title: Cognitive Maps to Visualise Clinical Cases in Handovers. Design, Implementation, Usability, and Attractiveness Testing.
abstract: BACKGROUND
  Clinical handovers at changes of shifts are typical scenarios of time restricted and information intensive communication, which are highly cognitively demanding. The currently available applications supporting handovers typically present complex information in a textual checklist-like manner. This presentation style has been criticised for not meeting the specific user requirements.
  
  
  OBJECTIVE
  We, therefore, aimed at developing a concept for visualising the overview of a clinical case that serves as an alternative way to checklist-like presentations in clinical handovers. We also aimed at implementing this concept in a handoverEHR in order to support the pre-handover phase, the actual handover, and the post-handover phase as well as at evaluating its usability and attractiveness.
  
  
  RESULTS
  We developed and implemented a concept that draws on Tolman's pioneering work on cognitive maps that we designed in accordance with Gestalt principles. These maps provide a pictorial overview of a clinical case. The application to build, manipulate, and store the cognitive maps was integrated into an openEHR based handover record that extends conventional records with handover specific information. Usability (n = 28) and attractiveness (n = 26) testing with experienced clinicians resulted in good ratings for suitability for the task as well as for attractiveness and pragmatism.
  
  
  CONCLUSIONS
  We propose cognitive maps to represent and visualise the clinical case in situations where there is limited time to present complex information.
authors.forename: D
authors.initials: D
authors.lastname: Flemming
authors.forename: M
authors.initials: M
authors.lastname: Przysucha
authors.affiliation: Prof. Dr. Ursula Hübner, P.O. Box 1940, 49009 Osnabrueck, Germany, E-mail. u.huebner@hs-osnabrueck.de.
authors.forename: U
authors.initials: U
authors.lastname: Hübner
mesh_terms: D057189:Checklist / Q000379:methods*; D057286:Electronic Health Records / Q000458:organization & administration*; D006747:Hospital Communication Systems / Q000458:organization & administration*; D033181:Information Dissemination / Q000379:methods*; D062527:Meaningful Use; D008498:Medical Record Linkage / Q000379:methods; D008962:Models, Theoretical; D062209:Patient Handoff / Q000458:organization & administration*; D012984:Software; D012985:Software Design; D014584:User-Computer Interface; D014600:Utilization Review
keywords: Clinical handover; Electronic Health Record; cognition; continuity of care; information visualisation