Development, implementation and evaluation of an information model for archetype based user responsive medical data visualization.

BACKGROUND: When medical data have been successfully recorded or exchanged between systems there appear a need to present the data consistently to ensure that it is clearly understood and interpreted. A standard based user interface can provide interoperability on the visual level. OBJECTIVES: The goal of this research was to develop, implement and evaluate an information model for building user interfaces for archetype based medical data. METHODS: The following types of knowledge were identified as important elements and were included in the information model: medical content related attributes, data type related attributes, user-related attributes, device-related attributes. In order to support flexible and efficient user interfaces an approach that represents different types of knowledge with different models separating the medical concept from a visual concept and interface realization was chosen. We evaluated the developed approach using Guideline for Good Evaluation Practice in Health Informatics (GEP-HI). RESULTS: We developed a higher level information model to complement the ISO 13606 archetype model. This enabled the specification of the presentation properties at the moment of the archetypes' definition. The model allows realizing different users' perspectives on the data. The approach was implemented and evaluated within a functioning EHR system. The evaluation involved 30 patients of different age and IT experience and 5 doctors. One month of testing showed that the time required reading electronic health records decreased for both doctors (from average 310 to 220s) and patients (from average 95 to 39s). Users reported a high level of satisfaction and motivation to use the presented data visualization approach especially in comparison with their previous experience. CONCLUSION: The introduced information model allows separating medical knowledge and presentation knowledge. The additional presentation layer will enrich the graphical user interface's flexibility and will allow an optimal presentation of medical data considering the different users' perspectives and different media used for data presentation.

Analysis of metrics for the usability evaluation of EHR management systems.

Electronic health records are replacing conventional paper-based health records. For a doctor it is a working instrument, which can significantly reduce the time spent on paper work. Patients can benefit from accessing the electronic health records even though they usually do not have a medical background. Therefore, when specifying a graphical user interface (GUI) it is necessary to take into account the requirements of the different users: e.g. the functionality for the doctors and the presentation of data in an understandable manner for the patients. The study aims to review and analyze metrics used to evaluate the usability of user interfaces in health information systems. The scope of the search included the analysis of existing usability evaluating metrics that are applied both in healthcare and other domains, where the standard of storage and presentation of information are applied. We identified a set of metrics and evaluation methods that provide holistic evaluation facilities for graphical user interfaces.

Standardized EHR interoperability - preliminary results of a German pilot project using the archetype methodology.

The mobility of doctors and patients asks for multilingualism of electronic health record (EHR) systems: Doctors might face language problems using foreign medical information systems; people working abroad ask for continuous care which requires the treating physician to consult and understand the patient's health record. To address these linguistic and interoperability issues a solution is being developed that is based on widely acclaimed standards. Medical concepts that are derived from ASTM CCR define an interface model (based on ISO 13606). A server manages the data exchange between heterogeneous systems based on the interface model. It provides web services (automatic) and web forms (manual) and performs a transformation from the legacy scheme to the common structure. Furthermore, the server provides rich visualization capabilities (e.g. language-switch, custom charts etc.) which are useful for those EHR systems that don't provide these features.

Analysis of metrics for the usability evaluation of electronic health record systems.

Electronic health records are gradually replacing conventional paper-based health records. For a doctor, it is a working instrument, which can significantly reduce the time spent on paper work. At the same time, patients can benefit from accessing the electronic health records even though they usually do not have a medical background. Therefore, when specifying a graphical user interface (GUI) it is necessary to take into account the requirements of the different users: e.g. the functionality for the doctors and the presentation of data in an understandable manner for the patients. The study aims to review and analyze metrics used to evaluate the usability of user interfaces in health information systems. A literature review was performed to identify existing metrics. The scope of the search included the analysis of existing usability evaluation metrics that are applied both in healthcare and other domains, where standards for storage and presentation of information are applied. The analysis focused on metrics that are applicable for evaluating GUIs of health information systems. Several approaches and standards have been studied. Finally, a set of metrics and evaluation methods that provide holistic evaluation facilities for graphical user interfaces has been identified.