Development and Evaluation of Patient-Reported Outcome Score Visualization to Improve Their Utilization (PROVIZ) (New York)

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Optimization of Patient-Reported Outcome Data Visualization to Improve Shared Decision Making

SIGNIFICANCE AND POTENTIAL IMPACT

Optimizing PRO data visualization with clinicians’ and patients’ input will improve clinicians’ ability to effectively synthesize and communicate complex data to provide patient-centered clinical management.

Patient-reported outcome measures are not always used to inform discussion with patients

The use of PRO measures to assess patients’ experiences of illness and wellness has been increasing, and may lead to improvements in clinical management, health outcomes, and patient engagement. However, even with PROs integrated into EHRs, clinicians may not always know how to interpret and use the data to inform discussions with patients for shared decision making and clinical management. Equally as important is the patient’s ability to understand the data and engage in decisions about their care.

How PRO data are interpreted is impacted by how they are visually presented

Visually presenting PRO data via EHRs can enhance clinicians’ ability to understand and utilize the data. There are several factors that can impact visual interpretation of data. One factor is that some data metrics represent improvements in patient symptoms when their value increases (e.g., physical function), whereas other metrics indicate improvements by decreasing values (e.g., pain). Another factor is that PRO visualizations often do not provide useful contextual information to help the viewer interpret the scores (e.g., information about changes over time or comparison to other patients).

Co-principal investigators Drs. Heather Gold and Enrico Bertini, with a team of investigators at New York University School of Medicine, are developing and testing PRO visual presentations in the EHR to improve PRO interpretability, usability, and data completion with the ultimate goal of improving clinical care and shared decision making.

“The purpose of this work is to figure out how we make these scores interpretable and usable so that clinicians are actually applying them as part of their clinical care. And in turn, these data visualizations would help clinicians have conversations with patients about the scores and improve shared decision making about their care.”
– Dr. Gold

Optimizing data visualizations based on clinician and patient input

The team is conducting research based on engineering and human-computer interaction principles to inform optimal data visualization and presentation of orthopedic PROs, including interference of pain in daily life, pain intensity, and limitations of physical function. Focus groups and interviews will be conducted with clinicians and their patients with hip and knee pain or osteoarthritis to understand current perceptions of PROs and preferences for data presentation. This input will inform the development of several prototypes of data visualizations that will then be evaluated by their usefulness, acceptability, and understanding by clinicians and patients.

Ultimately, the investigators hope that this study will improve patient outcomes by accelerating the ability of clinicians to effectively synthesize and communicate complex data to inform patient-centered clinical management for patients, families, and healthcare professionals. While the investigators chose PROs in musculoskeletal condition patients, the study can inform the optimal design of data visualizations for any type of health data.

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Optimizing PRO data visualization with clinicians’ and patients’ input will improve clinicians’ ability to effectively synthesize and communicate complex data to provide patient-centered clinical management.

Project Details - Ongoing

Summary:

Assessing the patient’s experience of illness and wellness is key to informing their goals of care and clinical management. It is important to understand how health information technology can facilitate the use of patient-reported outcome (PRO) measures to improve clinical management, health outcomes, and patient engagement. Researchers and clinicians must investigate the optimal methods and impact of collecting and disseminating PRO data with clinicians and patients in order to have positive effects on clinical care, quality of life, and outcomes in a practical way. Even with PROs integrated into electronic health records (EHRs), investigators found that clinicians do not always know how to interpret and use the data to inform patients and clinical management.

In this current research, investigators will develop and test PRO visual presentations for the EHR through research based on engineering and human-computer interaction principles to inform optimal data visualization and presentation. These data visualizations will be evaluated formally, focusing on outcomes of the usefulness, acceptability, and understanding of the scores by clinicians and patients.

The specific aims of this research are as follows:

  • Evaluate patient preferences, understanding, usability, and acceptability of modes of PRO score presentation in the patient portal. 
  • Evaluate clinician preferences, understanding, usability, and acceptability of modes of PRO score presentation in the EHR. 

The study will take place at NYU Langone Medical Center and includes three components. First, investigators will conduct qualitative interviews with patients and those clinicians treating hip and knee pain or osteoarthritis to understand their current perception of PROs and preferences for data presentation. Second, investigators will develop visualization prototypes that attempt to meet these preferences and use focus groups for evaluation. Finally, investigators will conduct a formal evaluation of the usefulness, acceptability, and understanding of the novel visualizations with clinicians and patients.

Ultimately, the investigators hope that this study will improve patient outcomes by accelerating the ability to effectively synthesize and communicate complex data to inform patient-centered clinical management for patients, families, and healthcare professionals.