Get To The Point! Problem-Based Curated Data Views To Augment Care For Critically Ill Patients

Abstract

Electronic health records in critical care medicine offer unprecedented opportunities for clinical reasoning and decision making. Paradoxically, these data-rich environments have also resulted in clinical decision support systems (CDSSs) that fit poorly into clinical contexts, and increase health workers cognitive load. In this paper, we introduce a novel approach to designing CDSSs that are embedded in clinical workflows, by presenting problem-based curated data views tailored for problem-driven discovery, team communication, and situational awareness. We describe the design and evaluation of one such CDSS, In-Sight, that embodies our approach and addresses the clinical problem of monitoring critically ill pediatric patients. Our work is the result of a co-design process, further informed by empirical data collected through formal usability testing, focus groups, and a simulation study with domain experts. We discuss the potential and limitations of our approach, and share lessons learned in our iterative co-design process.