Situation Awareness-Oriented Patient Monitoring with Visual Patient Technology: A Qualitative Review of the Primary Research

Abstract

Visual Patient technology is a situation awareness-oriented visualization technology that translates numerical and waveform patient monitoring data into a new user-centered visual language. Vital sign values are converted into colors, shapes, and rhythmic movements-a language humans can easily perceive and interpret-on a patient avatar model in real time. In this review, we summarize the current state of the research on the Visual Patient, including the technology, its history, and its scientific context. We also provide a summary of our primary research and a brief overview of research work on similar user-centered visualizations in medicine. In several computer-based studies under various experimental conditions, Visual Patient transferred more information per unit time, increased perceived diagnostic certainty, and lowered perceived workload. Eye tracking showed the technology worked because of the way it synthesizes and transforms vital sign information into new and logical forms corresponding to the real phenomena. The technology could be particularly useful for improving situation awareness in settings with high cognitive demand or when users must make quick decisions. This comprehensive review of Visual Patient research is the foundation for an evaluation of the technology in clinical applications, starting with a high-fidelity simulation study in early 2020.

Physicians’ Perceptions of a Situation Awareness–Oriented Visualization Technology for Viscoelastic Blood Coagulation Management (Visual Clot): Mixed Methods Study

“…Eighty-one percent (34/42) of the participants regarded the animated blood clot as useful in the decision-making process for coagulation management. Only one participant (N=42, 2%) agreed to the statement “I required more cognitive resources for the interpretation of Visual Clot than for the interpretation of conventional ROTEM.” The participant responses corresponded to the reactions to the similarly well-accepted Visual Patient technology [ 25 ]. In that assessment, only 11% (4/38) of the questioned subjects considered that technology not helpful in patient monitoring after their first contact with it [ 26 ].…”

Validation of the Raw National Aeronautics and Space Administration Task Load Index (NASA-TLX) Questionnaire to Assess Perceived Workload in Patient Monitoring Tasks: Pooled Analysis Study Using Mixed Models

“…Visual Patient technology is a situation awareness–oriented visualization tool that displays up to 11 of the most frequently used patient vital signs in the form of a patient avatar in addition to the standard monitoring screen [ 21 , 22 ]. Visual Patient transforms the conventional numerical and waveform display of the vital signs in real time into a patient avatar with the ability to adjust its color, shapes, and rhythmic movements depending on the patient’s current situation.…”

“…Patient monitoring can be generalized as continuous observation of a condition or certain parameters, regardless of the method used [ 19 , 20 ]. In previous studies, we simplified the presentation of information in different patient monitoring devices by creating two new situation awareness–oriented information transfer technologies called Visual Patient [ 21 , 22 ] and Visual Clot [ 23 ]. We further discuss the functionality and applicability of these technologies in the methods section.…”

Avatar-based patient monitoring in critical anaesthesia events: a randomised high-fidelity simulation study

“…This improvement in the verbalisation of the underlying cause may be explained based on previous research on information transfer in avatar-based monitoring with Visual Patient. 7,12,18 The technology presents vital signs in a pre-processed form by assigning them into easy-to-understand visualisations with clearly differentiable normal, too high, or too low states. For example, a cyanotic-looking avatar with low respiratory volumes and a small expiratory carbon dioxide cloud may facilitate a bronchospasm diagnosis compared with the multiple individual numbers required in conventional monitoring to convey the same information.…”