Sheba Hospital's emergency room dashboard displays medical data
to support doctors in decision-making
Introduction
Medical emergencies require quick and informed decision-making by doctors. To facilitate this, Sheba Hospital's emergency room is implementing a real-time medical dashboard
based on patient data.
We worked as a team of three UX designers together with a project of Unit 8200, which worked
in collaboration with the Center for Digital Innovation at Sheba Hospital.
About Emergency Room (ER)
ER Goal: Decision Making
Beyond saving lives in critical situations, ER aims to move its patients to the appropriate next stage:
being discharged or hospitalized.
To ensure continuous service, ER must always be cleared and make accurate and quick decisions
for every patient.
Goal-Reaching Strategy: Completing the Picture
To achieve the ER's goal, doctors usually require additional patient information, which obtained through physical exams, imaging, or specialist referral.
With dozens of patients to treat simultaneously, doctors always have to make two types of decisions:
Which patient
to focus on?
What follow-up care
is needed?
Challenge & Solution
A significant obstacle in the ER is the lack of an efficient decision-making tool for doctors.
​
We designed a real-time medical dashboard based on ER patients' data. This product helps doctors make informed decisions and prioritize tasks, ultimately achieving the ER's goal of accurate and quick decisions.
User Research
Research Methods​
User Interviews
We interviewed ER doctors
and nurses at Sheba.
Observations
We visited the ER and
joined a senior doctor's shift.
Surveys
We analyzed survey responses from 25 ER doctors
across Israel.
Benchmark
We researched articles
and studies on Sheba's ER
and other ERs.
Insights
Intensive Working Environment
You don't know what's behind the doors.
The load is consistent, always buzzing ...
The ER's heavy workload, along with constant movement
and beeping machines, makes it a hectic environment.
Inadequate Current System
The hospital uses "Chameleon", an information management system with medical data of all patients.
The "Chameleon" is not adapted
to the flow of the ER...
The "Chameleon" is crucial for making complex medical decisions in the ER, but its information architecture doesn't fit the the ER workflow and can causes delays in patient care, as basic information is hard to access and notifications are
non-existent. Slow performance and outdated design add to the difficulty of using the system.
The Doctor's Character
Cognitive load
There is always new information,
there is always something happening that you need to know about...
ER doctors must deal with constant distractions while making critical decisions based on a huge amount of information, resulting in a very
low attention level.
Poor Task Prioritization
I saw the patient's wife
and remembered that I should have looked at his blood tests.
Poor task organization tools prompt doctors
to use handwritten notes, leading to confusion between completed and pending tasks
and risking the oversight of less urgent cases.
Information Capacity
To an outside observer it looks chaotic,
But I can assure you that everyone knows
exactly what they are doing.
While holding an immense amount of medical information may seem overwhelming to non-medical professionals,
it doesn't bother doctors since they find it straightforward
and clear.
Goals
Our dashboard will equip doctors with necessary real-time information to determine the tasks that need to be performed and their level of urgency.
​
We hypothesized that distilling data would streamline doctors' decision-making in two ways:
Shortening the time needed
Reducing the effort spent
These will advance the goal of the ER - to reach a correct and quick decision regarding each patient.
​
The dashboard may also improve ER function by:
-
Reduction of mistakes in the shift.
-
Streamlining and improving the 'pass the baton' process between shifts.
Design Guidelines
Minimal interaction
Our design goal was minimal user interaction, to avoid adding complexity to the workflows.
All data, necessary only
We understood that looking for a passive interface requires displaying a large amount of data. However, the doctors have the expertise to interpret it as a coherent entity.
We will not prioritize patients
ER now uses a controversial urgency index, 'ESI', making it ethically problematic to use it for patient sorting on our dashboard. Instead, we will visually highlight abnormal data and leave
the prioritization decision to doctors.
No replacement of current system
The system is essential in hospitals for documenting medical data, so we can't replace it.
Final Designs
ER View by Spatial Simulation
After visiting the ER, we designed a display that simulates the ER's structure, including two corridors with numbered beds on either side.
​
User research revealed a challenge: patients sitting in unnumbered chairs, often moving between chairs or leaving the ER, causing doctors to waste time locating them. Although we were unable to solve this
in the field, we dedicated the left column to them, separated from the beds, to enable easier tracking.
​
We assumed that arranging patients in this manner would aid doctors in locating them both within the ER
and the system. Positive feedback from doctors in usability tests confirmed this.
​
Filter by status
To facilitate efficient patient management, we've included a patient filtering option by status. This allows doctors to easily group patients by tasks such as sending to imaging or observing blood test.​
Zoom-In: Patient Card
The patient card provides doctors with the minimum necessary data to make basic decisions.
By cross-referencing the data, doctors can determine if it's urgent to approach a patient at a given moment.
​
The elements composing the card:
Time spent in ER
Displaying the patient's length of stay in the ER saves doctors from time calculations, unlike arrival times displayed in the "Chameleon".
The source of the indices
Indicators were differentiated based on their source: real-time monitoring or a single point in time sample.
Abnormal indices
Abnormal indices, which go out of the pre-defined normal range, were marked
in red.
Urgency index
User research found that ER's current urgency index, 'ESI', is controversial.
We discussed developing a data-based alternative and designed it if adopted. The index is also represented by the color of the right border.
Patient status
The patient's status reflects their current stage and may impact their prioritization.
After conducting usability tests, we improved the 'waiting for the doctor' status by adding icons that display the reasons for the wait, and by including the waiting duration to highlight long wait times.
ER View by Arrival Time
The Chameleon uses arrival time to sort patients, placing those who have spent the most time in the ER
at the top of the table. Such a display helps doctors to follow the First-In-First-Out method and prioritize patients who have waited the longest, especially when there are no urgent cases.
​
Patients who sit in chairs, and may be hidden in the spatial simulation view, will receive their position in this view according to the time of their arrival at the ER.
Patient Panel
By clicking on the patient's card in the dashboard, doctors can enter an additional depth layer of in-depth
basic data.
​
Indices Change
Since the indices are already recorded in the systems, we decided to show their change over time.
This presentation received positive feedback.
​
Patient Story
We came up with an idea to add a log of events recorded about the patient. The feedback was more positive than expected, and user testing resulted in the addition of a completion task button (the 'eye' icon in the left), So that the doctor can see if the task has already been done or not yet. This significantly improved their work procedures according to usability tests.
Tablet Version
ER work is now done on computers, so we focused on designing a desktop interface, but to further aid doctors on duty, we also created a complementary tablet interface.
​
The tablet version was originally designed with a responsive approach, but after conducting usability tests, we adapted it to be better suited for dynamic use during "patient rounds", when doctors move sequentially between patients during quieter periods. The patient panel remains fixed, allowing doctors to focus on individual cases in-depth, unlike the desktop version which shows all patients at once.
Conclusion
As a UX Designer for Sheba Hospital's ER dashboard, my goal was to create a user-friendly interface that helps doctors organize their tasks and understand each patient's situation.
Through close collaboration with medical professionals and user testing, we designed a dashboard that allows doctors to easily track their progress, and prioritize tasks based on urgency. By providing a clear overview of each patient's status, we hope to improve the care efficiency in the ER.
It has been a rewarding experience to work on a project that has the potential to make a significant impact
on patient care.
