Enhancing Timely Management of Workflow with Interactive Visual Displays & Actions for Situation Awareness Processing Sureyya Tarkan UMD Dept. of Computer Science & HCIL Supervised by Ben Shneiderman & Catherine Plaisant
Situation Awareness ( Endsley, 2004 ) 1 Shared SA of a teamTemporal dynamic environment 1. Perception 2. Comprehension 3. Projection
Interruptions & Notifications October 8,
‘Missed Results’ Problem Mishandling of abnormal results & no follow-up (Wahls, 2007) Most common missing information: lab test results (Dovey, 2002) Delay in care, time/financial loss, pain/suffering, adverse clinical consequence (Hickner, 2008) 3 October 8, 2015
Test Process Steps 1. Pre-analytic a. Ordering the test b. Implementing the test 2. Analytic a. Performing the test 3. Post-analytic a. Reporting results to the clinician b. Responding to the results c. Notifying the patients of the results d. Following-up to ensure the patient took the appropriate action based on test results 4 Lab technician Patient & Physician Physician Specimen lost Specimen mislabeled in office Physician on vacation Results misplaced Specimen damaged during transport No documentation on record Nurse Patient doesn’t go
Medical Informatics Applications 5 VA View Alert Window Alert arrived results in chronological order Patient list Pending tests in patient chart
October 8, Motivation: Package Tracking Clear expectation Constant feedback Explicit responsibility
7 Motivation: Lists & Actions October 8, 2015
Approach for Reducing Missed Results Model user actions within workflow specification Assign temporal responsibility Derive an interactive display from the model From order time to until all follow-up actions are taken Support actor action sheets as part of tracking Provide retrospective analyses for manager to identify common problems and compare performance 8 October 8, 2015
Laboratory Test Result Management Workflow Schedule Exam (4 days) Accept Patient (1 hour) Confirm Appointment Update Patient Info Draw Sample (21 hours) Prepare Equipment Ship with Carrier Transport by self Examine Specimen (1 day) Access Patient Sample Conduct Test Write Results Analyze Results (1 day) Access Report Inform Patient Schedule Visit Repeat Test Order New Test 9 October 8, 2015
Modeling Actions 10
October 8, 2015 Multi-Step Task Analyzing, Reporting, Tracking (MSTART) Prototype 11
Rich Tabular Displays October 8,
October 8, 2015 Generating Actor Action Sheets: Result Review 13
14 October 8, 2015 Order
15 October 8, 2015 Retrospective Analysis
Proposed Work: Actions for Situation Awareness Processing (ASAP) October 8, More information Edit/Annotate Marking
October 8, Actions, Groups, and Values
Evaluation Plans for ASAP Iterative Design Reviews with Medical Professionals Usability Test 10 subjects, 25 tasks (1 hour) Inform design Feedback: Interview, Questionnaire Controlled Experiment Test whether ASAP reduces the amount of missed and delayed results Busy s imulation environment where multiple distracting factors are in place Compare to a plain list ordered by time of arrival 20 participants, 50 tasks (2 hours) October 8,
Summary Model user actions within workflow specification Allow actions as part of display Integrate review of results with possible actor actions from within same screen Tracking shows how much time has passed since last action Acknowledgments Zach Hettinger, Daniel Murphy, Archana Laxmisan, Hardeep Singh, Dean Sittig Strategic Health-IT Advanced Research Projects (SHARPC) Contact: Website: 19 October 8, 2015