User Interface and Visualization for
Results Management

Participants

• Sureyya Tarkan, Graduate Student in the Department of Computer Science, University of Maryland
• Kostas Pantazos, Visiting Graduate Student from Software and Systems, IT University of Copenhagen, Denmark
• Catherine Plaisant, (Co-PI) - Research Scientist, UMIACS, Associate Director of Research at HCIL
• Ben Shneiderman, (Co-PI) - Professor, Computer Science, Researcher (and Founding Director) at HCIL

Texas and Kentucky Partners

• University of Texas, Houston: Eliz Markovitz. Jorge Herskovic, Elmer V Bernstam, Jiaje Jang and Muhammad Walji (and many more providing feedback)
• University of Kentucky: Todd Johnson

Context: the SHARP-C Project

The University of Maryland is one of the nine institutions participating in the National Center for Cognitive Informatics and Decision Making in Healthcare (NCCD) led by The University of Texas Health Science Center at Houston. NCCD is funded by the Office of the National Coordinator for Health IT under the Strategic Health IT Advanced Research Projects (SHARP) Program. This program seeks to support improvements in the quality, safety and efficiency of health care through advanced information technology. The NCCD award was one of four presented by the Office of the National Coordinator for Health Information Technology (ONC) through the American Recovery and Reinvestment Act of 2009 to address key barriers to health information technology. NCCD's research focus area is Patient-Centered Cognitive Support.

For more information see:
1) the NCCD website at the University of Texas in Houston (the main PI) OR
2) the Maryland webpage which provides a summary of all the SharpC projects HCIL participated in.

Project Description: Results Management (once called "Missed Labs")

Clinicians manage medical orders to ensure that the results are returned promptly to the correct physician and followed up on time. Delays in results management occur frequently, physically harm patients, and often cause malpractice litigation.
Better tracking of medical orders that showed progress and indicated delays, could result in improved care, better safety, and reduced clinician effort. This research presents novel displays of rich tables with an interaction technique called ARCs (Actions for Rapid Completion). Rich tables are generated by MStart (Multi-Step Task Analyzing, Reporting, and Tracking) from a workflow model that defines order processes. Rich tables help clinicians perceive each order's status, prioritize the critical ones, and act on results in a timely fashion. A second contribution is the design of an interactive visualization called MSProVis (Multi-Step Process Visualization), which is composed of several PCDs (Process Completion Diagrams) that show the number and duration of in-time, late, and not-completed orders. With MSProVis, managers perform retrospective analyses to make decisions by studying an overview of the order process, durations of order steps, and performances of individuals.

Publications (from short briefs to very long thesis)

• Safety Enhanced Design Brief on table design (One-page guideline document - posted in NCCD website)
• Safety Enhanced Design Brief on result management (One-page guideline document - SOON TO BE posted in NCCD website)
• Short paper on design guidelines:
  Tarkan, S., Franklin, L., Plaisant, C., Shneiderman, B. Design Guidelines for Ensuring Timely Management of Medical Orders
• Detailed design guidelines:
  Design Guidelines for Results Management (including more general table design guidelines)
• Visualization for retrospective analysis:
  Pantazos, K., Tarkan, S., Plaisant, C., Shneiderman, B. Exposing Delays in Multi-Step Processes by Retrospective Analysis
• Dissertation for more details:
  Tarkan, S. Interactive Visual Displays for Results Management in Complex Medical Workflows
Older versions:

• Pantazos, K., Tarkan, S., Plaisant, C., Shneiderman, B. Promoting Timely Completion of Multi-Step Processes - A Visual Approach to Retrospective Analysis
• Tarkan, S., Plaisant, C., Shneiderman, B., Hettinger, A. Z., Ensuring Timely Clinical Lab Test Result Management: A Generative XML Process Model to Support Medical Care
• Tarkan, S., Plaisant, C., Shneiderman, B., Hettinger, A. Z., Reducing Missed Laboratory Results: Defining Temporal Responsibility, Generating User Interfaces for Test Process Tracking, and Retrospective Analyses to Identify Problems (AMIA Fall 2011)

Videos

1) Rich Tabular Displays (March 2013)

or Download the video (59 Mg)

2) Actions for Rapid Completion (March 2013)

or Download the video (76 Mg)

3) Views for Different Roles (March 2013)

or Download the video (44 Mg)

4) Table Design Guidelines (March 2013)

or Download the video (81 Mg)

5) Retrospective Analysis Visualization in short (March 2013)

or Download the video (30 Mg)

6) Download the video (10 Mg), Retrospective Analysis of Late and Lost Results (April 2012)

Lectures

• Interactive Visual Displays for Results Management in Complex Medical Workflows (Sureyya Tarkan)

  +++ See also from above section:
  +++ Associated VIDEO (results management) (59 Mg)
  +++ Associated VIDEO (integrated actions) (76 Mg)
  +++ Associated VIDEO (retrospective analysis) (30 Mg)

• HCIL Symposium, May 2012
  Ensuring Timely Management of Medical Orders (Sureyya Tarkan, Kostas Pantazos, Catherine Plaisant, Ben Shneiderman)

  +++ See also from above section:
  +++ Associated VIDEO (results management) (6 Mg)
  +++ Associated VIDEO (retrospective analysis) (10 Mg)

• AMIA Symposium, Fall 2011
  Reducing Missed Laboratory Results (Sureyya Tarkan, Catherine Plaisant, Ben Shneiderman, A. Zachary Hettinger)
• 5th Doctoral Consortium on Sociotechnical Issues in Medical Informatics 2011
  Enhancing Timely Management of Medical Workflow with Interactive Visual Displays (Sureyya Tarkan)
• HCIL Symposium, May 2011
  Electronic Health Record Interfaces: Reducing Missed Lab Results (Sureyya Tarkan, Catherine Plaisant, Ben Shneiderman)

Project Partners

• Yale University School of Medicine: Seth M. Powsner
• Washington Hospital Center/MedStar, Washington, DC: A. Zachary Hettinger

Sponsorship

This work is supported in part by Grant No. 10510592 for Patient-Centered Cognitive Support under the Strategic Health IT Advanced Research Projects Program (SHARP) from the Office of the National Coordinator for Health Information Technology.