Sparklines is a a graphical display that are typically line or bar graphs with all non-data elements removed. These graphs can provide clinicians with ‘embedded contextual information’5 and have been noted to have potential to reduce diagnostic errors by simplifying cognitive tasks and highlighting data trends.3.5 In addition to these important benefits, one of the primary advantages of sparklines is that they allow a significant amount of data to be presented on one screen in the EHR. This can enhance user satisfaction and usability by reducing screen navigation among necessary data while integrating a large amount of task-relevant data into the clinical data presentation.5
Sparklines are designed by designed by Edward Tufte. When considering any data display, one should consider the phenomenon of representational effect, which suggests that the ‘manner in which data are represented can have a profound effect on what information is perceived and the ease or difficulty of a task.’3 Patient data is frequently presented in a table format. While not inappropriate, this manner of data presentation can take a larger amount of space than some graphical alternatives and may not lend itself to rapid determination of important trends in patient results.3
In addition to using sparklines for displays of single patient data in the clinical workflow, they can also facilitate enhanced understanding of data when comparing large groups of patient data during quality improvement projects. One study demonstrated that by displaying 100 sparklines of individual patient data on a single screen, they were better able to understand the clinical data comparisons.6
In the interest in saving user’s time and reducing cognitive load, sparklines may be a good solution to the display of certain data in the EHR. There have been very few studies evaluating sparklines. Given their potential to improve usability while providing data needed for CDS, further evaluation seems warranted.
Data and Workflow
The nature of healthcare is extremely data-intense. One of many areas area where usability and CDS come together is in the display of patient-specific data. When delivered at appropriate times within the clinician’s workflow, well-designed data presentation can facilitate the decision making that is critical to establishing the appropriate plan of care, while saving clinician’s time and reducing cognitive load.3 However, users often complain that their natural workflow is interrupted by poorly designed EHR’s that require scrolling or navigating between several pages of the EHR in order to obtain necessary information. This takes extra time and adds to user frustration.3 Displaying relevant patient data in the simplest manner will enhance the usability of the system and also adhere to several of the CDS ‘ten commandments’.2,4
For graphic displays of sparklines, see References 3,5,6 below.
- Armijo D, McDonnell C, Werner K. Electronic Health Record Usability - Interface Design Considerations. Agency for Healthcare Research and Quality. 2010 May;1-27.
- Bates DW, Kuperman GJ, Wang S, Gandhi T, Kittler A, Volk L et al. Ten commandments for effective clinical cecision support:making the practice of evidence-based medicine a reality. J Am Med Inform Assoc. 2003;10:523–30.
- Bauer DT, Guerlain S, Brown PJ. The design and evaluation of a graphical display for laboratory data. J Am Med Inform Assoc 2010:17:416-24.
- Stone D, Jarrett C, Woodroffe M, Minocha S. User interface design and evaluation. San Francisco (CA): Morgan Kaufmann Publishers;2005. p.170-2.
- Radecki RP, Medow MA. Cognitive debiasing through sparklines in clinical data displays. Proceedings from the American Medical Informatics Association Symposium; 2007; Sep 26- 30; 2007. p.1085.
- Thomas P, Powsner S. Data presentation for quality improvement. Proceedings from the American Medical Informatics Association Symposium; 2005; Nov 30-Dec 3; Austin, Texas; 2005. p.1134.
Submitted by Andrea Martin