ArticleJournal of the American Medical Informatics Association : JAMIA2020
Integrated displays to improve chronic disease management in ambulatory care: A SMART on FHIR application informed by mixed-methods user testing.
Article in Journal of the American Medical Informatics Association : JAMIA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Characterizing Behaviors That Influence the Implementation of Digital-Based Interventions in Health Care: Systematic Review.Journal of medical Internet research · 2025Pooled it
- Design, effectiveness, and economic outcomes of contemporary chronic disease clinical decision support systems: a systematic review and meta-analysis.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Conceptualizing clinical decision support as complex interventions: a meta-analysis of comparative effectiveness trials.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Automated Filtering and Visualization of Patient-Centered Data from Electronic Health Records in Emergency Care: A Scoping Review.Journal of multidisciplinary healthcare · 2025Review
- An Interoperable Machine Learning Pipeline for Pediatric Obesity Risk Estimation.Proceedings of machine learning research · 2024Article
- Pitfalls of reasoning in hospital-based transfusion medicine.Transfusion medicine (Oxford, England) · 2024Review
- Machine Learning-Enabled Clinical Information Systems Using Fast Healthcare Interoperability Resources Data Standards: Scoping Review.JMIR medical informatics · 2023Article
- Designing Interoperable Health Care Services Based on Fast Healthcare Interoperability Resources: Literature Review.JMIR medical informatics · 2023Review
- Involving Health Care Professionals in the Development of Electronic Health Records: Scoping Review.JMIR human factors · 2023Article
- A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance.Applied clinical informatics · 2023Article
- Successful Integration of EN/ISO 13606-Standardized Extracts From a Patient Mobile App Into an Electronic Health Record: Description of a Methodology.JMIR medical informatics · 2022Article
- Human-centered design of clinical decision support for management of hypertension with chronic kidney disease.BMC medical informatics and decision making · 2022Article
- Barriers and enablers to implementing and using clinical decision support systems for chronic diseases: a qualitative systematic review and meta-aggregation.Implementation science communications · 2022Review
- Coordinated use of Health Level 7 standards to support clinical decision support: Case study with shared decision making and drug-drug interactions.International journal of medical informatics · 2022Article
- GARDE: a standards-based clinical decision support platform for identifying population health management cohorts.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Electronic Health Record-Embedded, Behavioral Science-Informed System for Smoking Cessation for the Parents of Pediatric Patients.Applied clinical informatics · 2022Article
- Evaluation in Life Cycle of Information Technology (ELICIT) framework: Supporting the innovation life cycle from business case assessment to summative evaluation.Journal of biomedical informatics · 2022Review
- Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities.Yearbook of medical informatics · 2021Review
- New Standards for Clinical Decision Support: A Survey of The State of Implementation.Yearbook of medical informatics · 2021Review
- Contemporary clinical decision support standards using Health Level Seven International Fast Healthcare Interoperability Resources.Journal of the American Medical Informatics Association : JAMIA · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
objectiveThe study sought to evaluate a novel electronic health record (EHR) add-on application for chronic disease management that uses an integrated display to decrease user cognitive load, improve efficiency, and support clinical decision making. MATERIALS AND
methodsWe designed a chronic disease management application using the technology framework known as SMART on FHIR (Substitutable Medical Applications and Reusable Technologies on Fast Healthcare Interoperability Resources). We used mixed methods to obtain user feedback on a prototype to support ambulatory providers managing chronic obstructive pulmonary disease. Each participant managed 2 patient scenarios using the regular EHR with and without access to our prototype in block-randomized order. The primary outcome was the percentage of expert-recommended ideal care tasks completed. Timing, keyboard and mouse use, and participant surveys were also collected. User experiences were captured using a retrospective think-aloud interview analyzed by concept coding.
resultsWith our prototype, the 13 participants completed more recommended care (81% vs 48%; P < .001) and recommended tasks per minute (0.8 vs 0.6; P = .03) over longer sessions (7.0 minutes vs 5.4 minutes; P = .006). Keystrokes per task were lower with the prototype (6 vs 18; P < .001). Qualitative themes elicited included the desire for reliable presentation of information which matches participants' mental models of disease and for intuitive navigation in order to decrease cognitive load. DISCUSSION: Participants completed more recommended care by taking more time when using our prototype. Interviews identified a tension between using the inefficient but familiar EHR vs learning to use our novel prototype. Concept coding of user feedback generated actionable insights.
conclusionsMixed methods can support the design and evaluation of SMART on FHIR EHR add-on applications by enhancing understanding of the user experience.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.