A Visual Analytics Framework for Emergency Room Clinical
Encounters
1 Department of Computer Science2 Department of Emergeny Medicine
Zhiyuan Zhang1, Supriya Garg1, Arunesh Mittal1,
Alex Dimitriyadi1, IV Ramakrishnan1, Rong Zhao1,
Klaus Mueller1, Asa Viccellio2
Medical Record
As old as Hippocrates (around 400 BC)• father of Western medicine
Should:• accurately reflect the course of disease• indicate the probable cause of disease
Paper-Based Medical Record
Electronic Medical Record (EMR)
• Transaction-driven: documentation + tables
• Non-intuitive interfaces
• Fragmented display of patient information
Typical Information Flow in the ER
Obtain Patient’s
Information
Current HistoryPast History
Family HistorySocial History
Review of System
Physical Examination
Order Laboratory
Data
Request and obtain
consultation
Take appropriate action within an appropriate time
Reevaluate and readjust therapy and diagnosis
Typical Information Flow in the ER
Obtain Patient’s
Information
Current HistoryPast History
Family HistorySocial History
Review of System
Physical Examination
Order Laboratory
Data
Request and obtain
consultation
Take appropriate action within an appropriate time
Reevaluate and readjust therapy and diagnosis
Obtain Patient’s History
Current HistoryPast History
Family HistorySocial History
Review of System
Physical Examination
Order Laboratory
Data
Request and obtain
consultation
Take appropriate action within an appropriate time
Reevaluate and readjust therapy and diagnosis
Obtain Patient’s History
Current HistoryPast History
Family HistorySocial History
Review of System
Physical Examination
Order Laboratory
Data
Request and obtain
consultation
Take appropriate action within an appropriate time
Reevaluate and readjust therapy and diagnosis
Obtain Patient’s
Information
Current HistoryPast History
Family HistorySocial History
Review of System
Physical Examination
Order Laboratory
Data
Request and obtain
consultation
Take appropriate action within an appropriate time
Reevaluate and readjust therapy and diagnosis
System Objectives
• Support and enhance the clinical decision-making
• Simple Interface to make data and information exploration easier
• Assimilation of data from different sources
• Visualization and visual reasoning is key
• Ease of data and information access is key
System Overview
The 5-W Scheme
• Use a strongly structured paradigm, the 5-W
• WHO : the patient and the history
• WHAT : Symptoms, tests and results, diagnosis, treatments and medications, etc.
• WHERE : locations (when appropriate) of the WHAT on the human body
• WHEN : time and duration of the WHAT
• WHY : cause and effect of the various WHAT constituents
Visualize the 5-W Scheme
• WHO : Basic Info and Vital Signs
• WHAT : Integrated in WHERE, WHEN, and WHY.
• WHERE : Human map
• WHEN : Time line
• WHY : Directed causal graph
Visualize Who, What and Where
(0) Start Screen
Visualize Who, What and Where
(a) Results of triage (name, weight, age, vitals with high fever)
Visualize Who, What and Where
(b) Populating the spatial map with symptoms (head problems)
Visualize Who, What and Where
(c) Adding past history (lung cancer in remission)
Visualize Who, What and Where
(d) Social history indicates patient has a history of smoking
Visualize Who, What and Where
(e) The diagnostic process begins, immediate actions
Visualize Who, What and Where
(e) The diagnostic process begins, using the Diagnostic Sandbox
Visualize Who, What and Where
(f) The diagnostics determines epidural hematoma
Visualizing When
Each entry is classified into:• Symptoms; Tests; Diagnosis; Treatments.
Visualizing When
Each sub-track within one track represents an event.
Visualizing When
Each sub-track has an explanation.
Visualizing When
Abnormal results or severe symptoms are highlighted in red to draw the physician’s attention.
Visualizing When
Brushing operation
Visualizing Why
• Symptom->Test/Data->Diagnosis->Treatment/Medication
• A modified version of the force-directed layout
• All symptoms have incoming edges from a node representing a visit to the physician.
• A convex hull is drawn for each visit.
Visualizing Why
• Enable quick mental analysis
• Help detect errors in diagnoses
Visualize Why
Visualizing Why Case Study
Visualize Why
Conclusions
Implemented an emerging visual analytics system
• For clinical encounters in emergency room scenarios
• Clinician and patient-focused
• Unifies all EMR information fragments into a single interactive visual framework
• Voice and multi-touch interaction capabilities
Current/Future Work
Improvements, fine-tuning, and additional features
• Include more formal user and affordance studies to fine-tune the various modules of our system.
• A more geometrically structured temporal plot for the casual graph.
• Treatment Outcome
• Integrate more analytics in the system.
Thanks For Listening…
