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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new information visualization dashboard to determine if it helps ICU doctors and advanced practice providers make better decisions compared to their usual electronic health records (EHRs). Participants will use both the new dashboard and their usual EHR to compare their effects on work. The trial targets ICU doctors and advanced practice providers who work full-time and use EHRs like Epic or Cerner. Participants should also be comfortable reading and speaking English. As an unphased trial, this study offers participants the chance to contribute to innovative research that could enhance decision-making tools in healthcare.

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 prior data suggests that this information visualization dashboard is safe for use in critical care decision-making?

Research has shown that information visualization dashboards can enhance decision-making and efficiency in healthcare settings, such as the ICU. These dashboards present data in a more understandable and actionable format.

Although specific safety data for these dashboards is unavailable, they function as tools rather than drugs or devices, so typical safety concerns do not apply. Studies have demonstrated that dashboards can clarify information and reduce errors. Unlike medications, they have no side effects. Instead, they aid healthcare providers in making safer decisions by presenting data more effectively.

In summary, despite the lack of direct safety data for the dashboards, they are designed to improve safety by clarifying and simplifying information in critical care situations. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Information Visualization Dashboard trial because it could revolutionize decision-making in critical care settings. Unlike traditional methods that rely heavily on standard electronic health records (EHR), this dashboard aims to enhance the way healthcare professionals process and visualize data. By potentially offering a more intuitive and comprehensive overview of patient information, it may lead to quicker and more informed decisions in critical situations. This approach could ultimately improve patient outcomes by reducing cognitive overload and streamlining complex information into actionable insights.

What evidence suggests that the Information Visualization Dashboard is effective for decision-making in critical care?

Studies have shown that information visualization dashboards can improve decision-making in healthcare. In this trial, participants will use the Information Visualization Dashboard, designed to help healthcare providers gather data quickly and easily, enabling faster decisions. Research also shows that these dashboards can reduce mental tiredness among ICU staff. As a result, doctors and nurses might feel less mentally exhausted, enhancing their performance. Overall, using these dashboards can lead to fewer mistakes and quicker task completion, making them valuable tools for improving care in intensive care units (ICUs). ^{3 5 6 7 8}

Who Is on the Research Team?

Saif Khairat, PhD

Principal Investigator

University of North Carolina, Chapel Hill

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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 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]

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]

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]

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]

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]

Citations

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EHR-based Visualization Tool: Adoption Rates, Satisfaction ... Patient outcomes following implementation of the tool indicate one-year improvements in some CVH metrics, such as body mass index and diabetes. Discussion:.

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Protocol Investigating Information Visualization to Combat ... We propose to study the effect of an information visualization dashboard on ICU providers' cognitive fatigue in 4 major US medical centers. In ...

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Investigating Information Visualization to Combat ... Objective: We propose to study the effect of an information visualization dashboard on ICU providers' cognitive fatigue in 4 major US medical ...

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Understanding Expert Exploration in EHR Visualization Tools The clinical researchers also saw clear potential for using the tool to support the formulation and investigation of clinical hypotheses.

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Automated Filtering and Visualization of Patient-Centered ... Automated, patient-centered dashboards can improve EHR usability and support safer, faster decision-making in acute care. However, further ...

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The Next-Generation Electronic Health Record in the ICU In this paper, we discuss the current challenges with representing ICU patient data in EHRs and the potential of data visualization dashboards.

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The Impact of Visualization Dashboards on Quality of Care ... A dashboard is a data-driven clinical decision support tool capable of querying multiple databases and providing a visual representation of ...