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Pilot Testing of Simulation in the Evaluation of a Novel, Rapidly Deployable Electronic Health Record for use in Disaster Intensive Care

Published online by Cambridge University Press:  22 October 2021

David E. Applebury
Affiliation:
Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA
Eric J. Robinson
Affiliation:
Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA
Jeffrey A. Gold*
Affiliation:
Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA
Jeffrey D. Davis
Affiliation:
Department of Anesthesia, Oregon Health & Science University, Portland, OR, USA
David Zonies
Affiliation:
Department of Surgery, Oregon Health & Science University, Portland, OR, USA
*
Corresponding author: Jeffrey A. Gold, Email: goldie@ohsu.edu.

Abstract

Objectives:

The SARS-CoV-2 pandemic has highlighted the need for rapid creation and management of ICU field hospitals with effective remote monitoring which is dependent on the rapid deployment and integration of an Electronic Health Record (EHR). We describe the use of simulation to evaluate a rapidly scalable hub-and-spoke model for EHR deployment and monitoring using asynchronous training.

Methods:

We adapted existing commercial EHR products to serve as the point of entry from a simulated hospital and a separate system for tele-ICU support and monitoring of the interfaced data. To train our users we created a modular video-based curriculum to facilitate asynchronous training. Effectiveness of the curriculum was assessed through completion of common ICU documentation tasks in a high-fidelity simulation. Additional endpoints include assessment of EHR navigation, user satisfaction (Net Promoter), system usability (System Usability Scale-SUS), and cognitive load (NASA-TLX).

Results:

A total of 5 participants achieved a 100% task completion on all domains except ventilator data (91%). Systems demonstrated high degrees of satisfaction (Net Promoter = 65.2), acceptable usability (SUS = 66.5), and acceptable cognitive load (NASA-TLX = 41.5); with higher levels of cognitive load correlating with the number of screens employed.

Conclusions:

Clinical usability of a comprehensive and rapidly deployable EHR was acceptable in an intensive care simulation which was preceded by < 1 hour of video education about the EHR. This model should be considered in plans for integrated clinical response with remote and accessory facilities.

Type
Original Research
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

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