CareView: analyzing nursing narratives for temporal trends

ABSTRACT

In a study of home-healthcare practitioners, we found that temporal trends contained in patients' clinical records form one of the most critical pieces of information when selecting and administering appropriate treatment. However, these records are comprised of quantitative and qualitative data, and recorded as a narrative. This format makes the extraction of historical trends difficult and time-consuming. To address this limitation, we introduce CareView, a system that utilizes a set of visualization techniques to increase the visibility of temporal trends in clinical narratives. Specifically, our system focuses on integrated temporal visualizations of numeric and qualitative records; a visualization to facilitate rapid comparison of a patient's condition against previously established care goals; and the ability to immediately visualize data as it is entered. Two experiments comparing the market-leading tabular interface with CareView revealed a significant reduction in the time required to identify trends in patients' conditions. However, interviews with nurses highlighted the importance of preserving the integrity of the holistic narrative and suggested extending the design space.

REFERENCES

• 1: Bay-Wei Chang , Jock D. Mackinlay , Polle T. Zellweger , Takeo Igarashi, A negotiation architecture for fluid documents, Proceedings of the 11th annual ACM symposium on User interface software and technology, p.123-132, November 01-04, 1998, San Francisco, California, United States [doi>10.1145/288392.288585]
• 2: Giles, T. The cost-effective way forward for the management of the patient with heart failure Cardiology 87(1) 1996 33--39
• 3: Catherine Plaisant , Brett Milash , Anne Rose , Seth Widoff , Ben Shneiderman, LifeLines: visualizing personal histories, Proceedings of the SIGCHI conference on Human factors in computing systems: common ground, p.221-ff., April 13-18, 1996, Vancouver, British Columbia, Canada [doi>10.1145/238386.238493]
• 4: Posner, SM, Tufte, ER, Graphical summary of patient status, The Lancet, 344:8919, August 6, 1994, 386--389.

INDEX TERMS

Primary Classification:
  H. Information Systems
  H.1 MODELS AND PRINCIPLES
      H.1.2 User/Machine Systems
          Subjects: Human factors

Additional Classification:
  H. Information Systems
  H.5 INFORMATION INTERFACES AND PRESENTATION (I.7)
      H.5.2 User Interfaces (D.2.2, H.1.2, I.3.6)
          Subjects: User-centered design

Keywords:
ethnographic observations, interaction design, medical records, screen design, temporal visualization, timelines