Department of Learning, Informatics, Management and Ethics, Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States.
Appl Clin Inform. 2019 May;10(3):454-470. doi: 10.1055/s-0039-1692400. Epub 2019 Jun 26.
Integration of electronic information is a challenge for multitasking emergency providers, with implications for patient safety. Visual representations can assist sense-making of complex data sets; however, benefit and acceptability in emergency care is unproven.
This article evaluates visually focused alternatives to lists or tabular formats, to better understand possible usability in Emergency Department Information System (EDIS).
A counterbalanced, repeated-measures experiment, satisfaction surveys, and narrative content analysis was conducted remotely by Web platform. Participants were 37 American emergency physicians; they completed 16 clinical cases comparing 4 visual designs to the control formats from a commercially available EDIS. They then evaluated two additional chart overview representations without controls.
Visual designs provided benefit in several areas compared to controls. Task correctness (90% to 76%; = 0.003) and completion time (median: 49-74 seconds; < 0.001) were superior for a medication history timeline with class and schedule highlighting. Completion time (median: 45-60 seconds; = 0.03) was superior for a past medical history design, using pertinent diagnosis codes in highlighting rules. Less mental effort was reported for visual allergy ( = 0.04), past medical history ( < 0.001), and medication timeline ( < 0.001) designs. Most of the participants agreed with statements of likeability, preference, and benefit for visual designs; nonetheless, contrary opinions were seen, and more complex designs were viewed less favorably.
Physician performance with visual representations of clinical data can in some cases exceed standard formats, even in absence of training. Highlighting of priority clinical categories was rated easier-to-use on average than unhighlighted controls. Perceived complexity of timeline representations can limit desirability for a subset of users, despite potential benefit.
电子信息的整合对多任务应急提供者来说是一个挑战，这对患者安全有影响。可视化表示可以帮助理解复杂数据集；然而，在急救护理中的益处和可接受性尚未得到证实。
本文评估了以视觉为重点的替代列表或表格格式的方法，以更好地了解在急诊部信息系统（EDIS）中可能的可用性。
通过网络平台远程进行了平衡、重复测量实验、满意度调查和叙述性内容分析。参与者为 37 名美国急诊医生；他们完成了 16 个临床病例，将 4 种视觉设计与来自商业 EDIS 的对照格式进行比较。然后，他们在没有对照的情况下评估了另外两种图表概述表示形式。
与对照相比，视觉设计在几个方面提供了益处。用药史时间线的分类和时间表突出显示，在任务正确性（90%对 76%；=0.003）和完成时间（中位数：49-74 秒；<0.001）方面表现更好。使用突出显示规则中的相关诊断代码，过去的病史设计在完成时间（中位数：45-60 秒；=0.03）方面表现更好。报告的视觉过敏（=0.04）、过去的病史（<0.001）和用药时间线（<0.001）设计的心理努力较少。大多数参与者同意视觉设计的喜欢、偏好和益处的说法；尽管存在相反的观点，但更复杂的设计的评价较差。
在某些情况下，临床数据的视觉表示形式的医生表现可以超过标准格式，即使没有培训。重点突出的优先级临床类别平均比未突出的对照更容易使用。尽管有潜在的益处，但时间线表示形式的感知复杂性可能会限制一部分用户的愿望。
