Visualizing Temporal Patterns
also including…
Twinlist for Medication Reconciliation
Catherine Plaisant
Human-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 enormous
Human 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.)
TREEMAP: E.G. SMARTMONEY
MARKETMAP
www.smartmoney.com/marketmap
e.g. Market falls 311 points, with a few exceptions
e.g. Market mixed
Energy & 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
INCLUDE SUMMARIZATION
• Important issue because of large time range
• Recursive aggregation mechanism
(set of events) --- (summary event)
LIFELINES
[Plaisant et al. 1998]
http://www.cs.umd.edu/hcil/lifelines
LIFELINES 2
RECORD
[Wang et al. 2008, 2009]
http://www.cs.umd.edu/hcil/lifelines2
LIFEFLOW
VISUALIZE
Display the
aggregation
RECORD
RECORD
RECORD
AGGREGATE
Merge multiple records into tree
TEMPORAL DATA
NUMERICAL
CATEGORICAL
VS.
04/26/2010 10:00
04/26/2010 10:15
04/26/2010 10:30
04/26/2010 10:45
04/26/2010 11:00
12/02/2008 14:26
12/02/2008 14:36
12/02/2008 22:44
12/05/2008 05:07
12/14/2008 06:19
Patient ID: 45851737
31.03
31.01
31.02
31.08
31.16
Patient ID: 45851737
Arrival
Emergency
ICU
Floor
Exit
Time
Arrival
Emergency
ICU
Floor
Exit
ALIGNMENT
• E.g. align by arrival
Time
June
Patient #45851737
July
August
Arrival
Emergency
ICU
Floor
Exit
Patient #43244997
Arrival
Emergency
ICU
Floor
Exit
ALIGNMENT
• E.g. align by arrival
Time
0
Patient #45851737
2M
1M
Arrival
Emergency
ICU
Floor
Exit
Patient #43244997
Arrival
Emergency
ICU
Floor
Exit
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
Integrated in i2b2 and BTRIS
Open source
The work of Dave Wang
[Wang et al. 2008, 2009] - www.cs.umd.edu/hcil/lifelines2
LIFEFLOW
VISUALIZE
Display the
aggregation
RECORD
RECORD
RECORD
AGGREGATE
Merge multiple records into tree
• Lifelines2: Specific query “Bounce backs”
ICU
Floor
ICU
within 2 days
• Lifeflow: Overview of sequences
Arrival
?
?
ICU
?
blabla
DEMO- LIFEFLOW
• Data = Patient transfers within hospital
ARRIVAL
EMERGENCY
ICU
Arrive the hospital
Emergency room
Intensive Care Unit
FLOOR
EXIT-ALIVE
Normal room
Leave the hospital alive
EXIT-DEAD
Leave the hospital dead
www.cs.umd.edu/hcil/eventflow
Twinlist
Facilitating Medication Reconciliation
with 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
Medication reconciliation
Scenario: Hospital discharge
Intake
-What’s unique?
-What’s identical?
-What’s equivalent?
Hospital
Levels of equivalences
Equivalence
Criteria
Example
Form
Equivalence
Identical except for
brand vs. generic
Advil = Ibuprofen
Senormin = 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 mg
Acetaminophen 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
29
TWINLIST Prototype originally developed by Tiffany Chao
Check for newer VIDEOS at www.cs.umd.edu/hcil/sharp
or search YouTube for Twinlist (and pick newest
version)
CODE AVAILABLE ON REQUEST (plaisant@cs.umd.edu)
THANK YOU
Acknowledgments
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
plaisant@cs.umd.edu
Join us for
HCIL symposium - May 22-23
www.cs.umd.edu/hcil/soh
Includes Medical Informatics Workshop
Also 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