Appl Clin Inform. 2012 Oct 31;3(4):404-18. doi: 10.4338/ACI-2012-05-RA-0017. Print 2012.
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.
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.
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.
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.
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.
由于叙述结构复杂、文档内冗余过多，以及数据不一致性的意外扩散，临床医生在电子健康记录（EHR）临床文档的合成过程中可能会耗费大量时间并且容易出错。开发易于适应用户工作流程的 EHR 系统需要研究可视化技术，以便在护理点优化信息合成。
评估一种针对临床相关新信息的原型可视化工具对临床医生合成 EHR 临床文档的影响，并了解该工具如何支持未来的临床文档用户界面设计。
使用混合方法分析了可视化工具的影响，研究对象为 8 名医学实习生，他们在使用出声思维协议完成 4 个预先设定的临床场景时，使用 EHR 临床文档进行了合成。
在缺失（未检索到）患者信息（使用可视化工具时为 2.3±1.2[与未使用时的 6.8±1.2相比]，p = 0.08）和准确推断（1.3±0.3 与 2.3±0.3，p = 0.09）方面的差异无统计学意义，但表明新信息可视化工具可能有所改进。尽管任务完成总时间（使用可视化工具时为 43±4 分钟，未使用时为 36±4 分钟，p = 0.35）无统计学差异，但我们观察到使用可视化工具时两个场景的完成时间更短，这表明该工具在某些临床流程中可能具有更明显的节省时间的优势。该工具的其他观察效果包括在患者详细信息之间更直观的导航，以及更有针对性地对临床文档进行系统性合成。
我们的研究提供了一些证据，表明 EHR 临床文档中的新信息可视化可能会对从 EHR 临床文档中综合患者信息产生积极影响。我们的研究结果为使用高级可视化应用程序更有效地显示 EHR 临床文档奠定了基础。
