This project focuses on designing and evaluating methods to improve clinician decision-making by generating clinician-tailored and patient-specific knowledge summaries. Knowledge summaries will consist of semantic fragments (i.e., small units of text that provide meaningful information) that are relevant to a clinician's patient specific information needs. This kind of decision support is important because clinicians often raise information needs in the course of patient care and these needs are largely unmet. Unmet information needs are missed opportunities for self-directed learning and improved patient care. Although answers to clinicians'questions can often be found in online health knowledge resources, significant barriers limit the use of these resources for patient care. An increasingly popular approach to lowering these barriers is to provide context-sensitive "infobutton" links within electronic health record (EHR) systems. Based on the clinical context, infobuttons anticipate clinicians'information needs and provide relevant links to knowledge resources. Infobuttons do a good job helping clinicians'meet simple information needs, but are less optimal when (i) answers cannot be easily found without substantial cognitive effort scanning the information retrieved;and (ii) the information need is associated with data not displayed on the EHR screen. In the proposed study, we will address limitations of previous approaches leveraging significant preliminary research, state-of-the-art information extraction and text summarization tools, and increasingly adopted EHR standards. The research will be guided by a foundation of information-seeking behavior theories. The study has the following aims and hypotheses: * Generate knowledge summaries leveraging patients'EHR data. H1: Knowledge summaries are more efficacious and efficient than manual search for finding answers to patient-specific questions. * Identify contextual and cognitive factors that contribute to clinicians'information needs and information-seeking behavior. H1: (i) Contextual and cognitive factors are associated with the type of information need;and (ii) with the decision to pursue an information need. * Transform knowledge summaries into tailored knowledge summaries based on clinician's contextual and cognitive factors. H1: Clinician tailored knowledge summaries are more efficacious and efficient than knowledge summaries for meeting clinicians'information needs and improving decision-making.

Public Health Relevance

The proposed research addresses a significant problem related to the large frequency of information needs that clinicians raise in the course of care and are not met. Unmet information needs are among the main causes of medical errors and are missed opportunities for self-directed learning. In this study, we will address this problem by providing clinicians with patient-specific and clinician-tailored knowledge summaries. The proposed system will be developed with a set of open source tools and resources, in a standards-compliant software architecture. Thus, our research has the potential to be replicated on a national scale and to play a significant role in the overall improvement of health and health care.

Agency
National Institute of Health (NIH)
Institute
National Library of Medicine (NLM)
Type
Research Project (R01)
Project #
5R01LM011416-02
Application #
8643820
Study Section
Biomedical Library and Informatics Review Committee (BLR)
Program Officer
Sim, Hua-Chuan
Project Start
2013-04-01
Project End
2017-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
2
Fiscal Year
2014
Total Cost
$316,986
Indirect Cost
$66,394
Name
University of Utah
Department
Miscellaneous
Type
Schools of Medicine
DUNS #
009095365
City
Salt Lake City
State
UT
Country
United States
Zip Code
84112
Mishra, Rashmi; Bian, Jiantao; Fiszman, Marcelo et al. (2014) Text summarization in the biomedical domain: a systematic review of recent research. J Biomed Inform 52:457-67