title: The implementation of clinician designed, human-centered electronic medical record viewer in the intensive care unit: a pilot step-wedge cluster randomized trial.
abstract: OBJECTIVE
  AWARE (Ambient Warning and Response Evaluation) is a novel electronic medical record (EMR) dashboard designed by clinicians to support bedside clinical information management in the ICU. AWARE sits on top of pre-existing, comprehensive EMR systems. The purpose of the study was to test the acceptance and impact of AWARE on data management in live clinical ICU settings. The primary outcome measure was observed efficiency of data utilization as determined by time spent in data gathering before morning rounds.
  
  
  METHODS
  Step wedge cluster randomization trial.
  
  
  METHODS
  Four ICUs (surgical, medical, and mixed) at an academic referral center.
  
  
  METHODS
  All members of the critical care team participating in morning ICU rounds.
  
  
  METHODS
  Pilot implementation of a novel EMR interface with direct observation and survey.
  
  
  RESULTS
  The study took place between April and July 2012. A total of 80 and 63 direct observations were made in the pre- and post-implementation study periods respectively. The time spent on pre-round data gathering per patient decreased from 12 (10-15) to 9 (7.3-11) min for pre- and post-implementation phases respectively (p=0.03). Compared to the existing EMR, information management (data presentation format, efficiency of data access) was reported to be better after AWARE implementation. AWARE made the task of gathering data for rounds significantly less difficult and mentally demanding.
  
  
  CONCLUSIONS
  The introduction of a novel, patient-centered EMR viewer for the ICU was associated with improved efficiency and ease of clinical data management compared to the standard EMR.
authors: Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States; Multidisciplinary Epidemiology and Translation Research in Intensive Care (METRIC), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. Electronic address: pickering.brian@mayo.edu.
authors: Brian W
authors: BW
authors: Pickering
authors: Multidisciplinary Epidemiology and Translation Research in Intensive Care (METRIC), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
authors: Yue
authors: Y
authors: Dong
authors: Multidisciplinary Epidemiology and Translation Research in Intensive Care (METRIC), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
authors: Adil
authors: A
authors: Ahmed
authors: Multidisciplinary Epidemiology and Translation Research in Intensive Care (METRIC), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
authors: Jyothsna
authors: J
authors: Giri
authors: Multidisciplinary Epidemiology and Translation Research in Intensive Care (METRIC), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
authors: Oguz
authors: O
authors: Kilickaya
authors: College of Business, University of Tennessee, 615 McCallie Avenue, Chattanooga, TN 37403, United States.
authors: Ashish
authors: A
authors: Gupta
authors: Department of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States; Multidisciplinary Epidemiology and Translation Research in Intensive Care (METRIC), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
authors: Ognjen
authors: O
authors: Gajic
authors: Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States; Multidisciplinary Epidemiology and Translation Research in Intensive Care (METRIC), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
authors: Vitaly
authors: V
authors: Herasevich
mesh_terms: D016000:Cluster Analysis; D057225:Data Mining / Q000379:methods* / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D062527:Meaningful Use / Q000706:statistics & numerical data; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D014584:User-Computer Interface; D016526:Workload / Q000706:statistics & numerical data*
keywords: Clinical data management; Cluster randomization trial; Electronic medical record; Human-centered; Implementation; Intensive care unit; Rounds