cognitive information design & visualization cognitive information design & visualization
TRANSCRIPT
Project 4: Cognitive Information Design
& Visualization
www.sharpc.org
Project Leaders: Todd R. JohnsonBen ShneidermanCatherine Plaisant
Project manager:
Chitra Shriram
Project Co-Is: Jorge HerskovicElmer Bernstram
Consultants: John Flach
Postdocs, GRAs, Programmers: Eliz MarkowitzSurreya TarkanTiffany Chao
Top 3 Accomplishments in Years 1-2
Medication Reconciliation: Spatial Layout with Animated Transitions
Test Result Management: Table Design & Retrospective Analysis
Systematic Yet Flexible Systems Analysis: Framework for analyzing HIT interface design
What’s unique? What’s identical? What’s equivalent?
Medication Reconciliation: Spatial Layout with Animated Transitions
Medication Reconciliation: Spatial Layout with Animated Transitions
“Automated medication reconciliation and complexity of care transitions”Bozzo Silva, Bernstam, Markowitz, Johnson, Zhang and Herskovic, AMIA 2011
Equivalence
Criteria Example
Form Identical except for brand vs. generic
Advil = IbuprofenSenormin = Atenolol
Functional Same therapeutic intent Atenolol & Propanolol both betablockers
Partial Form or functional equivalence, but differ in dosage, frequency, route
Advil 100 mgAcetaminophen 200mg
None Unique in form & function
LEVELS OF EQUIVALENCE
Medication Reconciliation: Spatial Layout with Animated Transitions
Prototype by Tiffany Chao
VIDEO AVAILABLE AT www.cs.umd.edu/hcil/sharp
DEMO
Twinlist running on Microsoft Amalga PlatformContact: Hank Rappaport
Twinlist adapted for problem list reconciliation in cancer risk assessment software (Hughes riskApps™) Contact: Kevin S. Hughes, Massachusetts General Hospital
Medication Reconciliation: Spatial Layout with Animated Transitions
“Best medication reconciliation interface I have seen” Shawn Murphy, MD, PhD, Harvard University “A sigh of relief when I saw Twinlist” Melinda Jenkins, PhD, FNP
Test Result Management: Table Design & Retrospective Analysis GOALS:
Help clinicians see what needs attention Rich tabular displays
Facilitate taking action Clarify responsibility Embed operations to save time
Allow retrospective analysis
Sample
Current
Design
VA
View
Alerts
Test Result Management: Table Design & Retrospective Analysis
Sample
Current
Design
VA
View
Alerts
Test Result Management: Table Design & Retrospective Analysis
Sample
Current
Design
VA
View
Alerts
Test Result Management: Table Design & Retrospective Analysis
Test Result Management: Table Design & Retrospective Analysis
Test Result Management: Table Design & Retrospective Analysis
Color-Coding, Icons, and Ranking
Compact Layouts
Test Result Management: Table Design & Retrospective Analysis
Improved Headers
Test Result Management: Table Design & Retrospective Analysis
Integrated Actions
Test Result Management: Table Design & Retrospective Analysis
DESIGN GUIDELINES: sample of 28 in total
Rank the table according to one or more column attribute(s), arranged vertically down (Few, 2004)
Use color coding of columns to show the ranking, by default the most severe value must appear at the top of the table while ensuring that the most important values are still visible
Round data displayed in table cells entries where it is not misleading to do so (MSCUI, 2008) but show more precision if space permits
Avoid a heading that is significantly wider than the data it is indicating (MSCUI, 2008) by splitting such headers into two or more lines
If a certain column always has the same value, it could be removed to save space
Keep table structure consistent from table to table, for example, distinct columns in tables should be placed at the rightmost end to allow for alignment of the same columns on the left side
Test Result Management: Table Design & Retrospective Analysis
Test Result Management: Table Design & Retrospective Analysis
Test Result Management: Table Design & Retrospective Analysis
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Systematic Yet Flexible Systems Analysis: Framework for analyzing HIT interface design Systematic, consistent approaches
Can improve Efficiency, Safety, Effectiveness
Examples Standard operating procedures, Clinical
guidelines Decision support, Hard stops in EHRs
But flexibility is needed to accommodate variation
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SYFSA in a Nutshell
Idealized: Logical
constraints on the work,
independent of any system
Natural: How the current
system supports and constrains
the work
System: A redesigned system that matches logical
constraints as closely as possible
Idealized Space for Medication Ordering
Procedural Flexibility: 3 bitsFunctional Flexibility: Approximately 14.58
Estimate from RxNorm: ~ 24,000 prescribable drugs, including those not in RxNorm
Open Vista Natural Space
OpenVista: Natural Space
OpenVista – The Natural Space
Too much procedural flexibility: 9.5 bits
Natural Space of “Droogle”an e-Prescription demonstration project inspired by Google
By Peter V. Killoran M.D
Droogle Procedural
Flexibility close to ideal: 1 bit
DEMO
RxTerm Medication Entry Demo Appfrom The National Library of Medicine, NIH
Keystrokes: war
From: http://rxterms.nlm.nih.gov:8080/
Keystrokes: war TAB
RxTerm Medication Entry Demo Appfrom The National Library of Medicine, NIH
Keystrokes: war TAB 5
RxTerm Medication Entry Demo Appfrom The National Library of Medicine, NIH
Keystrokes: war TAB 5 TAB
182 different drugs require only 4 keystrokes: letter TAB number TABFunctional flexibility matches ideal
RxTerm Medication Entry Demo Appfrom The National Library of Medicine, NIH
Procedural flexibility: 5.1bits
Maximum interface efficiency: ~ 68% (4 keystrokes)Minimum interface efficiency: ~ 5% (50 character free text entry)
RxTerm Medication Entry Demo Appfrom The National Library of Medicine, NIH
Reducing Wrong Patient Errors: Animated Transitions & Photos
BONUS
Reducing Wrong Patient Errors: Animated Transitions & Photos
Reducing Wrong Patient Errors: Animated Transitions & Photos
Reducing Wrong Patient Errors: Animated Transitions & Photos
Reducing Wrong Patient Errors: Animated Transitions & Photos
Error Recognition Rate for each Group
63%
43%
36%
7%
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
CombinedPhotoAnimationControl
(Taieb-Maimon, Plaisant & Shneiderman, 2012)
The combination of animation & photo resulted in a significant increase in error recognition rate relative to the control & animation groups Dramatic implications for commercial systems
Control Photo Combined
36%
Animation
7%
43%
63%
Year 3 & 4 Planned Deliverables
Medication Reconciliation
Lab Tracking
Systematic Yet Flexible Systems Analysis
Visualization Guidelines
Anticipated Challenges in Years 3-4
Clinical User Testing
Industry Collaboration in Technology Transfer
Resources for Widening Impact
Join us for HCIL symposium
May 22-23, 2012Includes Medical Informatics Workshop on Day 2
www.cs.umd.edu/hcil/soh