Assessing the usability by clinicians of VISION: A hierarchical display of patient-collected physiological information to clinicians

Abstract

BackgroundThe inability of patients to accurately and completely recount their clinical status between clinic visits reduces the clinician’s ability to properly manage their patients. One way to improve this situation is to collect objective patient information while the patients are at home and display the collected multi-day clinical information in parallel on a single screen, highlighting threshold violations for each channel, and allowing the viewer to drill down to any analog signal on the same screen, while maintaining the overall physiological context of the patient. All this would be accomplished in a way that was easy for the clinician to view and use.MethodsPatients used five mobile devices to collect six heart failure-related clinical variables: body weight, systolic and diastolic blood pressure, pulse rate, blood oxygen saturation, physical activity, and subjective input. Fourteen clinicians practicing in a heart failure clinic rated the display using the System Usability Scale that, for acceptability, had an expected mean of 68 (SD, 12.5). In addition, we calculated the Intraclass Correlation Coefficient of the clinician responses using a two-way, mixed effects model, ICC (3,1).ResultsWe developed a single-screen temporal hierarchical display (VISION) that summarizes the patient’s home monitoring activities between clinic visits. The overall System Usability Scale score was 92 (95% CI, 87-97), p < 0.0001; the ICC was 0.89 (CI, 0.79-0.97), p < 0.0001.ConclusionClinicians consistently found VISION to be highly usable. To our knowledge, this is the first single-screen, parallel variable, temporal hierarchical display of both continuous and discrete information acquired by patients at home between clinic visits that presents clinically significant information at the point of care in a manner that is usable by clinicians.

Visualization of Patient-Generated Health Data: A Scoping Review of Dashboard Designs

“…Similarly, color was commonly used to distinguish data series (for example, in one graph, 20 heart rate was plotted in red, activity in green, and oxygen saturation in blue). In one visualization, 20 black blocks were plotted on a timeline when some abnormal parameter occurred, which turned to red when the user selected a particular one to view in further detail. Another study, rather than using the common “stoplight” color coding, explained that “blue, orange, and yellow colors were used because they can be distinguished by individuals with color blindness.” 19 The study noted earlier as plotting multiple days' blood glucose values on the same 24-hour graph used seven different colors for each day of the week.…”

“…For example, one with black blocks on a timeline necessitated selection of a particular block to view what type of abnormality was captured. 20 Some allowed hovering within a region to get additional data. Pop-ups providing details were described 19 as aligning with the “Shneiderman Visual Information Seeking Mantra” of “Overview first, zoom and filter, then details-on-demand.” 33…”

“…use five different devices. 21 Most studies recorded data passively, although some used blood pressure measurements actively entered by patients. 19,22,28 One study required patient data entry into a portal.…”

Usability of an Educational Intervention to Overcome Therapeutic Inertia in Multiple Sclerosis Care

“…As a result, the possible values range from 0 to 100 ( 12 ). A score of 68 or higher is considered “highly acceptable” ( 13 – 16 ). The SUS has been validated in different populations and countries and used in over 500 instruments ( 13 – 16 ).…”

Technology Acceptance in Mobile Health: Scoping Review of Definitions, Models, and Measurement (Preprint)

“…The majority of publications (n=51) referred to technology acceptability. Among these, a small number (n=8) addressed the preuse stage, sometimes equating acceptability to users' interest or willingness to use a system [46][47][48][49][50]. The other 34 papers referred to acceptability in the context of initial or sustained use.…”