Neurological Dashboards and Consultation Turnaround Time at an Academic Medical Center

Kummer, Benjamin; Willey, Joshua Z.; Zelenetz, Michael Jacob; Hu, Yiping; SenGupta, Soumitra; Elkind, Mitchell S.V.; Hripcsak, George

doi:10.1055/s-0039-1698465

Cited by 9 publications

(9 citation statements)

References 40 publications

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“…Problem-oriented views have been shown to improve data retrieval workflows, allowing providers to complete EHR tasks more efficiently, with fewer errors and cognitive task load, and greater user satisfaction. [31][32][33][34] The importance of these benefits was highlighted during the coronavirus 2019 (COVID-19) pandemic, when emergency departments (EDs) became burdened with an overwhelming number of patients. Given the severity of COVID-19 and emergency medicine as a primary point of care, the pandemic provides an opportunity to study how HIE use may have changed during this period of heightened stress in EDs.…”

Section: Background and Significancementioning

confidence: 99%

Directly Integrating Health Information Exchange (HIE) Data with the Electronic Health Record Increases HIE Use by Emergency Department Clinicians

Rivera,

Hosler,

Jang

et al. 2023

ACI open

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Objectives This article (1) develops a Fast Healthcare Interoperability Resources app, Health Dart, that integrates information from Indiana's community health information exchange (HIE), the Indiana Network for Patient Care (INPC), directly with Cerner, an electronic health record (EHR), and (2) evaluates the effect of Health Dart's implementation on HIE use. Methods Health Dart was implemented in 14 Indiana University Health emergency departments (EDs) 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 coronavirus disease 2019 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 by 144% (from 3.6 to 8.8%; p < 0.001) more than 2 months postimplementation. After UI enhancements, postimplementation INPC use increased by 123% (from 3.5 to 7.8%) compared to 181% (from 3.6 to 10.1%; p < 0.001) in postimplementation encounters that occurred before UI enhancements. During the pandemic, postimplementation 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 postimplementation encounters that occurred before the pandemic. Statistical significance was determined using 95% confidence intervals (α = 0.05). Conclusion 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. HIE information integrated into EHRs in the form of problem-oriented dashboards can potentially make information retrieval more efficient and effective for clinicians.

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Section: Background and Significancementioning

confidence: 99%

Directly Integrating Health Information Exchange (HIE) Data with the Electronic Health Record Increases HIE Use by Emergency Department Clinicians

Rivera,

Hosler,

Jang

et al. 2023

ACI open

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show abstract

“…1,2 Dashboards are tools used to communicate information through interactive visualizations of critical metrics to help identify and achieve goals. 4,5 When data are made interactive through a dashboard, it may enhance understanding and allows users to view the data in multiple ways. 6,7 These interactive dashboards are an efficient visualization mechanism for presenting necessary data on which relevant stakeholders can act and engage in rapid decision-making.…”

Section: Background and Significancementioning

confidence: 99%

U.S. COVID-19 State Government Public Dashboards: An Expert Review

et al. 2021

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Background In the United States, all 50 state governments deployed publicly viewable dashboards regarding the novel coronavirus disease 2019 (COVID-19) to track and respond to the pandemic. States dashboards, however, reflect idiosyncratic design practices based on their content, function, and visual design and platform. There has been little guidance for what state dashboards should look like or contain, leading to significant variation. Objectives The primary objective of our study was to catalog how information, system function, and user interface were deployed across the COVID-19 state dashboards. Our secondary objective was to group and characterize the dashboards based on the information we collected using clustering analysis. Methods For preliminary data collection, we developed a framework to first analyze two dashboards as a group and reach agreement on coding. We subsequently doubled coded the remaining 48 dashboards using the framework and reviewed the coding to reach total consensus. Results All state dashboards included maps and graphs, most frequently line charts, bar charts, and histograms. The most represented metrics were total deaths, total cases, new cases, laboratory tests, and hospitalization. Decisions on how metrics were aggregated and stratified greatly varied across dashboards. Overall, the dashboards were very interactive with 96% having at least some functionality including tooltips, zooming, or exporting capabilities. For visual design and platform, we noted that the software was dominated by a few major organizations. Our cluster analysis yielded a six-cluster solution, and each cluster provided additional insights about how groups of states engaged in specific practices in dashboard design. Conclusion Our study indicates that states engaged in dashboard practices that generally aligned with many of the goals set forth by the Centers for Disease Control and Prevention, Essential Public Health Services. We highlight areas where states fall short of these expectations and provide specific design recommendations to address these gaps.

