Summary
Background: In this paper, we describe a new method for the study of clinical information system
(CIS) logfiles joined with information in the clinical data warehouse. This method
uses heatmap representations and clustering techniques to examine clinicians’ viewing
patterns of laboratory test results. The context of our application of these techniques
is to inform the creation of a widget-based interface to the CIS.
Objectives: We address the rationale, feasibility, and usefulness of our method through examination
of three hypotheses:
1) The frequency distribution of laboratory test viewing will follow a ’long tail’
pattern, indicating that patterns are highly variable and supporting the rationale
for a widget-based configurable system.
2) Patterns of laboratory testing viewing (by clinician, specialty, clinician/patient/day,
and ICD-9-CM codes) can be distinguished by our methods.
3) The identified clusters will include more than 80% of the laboratory test elements
found in 30 randomly selected patient records for one day.
Methods: The data were plotted as heatmaps and clustered using hierarchical clustering software.
Various parameters were tested to give the optimal clusters.
Results: All the hypotheses were supported. For Hypothesis 3, 91.4% of information elements
in the records were covered by the generated clusters.
Conclusions: Study findings support the rationale, feasibility, and usefulness of our methods
to examine patterns of information access among clinicians and to inform the creation
of widget-based interfaces. The results also contribute to our general understanding
of clinicians’ CIS use.
Keywords
Clinician information needs - widget-based interface - clinical information system
interface - web2.0
