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Integrating data from an online diabetes prevention program into an electronic health record and clinical workflow, a design phase usability study.

Mishuris RG, Yoder J, Wilson D, Mann D - BMC Med Inform Decis Mak (2016)

Bottom Line: There is an emerging opportunity to integrate this data directly into the electronic health record (EHR), but little is known about what information to share or how to share it most effectively.This provides a framework for how to integrate external data into provider workflow in efficient and effective ways.There is now the potential to realize the importance of having this data available in the clinical setting for patient engagement and health outcomes.

View Article: PubMed Central - PubMed

Affiliation: Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown 2nd floor, Boston, MA, 02118, USA. rgrochow@bu.edu.

ABSTRACT

Background: Health information is increasingly being digitally stored and exchanged. The public is regularly collecting and storing health-related data on their own electronic devices and in the cloud. Diabetes prevention is an increasingly important preventive health measure, and diet and exercise are key components of this. Patients are turning to online programs to help them lose weight. Despite primary care physicians being important in patients' weight loss success, there is no exchange of information between the primary care provider (PCP) and these online weight loss programs. There is an emerging opportunity to integrate this data directly into the electronic health record (EHR), but little is known about what information to share or how to share it most effectively. This study aims to characterize the preferences of providers concerning the integration of externally generated lifestyle modification data into a primary care EHR workflow.

Methods: We performed a qualitative study using two rounds of semi-structured interviews with primary care providers. We used an iterative design process involving primary care providers, health information technology software developers and health services researchers to develop the interface.

Results: Using grounded-theory thematic analysis 4 themes emerged from the interviews: 1) barriers to establishing healthy lifestyles, 2) features of a lifestyle modification program, 3) reporting of outcomes to the primary care provider, and 4) integration with primary care. These themes guided the rapid-cycle agile design process of an interface of data from an online diabetes prevention program into the primary care EHR workflow.

Conclusions: The integration of external health-related data into the EHR must be embedded into the provider workflow in order to be useful to the provider and beneficial for the patient. Accomplishing this requires evaluation of that clinical workflow during software design. The development of this novel interface used rapid cycle iterative design, early involvement by providers, and usability testing methodology. This provides a framework for how to integrate external data into provider workflow in efficient and effective ways. There is now the potential to realize the importance of having this data available in the clinical setting for patient engagement and health outcomes.

No MeSH data available.


Related in: MedlinePlus

Post-Phase 1 Usability Interview Design
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Fig5: Post-Phase 1 Usability Interview Design

Mentions: The study team engaged with an EHR design firm to develop the data integration and user interface prototype (see Fig. 2) that was presented to the study providers in the Phase 1 usability evaluations. The data presented in the user interface are a graphical representation of the data entered by patients into the external online diabetes prevention program GOALS. Weekly meetings allowed for rapid cycle iterative design and preliminary usability testing by study staff. Using the data collected in the Phase 1 usability sessions, a series of prototype refinements were created (see Fig. 5 for workflow, Fig. 6 for graphical display iterations, and Fig. 4 for the near-final dashboard and graphs). To improve usability and understanding of the data, the data visualization of patient-entered data from GOALS in the EHR evolved from bar charts to radar plots to speed dials over the course of the design cycles (see Fig. 6). Providers’ desire to see both patient engagement and progress towards goals drove the development of the graphs over time, dashboard, and lesson completion display. The locations in which the graphical display would appear in the EHR (see Fig. 5) were influenced by the provider interviews and known clinical workflows; 6 trigger points were identified. Given clinical workflows, there was also a desire to be notified that there was new information to review, pin the GOALS view to the side so providers could refer back and forth, and to print the information for patients (see Fig. 5).Fig. 5


Integrating data from an online diabetes prevention program into an electronic health record and clinical workflow, a design phase usability study.

Mishuris RG, Yoder J, Wilson D, Mann D - BMC Med Inform Decis Mak (2016)

Post-Phase 1 Usability Interview Design
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940704&req=5

Fig5: Post-Phase 1 Usability Interview Design
Mentions: The study team engaged with an EHR design firm to develop the data integration and user interface prototype (see Fig. 2) that was presented to the study providers in the Phase 1 usability evaluations. The data presented in the user interface are a graphical representation of the data entered by patients into the external online diabetes prevention program GOALS. Weekly meetings allowed for rapid cycle iterative design and preliminary usability testing by study staff. Using the data collected in the Phase 1 usability sessions, a series of prototype refinements were created (see Fig. 5 for workflow, Fig. 6 for graphical display iterations, and Fig. 4 for the near-final dashboard and graphs). To improve usability and understanding of the data, the data visualization of patient-entered data from GOALS in the EHR evolved from bar charts to radar plots to speed dials over the course of the design cycles (see Fig. 6). Providers’ desire to see both patient engagement and progress towards goals drove the development of the graphs over time, dashboard, and lesson completion display. The locations in which the graphical display would appear in the EHR (see Fig. 5) were influenced by the provider interviews and known clinical workflows; 6 trigger points were identified. Given clinical workflows, there was also a desire to be notified that there was new information to review, pin the GOALS view to the side so providers could refer back and forth, and to print the information for patients (see Fig. 5).Fig. 5

Bottom Line: There is an emerging opportunity to integrate this data directly into the electronic health record (EHR), but little is known about what information to share or how to share it most effectively.This provides a framework for how to integrate external data into provider workflow in efficient and effective ways.There is now the potential to realize the importance of having this data available in the clinical setting for patient engagement and health outcomes.

View Article: PubMed Central - PubMed

Affiliation: Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown 2nd floor, Boston, MA, 02118, USA. rgrochow@bu.edu.

ABSTRACT

Background: Health information is increasingly being digitally stored and exchanged. The public is regularly collecting and storing health-related data on their own electronic devices and in the cloud. Diabetes prevention is an increasingly important preventive health measure, and diet and exercise are key components of this. Patients are turning to online programs to help them lose weight. Despite primary care physicians being important in patients' weight loss success, there is no exchange of information between the primary care provider (PCP) and these online weight loss programs. There is an emerging opportunity to integrate this data directly into the electronic health record (EHR), but little is known about what information to share or how to share it most effectively. This study aims to characterize the preferences of providers concerning the integration of externally generated lifestyle modification data into a primary care EHR workflow.

Methods: We performed a qualitative study using two rounds of semi-structured interviews with primary care providers. We used an iterative design process involving primary care providers, health information technology software developers and health services researchers to develop the interface.

Results: Using grounded-theory thematic analysis 4 themes emerged from the interviews: 1) barriers to establishing healthy lifestyles, 2) features of a lifestyle modification program, 3) reporting of outcomes to the primary care provider, and 4) integration with primary care. These themes guided the rapid-cycle agile design process of an interface of data from an online diabetes prevention program into the primary care EHR workflow.

Conclusions: The integration of external health-related data into the EHR must be embedded into the provider workflow in order to be useful to the provider and beneficial for the patient. Accomplishing this requires evaluation of that clinical workflow during software design. The development of this novel interface used rapid cycle iterative design, early involvement by providers, and usability testing methodology. This provides a framework for how to integrate external data into provider workflow in efficient and effective ways. There is now the potential to realize the importance of having this data available in the clinical setting for patient engagement and health outcomes.

No MeSH data available.


Related in: MedlinePlus