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“…Visualization dashboards have been used to manage the multiple information streams in intensive care units, where they reduce cognitive load [ 6 ] and improve quality metric adherence [ 7 ], which is variable in neurology [ 8 ]. The time required for an inpatient neurology consultation shortened after implementation of a clinical data review platform that integrated clinical information with vital signs, imaging results, and lab findings [ 9 ]. Recently, a clinician- and patient-facing platform was designed for multiple sclerosis to serve as a personalized visual aid for understanding the disease course [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Enhancing Clinical Information Display to Improve Patient Encounters: Human-Centered Design and Evaluation of the Parkinson Disease-BRIDGE Platform

Brown¹,

Schleimer²,

Bledsoe³

et al. 2022

JMIR Hum Factors

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Background People with Parkinson disease (PD) have a variety of complex medical problems that require detailed review at each clinical encounter for appropriate management. Care of other complex conditions has benefited from digital health solutions that efficiently integrate disparate clinical information. Although various digital approaches have been developed for research and care in PD, no digital solution to personalize and improve communication in a clinical encounter is readily available. Objective We intend to improve the efficacy and efficiency of clinical encounters with people with PD through the development of a platform (PD-BRIDGE) with personalized clinical information from the electronic health record (EHR) and patient-reported outcome (PRO) data. Methods Using human-centered design (HCD) processes, we engaged clinician and patient stakeholders in developing PD-BRIDGE through three phases: an inspiration phase involving focus groups and discussions with people having PD, an ideation phase generating preliminary mock-ups for feedback, and an implementation phase testing the platform. To qualitatively evaluate the platform, movement disorders neurologists and people with PD were sent questionnaires asking about the technical validity, usability, and clinical relevance of PD-BRIDGE after their encounter. Results The HCD process led to a platform with 4 modules. Among these, 3 modules that pulled data from the EHR include a longitudinal module showing motor ratings over time, a display module showing the most recently collected clinical rating scales, and another display module showing relevant laboratory values and diagnoses; the fourth module displays motor symptom fluctuation based on an at-home diary. In the implementation phase, PD-BRIDGE was used in 17 clinical encounters for patients cared for by 1 of 11 movement disorders neurologists. Most patients felt that PD-BRIDGE facilitated communication with their clinician (n=14, 83%) and helped them understand their disease trajectory (n=11, 65%) and their clinician’s recommendations (n=11, 65%). Neurologists felt that PD-BRIDGE improved their ability to understand the patients’ disease course (n=13, 75% of encounters), supported clinical care recommendations (n=15, 87%), and helped them communicate with their patients (n=14, 81%). In terms of improvements, neurologists noted that data in PD-BRIDGE were not exhaustive in 62% (n=11) of the encounters. Conclusions Integrating clinically relevant information from EHR and PRO data into a visually efficient platform (PD-BRIDGE) can facilitate clinical encounters with people with PD. Developing new modules with more disparate information could improve these complex encounters even further.

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Neurological Dashboards and Consultation Turnaround Time at an Academic Medical Center

Cited by 9 publications

References 40 publications

Directly Integrating Health Information Exchange (HIE) Data with the Electronic Health Record Increases HIE Use by Emergency Department Clinicians

Directly Integrating Health Information Exchange (HIE) Data with the Electronic Health Record Increases HIE Use by Emergency Department Clinicians

U.S. COVID-19 State Government Public Dashboards: An Expert Review

Enhancing Clinical Information Display to Improve Patient Encounters: Human-Centered Design and Evaluation of the Parkinson Disease-BRIDGE Platform

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