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首页> 外文期刊>BMC Medical Informatics and Decision Making >Home blood pressure data visualization for the management of hypertension: designing for patient and physician information needs
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Home blood pressure data visualization for the management of hypertension: designing for patient and physician information needs

机译：家庭血压数据可视化，用于高血压管理：为患者和医生信息设计

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Nearly half of US adults with diagnosed hypertension have uncontrolled blood pressure. Clinical inertia may contribute, including patient-physician uncertainty about how variability in blood pressures impacts overall control. Better information display may support clinician-patient hypertension decision making through reduced cognitive load and improved situational awareness. A multidisciplinary team employed iterative user-centered design to create a blood pressure visualization EHR prototype that included patient-generated blood pressure data. An attitude and behavior survey and 10 focus groups with patients (N?=?16) and physicians (N?=?24) guided iterative design and confirmation phases. Thematic analysis of qualitative data yielded insights into patient and physician needs for hypertension management. Most patients indicated measuring home blood pressure, only half share data with physicians. When receiving home blood pressure data, 88% of physicians indicated entering gestalt averages as text into clinical notes. Qualitative findings suggest that including a data visualization that included home blood pressures brought this valued data into physician workflow and decision-making processes. Data visualization helps both patients and physicians to have a fuller understanding of the blood pressure ‘story’ and ultimately promotes the activated engaged patient and prepared proactive physician central to the Chronic Care Model. Both patients and physicians expressed concerns about workflow for entering and using home blood pressure data for clinical care. Our user-centered design process with physicians and patients produced a well-received blood pressure visualization prototype that includes home blood pressures and addresses patient-physician information needs. Next steps include evaluating a recent EHR visualization implementation, designing annotation functions aligned with users’ needs, and addressing additional stakeholders’ needs (nurses, care managers, caregivers). This significant innovation has potential to improve quality of care for hypertension through better patient-physician understanding of control and goals. It also has the potential to enable remote monitoring of patient blood pressure, a newly reimbursed activity, and is a strong addition to telehealth efforts.
机译：近一半的美国成年人具有诊断的高血压具有不受控制的血压。临床惯性可能会有所贡献，包括患者 - 医师的不确定性关于血压如何变化会影响整体控制。通过降低的认知负荷和改善的情境意识，更好的信息显示屏可能支持临床医生高血压决策。多学科团队采用迭代用户中心设计，以创建血压可视化EHR原型，包括患者产生的血压数据。一种态度和行为调查和10名患者的重点群（N？=？16）和医生（N？=？24）导游迭代设计和确认阶段。定性数据的主题分析产生了患者和医生对高血压管理的洞察力。大多数患者表明衡量家庭血压，只有一半的与医生股份数据。当接收家庭血压数据时，88％的医生表明将GESTALT平均作为文本进入临床笔记。定性结果表明，包括包括家庭血压的数据可视化将此值得的数据带入医生工作流程和决策过程。数据可视化有助于患者和医生对血压“故事”有更大的了解，并最终促进激活的接合患者并准备了慢性护理模型的主动医师核心。两位患者和医生都表示担心进入和使用家庭血压数据进行临床护理的工作流程。我们以用户为中心的医生和患者的设计过程产生了一个受到良好接受的血压可视化原型，包括家庭血压并解决患者医师信息需求。下一步包括评估最近的EHR可视化实现，设计了与用户需求保持一致的注释功能，并解决额外的利益相关者的需求（护士，护理经理，护理人员）。这一重大创新通过更好的患者 - 医师的控制和目标的理解，提高高血压的质量。它还有可能能够远程监测患者血压，新报销的活动，并且是对遥气努力的强烈补充。

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