Information Visualization for Decision-Making in Critical Care

Overseen By Jennifer Morelli

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of North Carolina, Chapel Hill

Disqualifiers: Non-ICU physicians, Residents without ICU experience

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

113 Participants Needed

Trial Summary

Do I need to stop taking my current medications for this trial?

The protocol does not specify whether participants must stop taking their current medications.

What data supports the effectiveness of the treatment Information Visualization Dashboard, EHR Visualization Tool, Clinical Decision Support Dashboard, Healthcare Information Visualization Platform?

Research shows that visualization dashboards in healthcare can improve patient outcomes by reducing information overload and medical errors, and enhancing decision-making in critical care settings. These tools help healthcare providers quickly access and interpret important clinical data, which is crucial in time-sensitive environments like intensive care units. ^{1 2 3 4 5}

Is the Information Visualization Dashboard safe for use in healthcare settings?

Research on visualization dashboards, like the Information Visualization Dashboard, suggests they are generally safe and can improve patient safety by helping healthcare providers better monitor and manage patient data. Users have found these tools to be highly usable and useful, which can enhance communication and reduce medical errors. ^{1 6 7 8 9}

How is the Information Visualization Dashboard treatment different from other treatments for decision-making in critical care?

The Information Visualization Dashboard is unique because it integrates and visually presents complex clinical data in a way that reduces cognitive overload for ICU clinicians, enabling quicker and more accurate decision-making compared to traditional methods that rely on less integrated and more cumbersome data systems. ^{1 2 3 10 11}

What is the purpose of this trial?

This study aims to test the efficacy of an information visualization dashboard on decision-making using a randomized controlled trial with crossover. This study aims to test the efficacy of using an information visualization dashboard on ICU providers' decision-making, efficiency, and performance compared to their institutional EHR through a randomized control trial with crossover.

Research Team

Saif Khairat, PhD

Principal Investigator

University of North Carolina, Chapel Hill

Eligibility Criteria

This trial is for ICU physicians and advanced practice providers who work full-time, have experience with institutional EHRs like Epic or Cerner, and are fluent in English. Residents must have prior ICU rotation experience to participate. Non-ICU staff or residents without ICU experience cannot join.

Inclusion Criteria

Residents with prior ICU rotation experience, use an institutional EHR (Epic or Cerner) to deliver care, and reads and speaks English

ICU physicians and advanced practice providers (APPs) with active full time ICU service, use an institutional EHR (Epic or Cerner) to deliver care, and reads and speaks English

Exclusion Criteria

Non-ICU Physicians or APPs

Residents with no prior ICU experience

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Training

Participants receive a short training presentation and a demonstration video on the AWARE system

1 day

1 visit (virtual)

Randomized Controlled Trial (RCT) Crossover

Participants review patient cases using both the institutional EHR and the AWARE system, with tasks and surveys to assess decision-making and usability

1 hour per session

2 sessions (in-person)

Follow-up

Participants complete post-intervention surveys to assess perceived workload and satisfaction

Immediately following each session

Treatment Details

Interventions

• Information Visualization Dashboard

Trial Overview The study is testing an information visualization dashboard called AWARE against standard electronic health records (EHR) systems used in ICUs. It's a randomized controlled trial where participants will switch between the two systems to compare decision-making efficiency.

Participant Groups

Group I: EHR (Control), then AWARE Experimental Treatment 2 Interventions

In this hour-long task, participants in this arm will first review and complete tasks using the institutional EHR. Then after an approximate 5 minute rest, participants will then review and complete tasks using AWARE.

Group II: AWARE Intervention, then EHR (Control) Experimental Treatment 2 Interventions

In this hour-long task, participants in this arm will first review and complete tasks using the AWARE intervention. Then after an approximate 5 minute rest, participants will then review and complete tasks using the institutional EHR.

Information Visualization Dashboard is already approved in United States, European Union for the following indications:

Approved in United States as EHR Visualization Dashboard for:

• Improving decision-making in ICU settings
• Enhancing efficiency in healthcare data management
• Reducing information overload in clinical environments

Approved in European Union as Clinical Decision Support Dashboard for:

• Supporting multidisciplinary rounds in ICUs
• Facilitating data-driven decision-making in healthcare
• Improving patient care through better information management

Who Is Running the Clinical Trial?

University of North Carolina, Chapel Hill

Lead Sponsor

Trials

1,588

Recruited

4,364,000+

Mayo Clinic

Collaborator

Trials

3,427

Recruited

3,221,000+

MedStar Health

Collaborator

Trials

9

Recruited

76,100+

National Library of Medicine (NLM)

Collaborator

Trials

42

Recruited

108,000+

University of Pittsburgh Medical Center

Collaborator

Trials

78

Recruited

77,600+

Findings from Research

Visualization dashboards in healthcare can significantly reduce the time and difficulty associated with data gathering, which helps decrease cognitive overload for clinicians and improve patient outcomes.

These dashboards enhance situation awareness and compliance with safety guidelines, indicating their potential to minimize medical errors and optimize care in high-pressure environments like Intensive Care Units.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Visualization Dashboards on Quality of Care and Clinician Satisfaction: Integrative Literature Review. Khairat, SS., Dukkipati, A., Lauria, HA., et al.[2023]

The use of electronic health records (EHRs) in critical care medicine is essential due to the vast amount of clinical data generated by ICU patients, but current data displays are not optimal for decision-making by ICU teams.

Implementing performance dashboards that adhere to usability principles can improve the way ICU performance data is presented, ultimately enhancing provider well-being and patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Next-Generation Electronic Health Record in the ICU: A Focus on User-Technology Interface to Optimize Patient Safety and Quality. Jalilian, L., Khairat, S.[2022]

A new integrated visualization tool was developed to help physicians in intensive care units make better decisions about antibiotic use, addressing the complex data environment they work in.

