The Design & Evaluation of an Information Visualization to Improve the Efficiency & Understanding of Patient Health State

Family physicians face the need to process and interpret an ever-increasing amount of patient data, which challenges their ability to address all relevant information in order to make informed decisions that influence patients’ lives. Healthcare professionals report frustration in locating, customising and prioritising data in the Electronic Health Record, with almost no time before or during the consultation to review the patient’s information. Presenting heterogeneous sources of data requires effective visualizations with considered organisation so users are not ‘overwhelmed’, and to guide the understanding and interpretation of information. This study seeks to design and evaluate a holistic information visualization, to provide clinicians in Primary Care with a quick overview and ‘essence’ of the patient. This offers an opportunity to capture and communicate a longitudinal history and story of a patient alongside assisting clinicians in coping with information overload, enhancing situation awareness, and efficiency in the understanding of the presented data.The first stage of the postgraduate study investigates visualizations in healthcare: its role, importance, applications, benefits and limitations through a scoping literature review. The second stage manifests the design of an information visualization, developed iteratively whilst applying both a bottom-up and a top-down approach. This includes understanding EHR users and other stakeholders’ needs and wants via interviews, focus groups and surveys.Towards eliciting opportunities in enhancing physicians’ situation awareness and reducing their cognitive overload, we conducted interviews with eight General Practitioners to explore what important information is required before and during the GP-patient consultation to enhance situation awareness, when is the right time to display this information, what is the desired format and what are the main barriers to gaining situation awareness [1]. Patient-information that health care professionals consider most important was discussed, in order to ascertain the type/s of information that is essential when providing a quick overview of the patient. The Situation Awareness model was used as a conceptual framework to classify emergent themes [1], [2]. Information visualization has the potential to enhance situation awareness during the clinical consultation. The findings from the study supports the need to enhance Situation Awareness prior to the GP-patient consultation [1] - [3]. All eight GPs concur that a visual presentation, which avoids having to sift through lines and lines of text could address some of the SA issues that were identified. GPs concur that a novel information visualization, that can be interpreted ‘at a glance’ (ideally in 20-30 seconds) before the patient arrives could be valuable [1].In a subsequent process of iterative design, feedback and insights attained at each stage from key stakeholders, GPs, designers, and patients, was used to refine and develop the design of the novel information visualization, alongside applying concepts and techniques of visual perception, including information processing, sensory organization and spatial organization [4], [5]. Different GPs and patients have varying needs, and thus the iterative design process explores options to customize the display of information for the GP, alongside taking into consideration different patient types, including those with chronic illnesses or multi-morbidities.In evaluating the outcome, both qualitative and quantitative studies will be employed. A quantitative study with 60 Primary Care GPs will evaluate the understanding of the visualization and data (i.e. situation awareness), usability of the visualization (i.e. time taken to perform the task), alongside a comparison against the current methods of communicating patient information using the EHR. A qualitative study consisting of semi-structured interviews with healthcare practitioners will provide insights and feedback on the acceptability of the visualization; how the visualization can be embedded in practice; how the visualization can support different user groups (healthy, chronic illnesses, multi-morbidity); and its role towards making informed decisions. The holistic integrated overview of the patient within the EHR, aims to enhance the clinician’s understanding of the patient, help coping with information overload and enhance efficiency, consequently providing healthcare practitioners with essential information, enhanced situation awareness, thus enabling timely decision making, interventions and advice.