Jeffery L Belden1,2, Pete Wegier1,3,4,5, Jennifer Patel6, Andrew Hutson7, Catherine Plaisant8, Joi L Moore2,9, Nathan J Lowrance9, Suzanne A Boren2,10, Richelle J Koopman1. 1. Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, Missouri, USA. 2. MU Informatics Institute, University of Missouri, Columbia, Missouri, USA. 3. Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, Ontario, Canada. 4. Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada. 5. Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada. 6. GoInvo, Boston, Massachusetts, USA. 7. Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, Missouri, USA. 8. Human Computer Interaction Laboratory, Institute for Advanced Computer Studies, University of Maryland, College Park, Maryland, USA. 9. The School of Information Science and Learning Technologies, College of Education, University of Missouri, Columbia, Missouri, USA. 10. Department of Health Management and Informatics, School of Medicine, University of Missouri, Columbia, Missouri, USA.
Abstract
Objective: Most electronic health records display historical medication information only in a data table or clinician notes. We designed a medication timeline visualization intended to improve ease of use, speed, and accuracy in the ambulatory care of chronic disease. Materials and Methods: We identified information needs for understanding a patient medication history, then applied human factors and interaction design principles to support that process. After research and analysis of existing medication lists and timelines to guide initial requirements, we hosted design workshops with multidisciplinary stakeholders to expand on our initial concepts. Subsequent core team meetings used an iterative user-centered design approach to refine our prototype. Finally, a small pilot evaluation of the design was conducted with practicing physicians. Results: We propose an open-source online prototype that incorporates user feedback from initial design workshops, and broad multidisciplinary audience feedback. We describe the applicable design principles associated with each of the prototype's key features. A pilot evaluation of the design showed improved physician performance in 5 common medication-related tasks, compared to tabular presentation of the same information. Discussion: There is industry interest in developing medication timelines based on the example prototype concepts. An open, standards-based technology platform could enable developers to create a medication timeline that could be deployable across any compatible health IT application. Conclusion: The design goal was to improve physician understanding of a patient's complex medication history, using a medication timeline visualization. Such a design could reduce temporal and cognitive load on physicians for improved and safer care.
Objective: Most electronic health records display historical medication information only in a data table or clinician notes. We designed a medication timeline visualization intended to improve ease of use, speed, and accuracy in the ambulatory care of chronic disease. Materials and Methods: We identified information needs for understanding a patient medication history, then applied human factors and interaction design principles to support that process. After research and analysis of existing medication lists and timelines to guide initial requirements, we hosted design workshops with multidisciplinary stakeholders to expand on our initial concepts. Subsequent core team meetings used an iterative user-centered design approach to refine our prototype. Finally, a small pilot evaluation of the design was conducted with practicing physicians. Results: We propose an open-source online prototype that incorporates user feedback from initial design workshops, and broad multidisciplinary audience feedback. We describe the applicable design principles associated with each of the prototype's key features. A pilot evaluation of the design showed improved physician performance in 5 common medication-related tasks, compared to tabular presentation of the same information. Discussion: There is industry interest in developing medication timelines based on the example prototype concepts. An open, standards-based technology platform could enable developers to create a medication timeline that could be deployable across any compatible health IT application. Conclusion: The design goal was to improve physician understanding of a patient's complex medication history, using a medication timeline visualization. Such a design could reduce temporal and cognitive load on physicians for improved and safer care.
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Authors: Richelle J Koopman; Shannon M Canfield; Jeffery L Belden; Pete Wegier; Victoria A Shaffer; K D Valentine; Akshay Jain; Linsey M Steege; Sonal J Patil; Mihail Popescu; Michael L LeFevre Journal: BMC Med Inform Decis Mak Date: 2020-08-18 Impact factor: 2.796
Authors: Pete Wegier; Jeffery L Belden; Shannon M Canfield; Victoria A Shaffer; Sonal J Patil; Michael L LeFevre; K D Valentine; Mihail Popescu; Linsey M Steege; Akshay Jain; Richelle J Koopman Journal: BMC Med Inform Decis Mak Date: 2021-08-05 Impact factor: 2.796