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用于支持实践反思的临床指标数据的先进仪表盘:范围审查

State-of-the-art Dashboards on Clinical Indicator Data to Support Reflection on Practice: Scoping Review.

作者信息

Bucalon Bernard, Shaw Tim, Brown Kerri, Kay Judy

机构信息

Human Centred Technology Cluster, School of Computer Science, The University of Sydney, Darlington, Australia.

Practice Analytics, Digital Health Cooperative Research Centre, Sydney, Australia.

出版信息

JMIR Med Inform. 2022 Feb 14;10(2):e32695. doi: 10.2196/32695.

Abstract

BACKGROUND

There is an increasing interest in using routinely collected eHealth data to support reflective practice and long-term professional learning. Studies have evaluated the impact of dashboards on clinician decision-making, task completion time, user satisfaction, and adherence to clinical guidelines.

OBJECTIVE

This scoping review aims to summarize the literature on dashboards based on patient administrative, medical, and surgical data for clinicians to support reflective practice.

METHODS

A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in 5 electronic databases (MEDLINE, Embase, Scopus, ACM Digital Library, and Web of Science) to identify studies that met the inclusion criteria. Study selection and characterization were performed by 2 independent reviewers (BB and CP). One reviewer extracted the data that were analyzed descriptively to map the available evidence.

RESULTS

A total of 18 dashboards from 8 countries were assessed. Purposes for the dashboards were designed for performance improvement (10/18, 56%), to support quality and safety initiatives (6/18, 33%), and management and operations (4/18, 22%). Data visualizations were primarily designed for team use (12/18, 67%) rather than individual clinicians (4/18, 22%). Evaluation methods varied among asking the clinicians directly (11/18, 61%), observing user behavior through clinical indicators and use log data (14/18, 78%), and usability testing (4/18, 22%). The studies reported high scores on standard usability questionnaires, favorable surveys, and interview feedback. Improvements to underlying clinical indicators were observed in 78% (7/9) of the studies, whereas 22% (2/9) of the studies reported no significant changes in performance.

CONCLUSIONS

This scoping review maps the current literature landscape on dashboards based on routinely collected clinical indicator data. Although there were common data visualization techniques and clinical indicators used across studies, there was diversity in the design of the dashboards and their evaluation. There was a lack of detail regarding the design processes documented for reproducibility. We identified a lack of interface features to support clinicians in making sense of and reflecting on their personal performance data.

摘要

背景

利用常规收集的电子健康数据来支持反思性实践和长期专业学习的兴趣日益浓厚。研究评估了仪表盘对临床医生决策、任务完成时间、用户满意度以及遵循临床指南情况的影响。

目的

本范围综述旨在总结基于患者管理、医疗和手术数据的仪表盘相关文献,以支持临床医生的反思性实践。

方法

采用阿克斯赛和奥马利框架进行范围综述。在5个电子数据库(MEDLINE、Embase、Scopus、ACM数字图书馆和科学引文索引)中进行检索,以识别符合纳入标准的研究。研究选择和特征描述由2名独立评审员(BB和CP)进行。一名评审员提取数据并进行描述性分析,以梳理现有证据。

结果

共评估了来自8个国家的18个仪表盘。仪表盘的用途包括性能改进(10/18,56%)、支持质量和安全举措(6/18,33%)以及管理和运营(4/18,22%)。数据可视化主要设计用于团队使用(12/18,67%),而非个体临床医生(4/18,22%)。评估方法各不相同,包括直接询问临床医生(11/18,61%)、通过临床指标和使用日志数据观察用户行为(14/18,78%)以及可用性测试(4/18,22%)。研究报告在标准可用性问卷、满意度调查和访谈反馈方面得分较高。78%(7/9)的研究观察到基础临床指标有所改善,而22%(2/9)的研究报告性能无显著变化。

结论

本范围综述梳理了基于常规收集的临床指标数据的仪表盘当前文献情况。尽管各研究中使用了常见的数据可视化技术和临床指标,但仪表盘的设计及其评估存在多样性。缺乏关于可重复性的设计过程记录细节。我们发现缺乏支持临床医生理解和反思其个人绩效数据的界面功能。

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