of an electronic health record-embedded, interactive information visualization in the emergency department using fast healthcare interoperability resources

Cited by 19 publications

References 40 publications

Does directly integrating health information exchange (HIE) data with the electronic health record increase HIE use by clinicians in the emergency department?

Does directly integrating health information exchange (HIE) data with the electronic health record increase HIE use by clinicians in the emergency department?

Best Papers in Human Factors and Sociotechnical Development

Electronic Health Record-Embedded, Behavioral Science-Informed System for Smoking Cessation for the Parents of Pediatric Patients

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