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Assessing the usability by clinicians of VISION: A hierarchical display of patient-collected physiological information to clinicians

View Article: PubMed Central - PubMed

ABSTRACT

Background: The inability of patients to accurately and completely recount their clinical status between clinic visits reduces the clinician’s ability to properly manage their patients. One way to improve this situation is to collect objective patient information while the patients are at home and display the collected multi-day clinical information in parallel on a single screen, highlighting threshold violations for each channel, and allowing the viewer to drill down to any analog signal on the same screen, while maintaining the overall physiological context of the patient. All this would be accomplished in a way that was easy for the clinician to view and use.

Methods: Patients used five mobile devices to collect six heart failure-related clinical variables: body weight, systolic and diastolic blood pressure, pulse rate, blood oxygen saturation, physical activity, and subjective input. Fourteen clinicians practicing in a heart failure clinic rated the display using the System Usability Scale that, for acceptability, had an expected mean of 68 (SD, 12.5). In addition, we calculated the Intraclass Correlation Coefficient of the clinician responses using a two-way, mixed effects model, ICC (3,1).

Results: We developed a single-screen temporal hierarchical display (VISION) that summarizes the patient’s home monitoring activities between clinic visits. The overall System Usability Scale score was 92 (95% CI, 87-97), p < 0.0001; the ICC was 0.89 (CI, 0.79-0.97), p < 0.0001.

Conclusion: Clinicians consistently found VISION to be highly usable. To our knowledge, this is the first single-screen, parallel variable, temporal hierarchical display of both continuous and discrete information acquired by patients at home between clinic visits that presents clinically significant information at the point of care in a manner that is usable by clinicians.

No MeSH data available.


Data collection over six nights; device data is extracted with device-specific software and uploaded to the MySQL database using R programming language
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Fig1: Data collection over six nights; device data is extracted with device-specific software and uploaded to the MySQL database using R programming language

Mentions: We previously conducted a 39 heart failure patient study to assess patients’ ability to use mobile devices at home [22]. Experienced heart failure clinicians selected five clinical variables for their diagnostic and prognostic value in heart failure. These variables were consistent with the important variables in the heart failure literature. The clinical variables were: systolic and diastolic blood pressure, heart rate, blood oxygen saturation, physical activity, and body weight. Patients received five devices: blood pressure, pulse oximeter, actigraph, body weight scale, and an iPad. They used these devices at home for six consecutive nights. The procedure for patient data collection is shown in Fig. 1. We found that patients were able to use all of the devices and they rated the usability of all the devices higher than expected. Our study provided support for at-home patient-collected physiologic data. To our knowledge, this was the first study to assess the patient use and usability of mobile electronic devices by heart failure patients in their homes at night. These data were used as the input to VISION.Fig. 1


Assessing the usability by clinicians of VISION: A hierarchical display of patient-collected physiological information to clinicians
Data collection over six nights; device data is extracted with device-specific software and uploaded to the MySQL database using R programming language
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5391572&req=5

Fig1: Data collection over six nights; device data is extracted with device-specific software and uploaded to the MySQL database using R programming language
Mentions: We previously conducted a 39 heart failure patient study to assess patients’ ability to use mobile devices at home [22]. Experienced heart failure clinicians selected five clinical variables for their diagnostic and prognostic value in heart failure. These variables were consistent with the important variables in the heart failure literature. The clinical variables were: systolic and diastolic blood pressure, heart rate, blood oxygen saturation, physical activity, and body weight. Patients received five devices: blood pressure, pulse oximeter, actigraph, body weight scale, and an iPad. They used these devices at home for six consecutive nights. The procedure for patient data collection is shown in Fig. 1. We found that patients were able to use all of the devices and they rated the usability of all the devices higher than expected. Our study provided support for at-home patient-collected physiologic data. To our knowledge, this was the first study to assess the patient use and usability of mobile electronic devices by heart failure patients in their homes at night. These data were used as the input to VISION.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: The inability of patients to accurately and completely recount their clinical status between clinic visits reduces the clinician’s ability to properly manage their patients. One way to improve this situation is to collect objective patient information while the patients are at home and display the collected multi-day clinical information in parallel on a single screen, highlighting threshold violations for each channel, and allowing the viewer to drill down to any analog signal on the same screen, while maintaining the overall physiological context of the patient. All this would be accomplished in a way that was easy for the clinician to view and use.

Methods: Patients used five mobile devices to collect six heart failure-related clinical variables: body weight, systolic and diastolic blood pressure, pulse rate, blood oxygen saturation, physical activity, and subjective input. Fourteen clinicians practicing in a heart failure clinic rated the display using the System Usability Scale that, for acceptability, had an expected mean of 68 (SD, 12.5). In addition, we calculated the Intraclass Correlation Coefficient of the clinician responses using a two-way, mixed effects model, ICC (3,1).

Results: We developed a single-screen temporal hierarchical display (VISION) that summarizes the patient’s home monitoring activities between clinic visits. The overall System Usability Scale score was 92 (95% CI, 87-97), p < 0.0001; the ICC was 0.89 (CI, 0.79-0.97), p < 0.0001.

Conclusion: Clinicians consistently found VISION to be highly usable. To our knowledge, this is the first single-screen, parallel variable, temporal hierarchical display of both continuous and discrete information acquired by patients at home between clinic visits that presents clinically significant information at the point of care in a manner that is usable by clinicians.

No MeSH data available.