title: Integrating Patient-Reported Outcomes into Spine Surgical Care through Visual Dashboards: Lessons Learned from Human-Centered Design.
abstract: BACKGROUND
  The collection of patient-reported outcomes (PROs) draws attention to issues of importance to patients-physical function and quality of life. The integration of PRO data into clinical decisions and discussions with patients requires thoughtful design of user-friendly interfaces that consider user experience and present data in personalized ways to enhance patient care. Whereas most prior work on PROs focuses on capturing data from patients, little research details how to design effective user interfaces that facilitate use of this data in clinical practice. We share lessons learned from engaging health care professionals to inform design of visual dashboards, an emerging type of health information technology (HIT).
  
  
  METHODS
  We employed human-centered design (HCD) methods to create visual displays of PROs to support patient care and quality improvement. HCD aims to optimize the design of interactive systems through iterative input from representative users who are likely to use the system in the future. Through three major steps, we engaged health care professionals in targeted, iterative design activities to inform the development of a PRO Dashboard that visually displays patient-reported pain and disability outcomes following spine surgery.
  
  
  RESULTS
  Design activities to engage health care administrators, providers, and staff guided our work from design concept to specifications for dashboard implementation. Stakeholder feedback from these health care professionals shaped user interface design features, including predefined overviews that illustrate at-a-glance trends and quarterly snapshots, granular data filters that enable users to dive into detailed PRO analytics, and user-defined views to share and reuse. Feedback also revealed important considerations for quality indicators and privacy-preserving sharing and use of PROs.
  
  
  CONCLUSIONS
  Our work illustrates a range of engagement methods guided by human-centered principles and design recommendations for optimizing PRO Dashboards for patient care and quality improvement. Engaging health care professionals as stakeholders is a critical step toward the design of user-friendly HIT that is accepted, usable, and has the potential to enhance quality of care and patient outcomes.
authors.affiliation: Group Health Research Institute.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Hartzler
authors.affiliation: University of Washington.
authors.forename: Shomir
authors.initials: S
authors.lastname: Chaudhuri
authors.affiliation: University of Washington.
authors.forename: Brett C
authors.initials: BC
authors.lastname: Fey
authors.affiliation: University of Washington.
authors.forename: David R
authors.initials: DR
authors.lastname: Flum
authors.affiliation: University of Washington.
authors.forename: Danielle
authors.initials: D
authors.lastname: Lavallee
keywords: Data Use and Quality; Engagement; Formative evaluation; Health Information Technology; Human Computer Interaction (HCI); Human-centered design; Information display; Learning Health System; Patient-Centered Outcomes Research (PCOR); Patient-reported outcomes; Visualization