Design and Implementation of a Visual Analytics Electronic Antibiogram within an Electronic Health Record System at a Tertiary Pediatric Hospital

Simpao, Allan F.; Ahumada, Luis M.; Martinez, Beatriz Larru; Cárdenas, Ana Marı́a; Metjian, Talene A.; Sullivan, Kaede V.; Gálvez, Jorge A.; Desai, Bimal R.; Rehman, Mohamed A.; Gerber, Jeffrey S.

doi:10.1055/s-0037-1615787

Cited by 42 publications

(46 citation statements)

References 16 publications

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“…10 High-dimensional data can support clinical decision making. 8 Visual analytics dashboards have been used to allow real-time tracking of information in health care, including creation of a hospitalspecific antibiogram, 11 to monitor for adverse drug events, 12 and to track departmental performance metrics. 13 Visual analytics tools have been used across various health care settings to decrease information overload.…”

Section: Discussionmentioning

confidence: 99%

A Visual Analytics Dashboard to Summarize Serial Anesthesia Records in Pediatric Radiation Treatment

et al. 2019

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Background Young children who undergo radiation therapy may require general anesthesia to remain still during weeks of radiation sessions. On a typical day at our hospital, an anesthesia team will care for 10 patients in the radiation therapy suite, and each patient will have multiple prior anesthetic records. Daily review of prior anesthesia records is important to maintain anesthetic consistency and to identify potential improvement, yet our electronic health record (EHR) made such review time-consuming and cumbersome. Objectives This article aims to design a visual analytics interface that simultaneously displays data from multiple anesthesia encounters to support clinical consistency in medications and airway management. Methods Documentation from the EHR is available in the clinical data warehouse following daily backups. A visual analytics interface was built to aggregate important components of multiple anesthesia encounters in pediatric radiation oncology on a single screen. The application was embedded in the EHR's anesthesia module and updated daily. Results Each anesthesia encounter was represented by a vertical line with the date at the bottom of the screen. Each vertical line was divided into sections corresponding to the medications, type of airway device, type of radiation oncology procedure, days between treatments, and recovery score and time. Information about the medications, airways, and procedures was shown with icon legends. This layout enabled users to quickly see the key components of multiple anesthetics and make inferences between, for example, the medications used and the recovery score. Conclusion The dashboard provides a high-level summary of all radiation therapy anesthesia records for children receiving recurrent treatments. In this clinical scenario, it is desirable to replicate an optimal anesthetic approach for daily or near-daily treatments or adjust the anesthetic based on observed patterns.

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Section: Discussionmentioning

confidence: 99%

A Visual Analytics Dashboard to Summarize Serial Anesthesia Records in Pediatric Radiation Treatment

et al. 2019

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“…The resulting ontology describes a hierarchy of 337 total classes, with seven toplevel classes: comorbidity, diagnosis/monitoring method, IBD course, quality of life, risk factor, symptom, and treatment method, and a maximum depth of 6. The ontology was created using Protégé, 19 exported in OWL format 4 , and converted to an OBO Graph 5 using ROBOT 6 for easy ingestion into our visualization tool. Based on the content analysis, each research topic was labeled with one or more terms from the ontology.…”

Section: Ontology Creationmentioning

confidence: 99%

“…Interactive visualization has proven to be a useful method for analyzing datasets across a wide range of disciplines, including in the health care domain, 2,3 and holds great promise for advancing the state-of-the-art in health care Many visualization tools for health care applications operate on a wide variety of structured data. [4][5][6][7] Prior work in visualizing structured data from patients with various types of abdominal pain includes that of Rao et al, which involves the extraction of diagnostic paths from electronic health record (EHR) data. 8 While such work can be very effective, much of it is not directly applicable to the visualization of largely unstructured text from an online patient forum.…”

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confidence: 99%

Ontology-Based Interactive Visualization of Patient-Generated Research Questions

2019

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Background Crohn's disease and colitis are chronic conditions that affect every facet of patients' lives (e.g., social interaction, family, work, diet, and sleep). Thus, treatment consists largely of disease management. The University of North Carolina at Chapel Hill chapter of the Crohn's and Colitis Foundation—IBD Partners—has created an interactive website that, in addition to providing helpful information and disease management tools, provides a discussion forum for patients to talk about their experiences and suggest new lines of research into Crohn's disease and colitis. Objectives The primary objective of this work is to enable researchers to more effectively browse the forum content. Researchers wish to identify important/popular patient-suggested research topics, appreciate the full breadth of the research topics, and see connections between them, in order to more effectively prioritize research agendas. Methods To help structure the forum content we have developed an ontology describing the major themes in the discussion forum. We have also created a prototype interactive visualization tool that leverages the ontology to help researchers identify common themes and related patient-generated research topics via linked views of (1) the ontology, (2) a research topic overview clustered by relevant ontology terms, and (3) a detailed view of the discussion forum content. Results We discuss visualizations and interactions enabled by the visualization tool, provide an example scenario using the tool, and discuss limitations and future work based on feedback from potential users. Conclusion The integration of a user-community specific ontology with an interactive visualization tool is a promising approach for enabling researchers to more effectively study user-generated research questions.

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“…Unfortunately, these challenges mean that the work of determining optimal reporting and visualization of CAUTI data to guide health care policy has not even started. 19 The authors could find no recommendations for optimal visual presentation of such data, even from NHSN. It was not possible to consider improving upon the NHSN system due to the many technical issues arising from having one centralized system for surveillance of many different types of infections.…”

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confidence: 99%

Visualizing Infection Surveillance Data for Policymaking Using Open Source Dashboarding

Wahi

Dukach

2019

Appl Clin Inform

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Background Health care-associated infections, specifically catheter-associated urinary tract infections (CAUTIs), can cause significant mortality and morbidity. However, the process of collecting CAUTI surveillance data, storing it, and visualizing the data to inform health policy has been fraught with challenges. Objectives No standard has been developed, so the objective of this article is to present a prototype solution for dashboarding public health surveillance data based on a real-life use-case for the purposes of enhancing clinical and policy-level decision-making. Methods The solution was developed in open source software R, which allows for the creation of dashboard applications using the integrated development environment developed for R called RStudio, and a package for R called Rshiny. How the surveillance system was designed, why R was chosen, how the dashboard was developed, and how the dashboard features were programmed and function will be described. Results The prototype dashboard includes multiple tabs for visualizing data, and allows the user to interact with the data by setting dynamic filters. Controls were used to facilitate the interaction between the user and application. Rshiny is reactive, in that when the user (e.g., clinician or policymaker) changes the parameters on the data, the application automatically updates the visualization as well as parameters available based on current filters. Conclusion The prototype dashboard has the potential to enhance clinical and policy-level decision-making because it facilitates interaction with the data that provides useful visualizations to provide such guidance.

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Design and Implementation of a Visual Analytics Electronic Antibiogram within an Electronic Health Record System at a Tertiary Pediatric Hospital

Abstract: An e-antibiogram that was built and is updated using EHR data and adheres to national guidelines is a feasible replacement for an annual, static, manually compiled antibiogram. Future research will examine the impact of the e-antibiogram on antibiotic prescribing patterns.

Cited by 42 publications

References 16 publications

A Visual Analytics Dashboard to Summarize Serial Anesthesia Records in Pediatric Radiation Treatment

A Visual Analytics Dashboard to Summarize Serial Anesthesia Records in Pediatric Radiation Treatment

Ontology-Based Interactive Visualization of Patient-Generated Research Questions

Visualizing Infection Surveillance Data for Policymaking Using Open Source Dashboarding

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