Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

EMR Usability and Cognitive Task Load

talk @ UCSD bioinfo 4.2011
by

Alan Calvitti

on 21 February 2012

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of EMR Usability and Cognitive Task Load

electronic medical records
usability and cognitive task load alphabet soups: emr: electronic medical record
ehr: electronic health record
phr: personal health record alan calvitti phd
health srvc r&d va san diego "usability" (iso 9241-11) "usability is the effectiveness, efficiency and satisfaction with
which the intended users can achieve their tasks in the intended
context of product use" usability is not utility
effectiveness: facilitate users in accomplishing goals
efficiency: time required to complete tasks
satisfaction: subjective user perception nist "user centered design" understand user needs, workflows, environments
engage users early/often
set user performance objectives
design ui from known behavior principles
conduct usability tests
adapt design iteratively pilot: gaze+verbal physician gaze
chromograms n=9 sample physician + patient utterances key result: gaze+emr behavior 'signatures' key result: verbal comm is extensive emr in the news pace: n=17 mouse activity observational study
6 established patients per primary care physician, 30x VA+UCSD?
office visit, minimally intrusive room camera + emr capture
multi-modal ethnographic profiling
hierarchical + sequential usability & cognitive load modeling methods detour #1 now: exploratory data analysis +viz key result:emr use extensive emr (vista/cprs) mouse activity actograms manual coding of click events to categories categories per-visit mouse activity summary key result: 100s of clicks/visit phys+patient survey outcomes key result: noisy. factor analysis needed theory: cognitive task load neerincx's task load cube pace: anatomy of 'red zone' 2 sample visits: mouse + gaze mouse activity
transition graphs visit 1
32:45 visit 2
40:44 physician gaze summary measures from graphs van mieghem "graph spectra for complex networks"2011 human-coded mouse click categories (hierarchical analysis)
x-->y arc labels: {# observed transitions, transition times}
rank-order n-grams (~nlp), n=1,2,3... 1= most freq click type
common subgraphs
codiveristy of graph measures: topological, spectral, metric.. . from study of operator task load
royal netherlands navy emr usability requires
"systems" thinking patient-centered emr "pace" study pi: zia agha (vasd)
eda+viz: alan calvitti (vasd) s hurst (vasd), r street (ut austin), y chen (uci), k bell (vasd), n farber (ucsd), d zuest (vasd), l pua (vasd), b gray (vasd), f adegbemle (sdsu), s feupe (sdsu) key result: high invididual variation --> clicks--> ergonomics & cognitive task load time-domain profiling time-domain profiling (hierarchical+sequential) pace: n=17 survey outcomes summary: tot pts missed l8r: large var --> factor analysis stability? methods detour #2 computational co-heterogeneity time-domain profiling, covariates, mouse transition graphs "surveys can be helpful but need to be paired with other data sources"
patient-centered is not just patient-satisfaction + effective
+ efficient
+ safe
+ patient-centered
+ timely
+ equitable berwick: "what patient centerdness should mean" elements: count, average, rank-order methods detour #3 "compromise words surfaced" + "partnership"
+ "sharing"
+ "respect for patients"
+ "responsive to individual preferences" health affairs 2009 iom 2001 goals
for quality care utterance categories include
+ biomed talk (most common) @ bottom
+ psychosocial
+ distinction b/w open- vs closed- q's nist<--ahrq<--hhs-->ansi-->hitsp entelons, units, scales of measurement study limitations: complexity patient-centered care =
cognitively demanding
tasks ~79 age (diff anon) ~67
5 reasons for visit 4 methods detour #4 surveys require composite scales importance of the narrative component in ambulatory care problems with surveys emr meaningful use
utility-->usability standards? alternative models of cognition.. . range of specificity disease---illness gap inpatient---outpatient duality the computer in the room variety of confounders summary hi-res ethnographic profiling achievable (w/ manual coding)
multi-modal integration likely to yield workflow & emr usability measures
patient-centerdess is a complex (bio-, behavioral-, values- heterogeneity) "it does not appear that the physician studies even health in the abstract:
he studies the health of the human being - or rather some particular human being
for it is individuals he has to cure"
-- aristotle "n. ethics i"
Full transcript