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Clinical visualizations - Antiobiotic grid

11:28 AM Posted by David Do, MD , , No comments

Physicians need to be able to understand the history of antibiotics given in order to make decisions about broadening antibiotics, narrowing antibiotics, and administering the correct duration of therapy. The standard EMR's medication administration record is not optimized for these needs (Figure 1).

Figure 1: EMR's medication administration record

Problems of the current visual display include
  1. Difficult to tell at a glance what antibiotics a patient is currently on
  2. Difficult to tell how long a patient has been on antibiotics for
  3. The need to scroll
  4. Visual sparseness

The first step in our redesign is to use a filter to select the antimicrobials. The second is to reduce the visual sparseness of the grid by grouping by day (Figure 2).

Figure 2

While this view is cleaner than the original, we lost some information about sequence due to grouping--for example, it's not clear what the dose progression of vancomycin has been. To fix this problem, we can create multiple time bins daily, experimenting with three daily time bins (Figure 3) and four daily time bins (Figure 4).

Figure 3: Grouping by up to three time bins daily

Figure 4: Grouping by up to four time bins daily

For the purpose of conveying antibiotic history, three time bins seems to have the best balance of chronology while limiting sparseness. Finally, for visual simplicity, we remove gridlines and lightly shade every other day (Figure 5).

Figure 5: Final design for an antibiotic grid to help make management decisions


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