The Improvement of the Electronic Health Record User Experience by Screen Design Principles.

The amount and complexity of data accumulated in electronic health record (EHR) is quite large, and the quantity of information that clinicians can examine and handle is very limited. Thus, it is necessary to enhance the accessibility of EHR by improving the user experience (UX). To apply information visualization that turns EHR data into an understandable visual format, we propose following five screen design principles when designing UX interfaces. #1: One view should contain single patient data. #2: Data should be summarized or titled for overview and details should be given on-demand. #3: Data should be displayed in time-series. #4: Data should be categorized by primary type. #5: More data should be displayed at the same time. Three screen designs are plausible utilizing the above-mentioned principles. To measure the UX of screen designs and validate the design principles, we built an EHR viewer system that has three windows corresponding to these screen designs and had it tested by medical staff. The results of the test revealed that the UX of the screen design is proportional to the number of design principles that the screen design incorporates. It shows that the proposed screen design principles improve the UX of EHR.

Type III procollagen-N-peptide as a predictor of persistent atrial fibrillation recurrence after cardioversion.

AIMS: Fibrosis and inflammation may play a significant role in the pathogenesis of atrial fibrillation (AF) recurrence. Type III procollagen-N-peptide (PIIINP) may be related to atrial fibrosis and play a role in predicting the recurrence of AF. We investigated whether PIIINP as a fibrosis marker predicts the recurrence of AF after cardioversion. METHODS AND RESULTS: Serum PIIINP, interleukin-6, high-sensitivity C-reactive protein, brain natriuretic peptide, renin and aldosterone were measured at baseline and 24 months in 88 patients (62%) with sinus rhythm (SR) maintenance and 54 patients (38%) with AF recurrence. Furthermore, the root mean square voltage in the last 20 ms (RMS20) via P-wave signal-averaged electrocardiogram (P-SAECG) was measured and the relationship between fibrosis biomarkers and RMS20 was examined. Baseline PIIINP with AF recurrence was significantly higher than for those with SR maintenance (0.664 vs. 0.581 U/mL, P = 0.001). However, there were no significant differences in other biomarkers. A logistic regression identified PIIINP (odds ratio 2.61, P = 0.008) as an independent predictor of AF recurrence. The RMS20 as measured by P-SAECG with SR maintenance and PIIINP levels <0.72 U/mL (at baseline) was significantly higher after 24 months than at baseline. Furthermore, the RMS20 with AF recurrence and PIIINP levels >0.72 U/mL (at baseline) was significantly lower after 24 months than baseline. CONCLUSIONS: Elevated baseline PIIINP concentration is an independent predictor for AF recurrence after cardioversion. Furthermore, there is a relationship between PIIINP and RMS20 and the fibrosis of AF.