Clinical Practice - Health Informatics in the Cloud - page 50

Fig. 4.4 Visualization of the Interventions and Observations that Relate to a Specific Clinical
Condition
of whom were physicians, deliberate and it was clear they would have liked a visu-
alization tool that provided all three capabilities. I would bet that most clinicians
agree with the judges but no EHRs yet provide all these capabilities, although many
do provide some of the user configurability that team two offered.
People are starting to focus on visualization. A major 2009 report by several
committees of the National Research Council reviewed the current state of clinical
health informatics and developed a roadmap for the future. One of its key conclu-
sions was that today's systems tend “to squeeze all cognitive support for the clini-
cian through the lens of healthcare transactions and the related raw data, without an
underlying representation of a conceptual model for the patient showing how data
fit together and which are important or unimportant. As a result, an understanding
of the patient can be lost amidst all the data, all the tests, and all the monitoring
equipment.” [ 14 ] I urge readers with a serious interest in cognitive support of pro-
viders and patients to read the entire report.
Improved data visualization is a key strategy to implement this recommendation.
Implementing it will likely require novel underlying data representations that more
clearly mirror the thought processes of healthcare providers. It might also require
the development of new systems (sometimes called “middleware”) to make the
needed data connections. Dr. Jonathan Nebeker, Lead, iEHR Presentation Layer at
Veterans Health Administration, presented an interesting proposed user interface
based on this idea at the 2012 HIMSS conference (Fig. 4.4 ).
A lot remains to be done but it is encouraging that visualization of clinical data
in ways that can help providers and their patients make more informed decisions
now seems to be a topic that is attracting increasing attention.
References
1. Consensus Report (1999) To Err is Human: Building a Safer Health System, National Academies
Press http://www.iom.edu/Reports/1999/To-Err-is-Human-Building-A-Safer-Health-System.
aspx Accessed 19 July, 2012
2. Classen D et al (2011) 'Global Trigger Tool' Shows That Adverse Events In Hospitals May Be
Ten Times Greater Than Previously Measured. Health Aff 30:4 581-589