Improving efficiency of electronic health records: longitudinal dashboard design for post-kidney transplant pediatric patients

The purpose of EHR systems is to attain greater universal access to patient medical information, enhance communication, and improve documentation efficiency. The main motivation for this project was to engage in a high-risk, high-reward initiative to enhance the use of the EHR system within the pediatric clinics at the University of Virginia Medical Center. The specific initiative of this project was to create a single-screen longitudinal dashboard that supported clinical decisionmaking using both textual and graphical information for post-kidney transplant patients in the Pediatric Nephrology Clinic. This dashboard and process of development could be used as a proof-of-concept for other clinics with long-term patients. Observations and interviews were conducted with nine clinicians and two EHR builders. User requirements were categorized by development effort and priority. Many high priority requirements were not met by the existing EHR system. Due to limitations of the EHR system, a single-screen solution was deemed infeasible. Elements of the planned longitudinal dashboard had to be divided into two parts: qualitative and quantitative. Testing was conducted to evaluate changes in usability and efficiency by comparing the existing version of the EHR to the new release of the EHR, which included a two-screen dashboard solution. The results showed high standard deviations in task completion. Given the infeasibility of implementing the single-screen dashboard, multiple mockups of an ideal single-screen solution were also created and evaluated with stakeholders. The stakeholders were in agreement that further iterations and implementation of this ideal dashboard would be the next steps for the project.