Usability testing showed that this tool improved user performance and preferences, suggesting it can enhance understanding of a patient's infection status and support more informed antibiotic prescribing.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrated information visualization to support decision making for use of antibiotics in intensive care: design and usability evaluation. Forsman, J., Anani, N., Eghdam, A., et al.[2022]

The development of a dashboard and scorecard for visualizing process metrics in a hospital setting has enhanced real-time situational awareness for frontline coordinators and provided monthly performance insights for strategic improvements.

These visualization tools, created by a multidisciplinary team, have successfully made performance gaps more visible, leading to the identification of new targets for quality improvement initiatives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of data integration and visualization tools for the Department of Radiology to display operational and strategic metrics. Romero-Brufau, S., Kostandy, P., Maass, KL., et al.[2020]

The keystone dashboard is a comprehensive visual analytical tool designed to monitor key performance metrics across an entire healthcare organization, integrating data from patient safety, quality improvement, human resources, and risk management.

This dashboard uses a heatmap and density visualization to highlight areas of concern in real-time, allowing for immediate insights into the organization's overall health and performance metrics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How do we measure organisational wellness? Development of a comprehensive patient-centred and employee-centred visual analytical solution. Watkins, SC., Hammerschmidt, C., Gray, GM., et al.[2023]

The Patient Safety Dashboard was utilized 70% of the time it was available, indicating a good level of engagement among healthcare providers, particularly among nurses and physician assistants during specific times like morning rounds.

Providers generally found the Dashboard easy to use, with attendings rating it highly for usability (4.23), but nurses expressed concerns about its impact on their quality of work life, rating it lower (2.88), highlighting areas for improvement in future implementations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use, Perceived Usability, and Barriers to Implementation of a Patient Safety Dashboard Integrated within a Vendor EHR. Bersani, K., Fuller, TE., Garabedian, P., et al.[2021]

A systematic review of 33 publications revealed that while the use of patient safety dashboards has increased over the past 15 years, their direct impact on patient safety remains poorly understood.

Most dashboard designs lack the incorporation of informatics and human factors principles, which are essential for enhancing usability and effectiveness in supporting patient safety monitoring.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dashboards for visual display of patient safety data: a systematic review. Murphy, DR., Savoy, A., Satterly, T., et al.[2021]

The patient safety dashboard, developed for interdisciplinary teams in hospitals, collects real-time data across 13 safety domains and generates alerts to enhance communication and management of safety concerns.

Users reported the dashboard as highly usable and useful, indicating its potential to improve patient safety in clinical settings by integrating seamlessly with existing electronic health record systems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

User-Centered Collaborative Design and Development of an Inpatient Safety Dashboard. Mlaver, E., Schnipper, JL., Boxer, RB., et al.[2019]

The 'VisualDecisionLinc' (VDL) tool prototype utilizes visual analytics to simplify the interpretation of large volumes of patient data from Electronic Health Records (EHR), aiding clinicians in making informed decisions about therapeutic options.

By providing summarized data on the effectiveness and risks of treatments tailored to specific patient subpopulations, the VDL tool helps reduce information overload and supports individualized patient care in time-pressured clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

VisualDecisionLinc: a visual analytics approach for comparative effectiveness-based clinical decision support in psychiatry. Mane, KK., Bizon, C., Schmitt, C., et al.[2022]

A pilot test of an interactive clinical decision dashboard for knee osteoarthritis treatment showed high usability and acceptability among 25 participants, with average scores indicating ease of use and effectiveness in aiding decision-making.

The dashboard successfully summarized key information about treatment options, leading to reduced decisional uncertainty and improved clarity of values, suggesting it could enhance patient-centered care in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and initial evaluation of a treatment decision dashboard. Dolan, JG., Veazie, PJ., Russ, AJ.[2022]

The MIVA 2.0 dashboard significantly improved the speed and accuracy of clinical decision-making compared to traditional ICU paper medical charts, based on a study with 12 participants.

Participants reported that MIVA 2.0 effectively reduced cognitive load, suggesting it could enhance the overall efficiency of healthcare providers in analyzing real-time clinical data.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supporting Clinical Cognition: A Human-Centered Approach to a Novel ICU Information Visualization Dashboard. Faiola, A., Srinivas, P., Duke, J.[2022]

References

1. Canada pubmed.ncbi.nlm.nih.gov

The Impact of Visualization Dashboards on Quality of Care and Clinician Satisfaction: Integrative Literature Review. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

The Next-Generation Electronic Health Record in the ICU: A Focus on User-Technology Interface to Optimize Patient Safety and Quality. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Integrated information visualization to support decision making for use of antibiotics in intensive care: design and usability evaluation. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Development of data integration and visualization tools for the Department of Radiology to display operational and strategic metrics. [2020]

5. England pubmed.ncbi.nlm.nih.gov

How do we measure organisational wellness? Development of a comprehensive patient-centred and employee-centred visual analytical solution. [2023]

6. Germany pubmed.ncbi.nlm.nih.gov

Use, Perceived Usability, and Barriers to Implementation of a Patient Safety Dashboard Integrated within a Vendor EHR. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Dashboards for visual display of patient safety data: a systematic review. [2021]

8. Netherlands pubmed.ncbi.nlm.nih.gov

User-Centered Collaborative Design and Development of an Inpatient Safety Dashboard. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

VisualDecisionLinc: a visual analytics approach for comparative effectiveness-based clinical decision support in psychiatry. [2022]

10. England pubmed.ncbi.nlm.nih.gov

Development and initial evaluation of a treatment decision dashboard. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Supporting Clinical Cognition: A Human-Centered Approach to a Novel ICU Information Visualization Dashboard. [2022]