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J Am Med Inform Assoc. 2015 Mar;22(2):263-74. doi: 10.1136/amiajnl-2014-002945. Epub 2014 Oct 28.

HARVEST, a longitudinal patient record summarizer.

Author information

1
Department of Biomedical Informatics, Columbia University, New York, USA Division of Nephrology, Department of Medicine, Columbia University, New York, USA.
2
College of Physicians and Surgeons, Columbia University, New York, USA.
3
Department of Biomedical Informatics, Columbia University, New York, USA.
4
New York Presbyterian Hospital, New York, USA.

Abstract

OBJECTIVE:

To describe HARVEST, a novel point-of-care patient summarization and visualization tool, and to conduct a formative evaluation study to assess its effectiveness and gather feedback for iterative improvements.

MATERIALS AND METHODS:

HARVEST is a problem-based, interactive, temporal visualization of longitudinal patient records. Using scalable, distributed natural language processing and problem salience computation, the system extracts content from the patient notes and aggregates and presents information from multiple care settings. Clinical usability was assessed with physician participants using a timed, task-based chart review and questionnaire, with performance differences recorded between conditions (standard data review system and HARVEST).

RESULTS:

HARVEST displays patient information longitudinally using a timeline, a problem cloud as extracted from notes, and focused access to clinical documentation. Despite lack of familiarity with HARVEST, when using a task-based evaluation, performance and time-to-task completion was maintained in patient review scenarios using HARVEST alone or the standard clinical information system at our institution. Subjects reported very high satisfaction with HARVEST and interest in using the system in their daily practice.

DISCUSSION:

HARVEST is available for wide deployment at our institution. Evaluation provided informative feedback and directions for future improvements.

CONCLUSIONS:

HARVEST was designed to address the unmet need for clinicians at the point of care, facilitating review of essential patient information. The deployment of HARVEST in our institution allows us to study patient record summarization as an informatics intervention in a real-world setting. It also provides an opportunity to learn how clinicians use the summarizer, enabling informed interface and content iteration and optimization to improve patient care.

KEYWORDS:

electronic health record; natural language processing; summarization; visualization

PMID:
25352564
PMCID:
PMC4394965
DOI:
10.1136/amiajnl-2014-002945
[Indexed for MEDLINE]
Free PMC Article

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