Visualizing Temporal Patternsalso including… Twinlist for Medication Reconciliation
Catherine PlaisantHuman-Computer Interaction Lab University Of Maryland, College Park
HFES Baltimore – March 12 2013
Interdisciplinary research community - Computer Science - Information Studies - Psychology, Sociology, Engineering, etc. in College Park MD ~ www.cs.umd.edu/hcil
INFORMATION VISUALIZATION
Compact graphical presentation and user interface for manipulating large numbers of items (102 - 106), Enables users to make
discoveries, decisions, or explanations about patterns or groups of items
Visual bandwidth is enormousHuman perceptual skills are remarkable
SPOTFIRE: E.G. RETINOL’S ROLE IN EMBRYOS & VISION
Revealed the previously unknown involvement of the retinol binding protein RBP1 in cell cycle control.(Stubbs S, & Thomas N. 2006 Methods in Enzymology; 414:1-21.)
www.smartmoney.com/marketmap
TREEMAP: E.G. SMARTMONEY MARKETMAP
e.g. Market falls 311 points, with a few exceptions
e.g. Market mixedEnergy & Technology up, Financial & Health Care down
e.g. NCHS data Size = #Deaths per 100 000, in 1998 Color = Rate of change compared to 1981
LifeLines – Single Patient[Plaisant 1998] - PAPERS AND VIDEOS at www.cs.umd.edu/hcil/lifelines
• Important issue because of large time range
• Recursive aggregation mechanism (set of events) --- (summary event)
INCLUDE SUMMARIZATION
LIFELINES
SINGLE RECORD
[Plaisant et al. 1998]http://www.cs.umd.edu/hcil/lifelines
LIFELINES 2
RECORDRECORDRECORD
RECORD
RECORD
[Wang et al. 2008, 2009]http://www.cs.umd.edu/hcil/lifelines2
LIFEFLOW
RECORD
RECORD
RECORD
RECORD
RECORD
RECORD
RECORD
RECORD
AGGREGATEMerge multiple records into
tree
VISUALIZEDisplay the aggregation
Patient ID: 4585173712/02/2008 14:26 Arrival12/02/2008 14:36 Emergency12/02/2008 22:44 ICU12/05/2008 05:07 Floor12/14/2008 06:19 Exit
Time
EmergencyICU
FloorExit
TEMPORAL DATA NUMERICAL VS. CATEGORICAL
04/26/2010 10:00 31.0304/26/2010 10:15 31.0104/26/2010 10:30 31.0204/26/2010 10:45 31.0804/26/2010 11:00 31.16
Patient ID: 45851737
Arrival
ALIGNMENT• E.g. align by arrival
Time
Patient #45851737 ArrivalEmergency
ICUFloor
ExitPatient #43244997 Arrival
EmergencyICU
FloorExit
June July August
ALIGNMENT• E.g. align by arrival
Time
Patient #45851737 ArrivalEmergency
ICUFloor
ExitPatient #43244997 Arrival
EmergencyICU
FloorExit
0 1 M 2 M
LIFELINES2• Introduce powerful combination of simple operators Align, Rank, Filter, and Summarize
• Multiple records simultaneously visible• Align by key events• Rank by frequency• Filter by events sequences• Provide summaries
[Wang et al. 2008, 2009] - www.cs.umd.edu/hcil/lifelines2
Integrated in i2b2 and BTRISOpen source
The work of Dave Wang
LIFEFLOW
RECORD
RECORD
RECORD
RECORD
RECORD
RECORD
RECORD
RECORD
AGGREGATEMerge multiple records into
tree
VISUALIZEDisplay the aggregation
within 2 days
ICU Floor ICU
• Lifelines2: Specific query “Bounce backs”
• Lifeflow: Overview of sequencesArrival
ICU
?
??
blabla
DEMO- LIFEFLOW• Data = Patient transfers within hospital
ARRIVAL Arrive the hospitalEMERGENCY Emergency roomICU Intensive Care UnitFLOOR Normal roomEXIT-ALIVE Leave the hospital aliveEXIT-DEAD Leave the hospital dead
Twinlist Facilitating Medication Reconciliationwith Animation and Spatial Layout
Medication reconciliation
• Develop list of current medications• Develop list of medications to be prescribed• Compare lists• Make clinical decision based on comparison• Communicate the new list to
appropriate caregivers and to patient
One definition from: http://www.ihs.gov/cio/ehr/index.cfm?module=medication_reconciliation
Intake Hospital
- What’s unique?- What’s identical?- What’s equivalent?
Medication reconciliationScenario: Hospital discharge
Levels of equivalences
29
Equivalence Criteria Example
Form Equivalence
Identical except for brand vs. generic
Advil = IbuprofenSenormin = Atenolol
Functional Equivalence
Same therapeutic intent Atenolol and Propanolol both betablockers
Partial Equivalence
Form or functional equivalence, but differ in dosage, frequency, or route
Advil 100 mgAcetaminophen 200mg
No equivalence
Unique in form and function
“Automated medication reconciliation and complexity of care transitions”Bozzo Silva, Bernstam, Markowitz, Johnson, Zhang and Herskovic, AMIA 2011
TWINLIST Prototype originally developed by Tiffany ChaoCheck for newer VIDEOS at www.cs.umd.edu/hcil/sharp or search YouTube for Twinlist (and pick newest version)CODE AVAILABLE ON REQUEST ([email protected])
THANK YOUAcknowledgments Ben Shneiderman Students past and present:
Megan Monroe, Rongjian Lan, Tiffany Chao, Johnny Wu Krist Wongsuphasawat, David Wang
Clinicians/Partners Zach Hettinger (MI2),Seth Powsner (Yale); Tamra Meyer (ARMY PharmacoVigilance Center)
Elmer V. Bernstam, Jorge Herskovic, Todd R. Johnson (SharpC), and many more Sponsors Oracle Health Science National Institutes of Health (RC1CA147489-02) Office of the National Coordinator for Health Information Technology (SHARP ~ #10510592)
www.cs.umd.edu/hcil www.cs.umd.edu/hcil/eventflow www.cs.umd.edu/hcil/sharp
THANK YOU
Join us forHCIL symposium - May 22-23www.cs.umd.edu/hcil/soh Includes Medical Informatics WorkshopAlso projects on wrong patient selection, results management, risk communication
www.cs.umd.edu/hcil
www.cs.umd.edu/hcil/eventflow www.cs.umd.edu/hcil/sharp
