Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug;10(4):693-706.
doi: 10.1055/s-0039-1695800. Epub 2019 Sep 18.

Design and Evaluation of an Integrated, Patient-Focused Electronic Health Record Display for Emergency Medicine

Xiaomei Wang  1 , Tracy C Kim  2 , Sudeep Hegde  1 , Daniel J Hoffman  2 , Natalie C Benda  2 , Ella S Franklin  2 , David Lavergne  3 , Shawna J Perry  4 , Rollin J Fairbanks  2 , A Zachary Hettinger  2 , Emilie M Roth  5 , Ann M Bisantz  1
Affiliations

Design and Evaluation of an Integrated, Patient-Focused Electronic Health Record Display for Emergency Medicine

Xiaomei Wang et al. Appl Clin Inform. 2019 Aug.

Abstract

Background: Hospital emergency departments (EDs) are dynamic environments, involving coordination and shared decision making by staff who care for multiple patients simultaneously. While computerized information systems have been widely adopted in such clinical environments, serious issues have been raised related to their usability and effectiveness. In particular, there is a need to support clinicians to communicate and maintain awareness of a patient's health status, and progress through the ED plan of care.

Objective: This study used work-centered usability methods to evaluate an integrated patient-focused status display designed to support ED clinicians' communication and situation awareness regarding a patient's health status and progress through their ED plan of care. The display design was informed by previous studies we conducted examining the information and cognitive support requirements of ED providers and nurses.

Methods: ED nurse and provider participants were presented various scenarios requiring patient-prioritization and care-planning tasks to be performed using the prototype display. Participants rated the display in terms of its cognitive support, usability, and usefulness. Participants' performance on the various tasks, and their feedback on the display design and utility, was analyzed.

Results: Participants provided ratings for usability and usefulness for the display sections using a work-centered usability questionnaire-mean scores for nurses and providers were 7.56 and 6.6 (1 being lowest and 9 being highest), respectively. General usability scores, based on the System Usability Scale tool, were rated as acceptable or marginally acceptable. Similarly, participants also rated the display highly in terms of support for specific cognitive objectives.

Conclusion: A novel patient-focused status display for emergency medicine was evaluated via a simulation-based study in terms of work-centered usability and usefulness. Participants' subjective ratings of usability, usefulness, and support for cognitive objectives were encouraging. These findings, including participants' qualitative feedback, provided insights for improving the design of the display.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Image of the patient-focused display prototype with different sections for a given emergency department (ED) patient profile (For the purpose of the study, the patient’s name, image, and demographics were replaced with fictitious information).
Fig. 2
Fig. 2
Example of Specific Usability Questions for the top banner section.
Fig. 3
Fig. 3
Average usability, usefulness, and median frequency of use scores for each display section and for shared features.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Fong A, Ratwani R M. Understanding emergency medicine physicians multitasking behaviors around interruptions. Acad Emerg Med. 2018;25(10):1164–1168. - PubMed
    1. Kellogg K M, Wang E, Fairbanks R J, Ratwani R. 286 Sources of interruptions of emergency physicians: A pilot study. Ann Emerg Med. 2016;68(04):S111–S112.
    1. Laxmisan A, Hakimzada F, Sayan O R, Green R A, Zhang J, Patel V L.The multitasking clinician: decision-making and cognitive demand during and after team handoffs in emergency care Int J Med Inform 200776(11-12):801–811. - PubMed
    1. Fairbanks R J, Bisantz A M, Sunm M. Emergency department communication links and patterns. Ann Emerg Med. 2007;50(04):396–406. - PubMed
    1. Bisantz A, Pennathur R, Fairbanks R et al.Emergency department status boards: a case study in information systems transition. J Cogn Eng Decis Mak. 2010;4(01):39–68.

Publication types