Enhancing Timely Management of
Workflow with Interactive Visual
Displays & Actions for Situation
Awareness Processing
Sureyya Tarkan
UMD Dept. of Computer Science & HCIL
sureyya@cs.umd.edu
http://www.cs.umd.edu/hcil/sharpc/
Supervised by Ben Shneiderman & Catherine Plaisant
Situation Awareness
(Endsley, 2004)
1. Perception
Shared SA of a team
2. Comprehension
3. Projection
Temporal dynamic environment
1
Interruptions & Notifications
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‘Missed Results’ Problem
 Mishandling of abnormal results & no follow-up (Wahls,
2007)
 Most common missing information: lab test results
(Dovey, 2002)
 Delay in care, time/financial loss, pain/suffering,
adverse clinical consequence (Hickner, 2008)
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3
Test Process Steps
1. Pre-analytic
a. Ordering the test
b. Implementing the test
2. Analytic
a. Performing the test
3. Post-analytic
a.
b.
c.
d.
Specimen
lost
Specimen
damaged during
transport
Lab
Patient
technician
doesn’t go
Patient &
Physician
Specimen
mislabeled in
office
Reporting results to the clinician
PhysicianResults misplaced
Responding to the results
Notifying the patients of the results
Nurse
No
documentation
Following-up to ensure the patient took the appropriate
on action
record
based on test results
Physician on
vacation
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27, 2016
4
Medical Informatics Applications
Patient list
Pending tests in
patient chart
Alert arrived results
in chronological
order
VA View Alert Window
5
Motivation: Package Tracking
Clear expectation
Constant feedback
Explicit responsibility
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Motivation: Lists & Actions
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Approach for Reducing
Missed Results
 Model user actions within workflow specification
 Assign temporal responsibility
 Derive an interactive display from the model
 From order time to until all follow-up actions are taken
 Support actor action sheets as part of tracking
 Provide retrospective analyses for manager to identify
common problems and compare performance
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Laboratory Test Result
Management Workflow
Schedule
Exam
(4 days)
Accept Patient
(1 hour)
• Confirm
Appointment
• Update Patient
Info
Draw Sample
(21 hours)
•Prepare Equipment
•Ship with Carrier
•Transport by self
Examine Specimen
(1 day)
•Access Patient
Sample
•Conduct Test
•Write Results
Analyze Results
(1 day)
• Access Report
• Inform Patient
• Schedule Visit
• Repeat Test
• Order New Test
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Modeling Actions
10
Multi-Step Task Analyzing, Reporting,
Tracking (MSTART) Prototype
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Rich Tabular Displays
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Generating Actor Action Sheets:
Result Review
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Order
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Retrospective Analysis
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Proposed Work: Actions for Situation
Awareness Processing (ASAP)
 More information
 Edit/Annotate
 Marking
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Actions, Groups, and Values
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Evaluation Plans for ASAP
 Iterative Design Reviews with Medical Professionals
 Usability Test
 10 subjects, 25 tasks (1 hour)
 Inform design
 Feedback: Interview, Questionnaire
 Controlled Experiment
 Test whether ASAP reduces the amount of missed and delayed
results
 Busy simulation environment where multiple distracting factors
are in place
 Compare to a plain list ordered by time of arrival
 20 participants, 50 tasks (2 hours)
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Summary
 Model user actions within workflow specification
 Allow actions as part of display
 Integrate review of results with possible actor actions from within
same screen
 Tracking shows how much time has passed since last action
Acknowledgments

Zach Hettinger, Daniel Murphy, Archana Laxmisan, Hardeep Singh, Dean Sittig

Strategic Health-IT Advanced Research Projects (SHARPC)
Contact: sureyya@cs.umd.edu
Website: http://www.cs.umd.edu/hcil/sharp/
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