The EHR TimeBar functions as a high-level overview of the patient record, as a query device, and as an intuitive navigation tool. Each EHR file (event) for the patient is represented by an icon. The set of icons and their labels are displayed in column format on the right side of the screen.
The icons are connected to the TimeBar by vertical lines. Because the vertical lines accurately position each event on the TimeBar, the date of each event is usually omitted in order to reduce clutter.
- I can open and view any file by clicking directly on its icon. While the file is open, its icon is highlighted, orienting me to how that file fits into the larger framework. Also, its exact date displays within the time bar.
- In addition to being able to open a file by clicking directly on its icon, I can also open files in sequence by using the back or forward buttons ( < , > ) in order to step backward or forward along the row of icons.
- Depending on the density of events, I can use the time interval buttons ( 3 yr, 1 yr . . ) below the TimeBar
to change the time scale. I can view earlier or later periods of time by using the arrow buttons ( ← , → )
on either side of the TimeBar. In addition, I can use the sliding tabs below the TimeBar to ‘zoom in’ on a particular time interval.
- The show and hide buttons allow me to display a subset of icons on the TimeBar. For instance, I could choose to display only office visits and consults by clicking the show button and then clicking those two icons from the right hand column.
- The search button permits queries such as: Search procedures and imaging for ‘coronary’. Any file that meets the search criteria would be flagged by a change in appearance of its icon on the time bar.
- The compare button permits selection of more than one file for simultaneous display. For instance, the 2 most recent ECGs could be selected to display on the same screen in order to facilitate comparison.
- If I want to quickly see a summary description without actually opening a file, a mouse-over hover query can be used:
Additional design options:
- Visual ‘bookmarks’ can be used to flag important files for future reference.
- Upcoming health maintenance events such as immunizations and yearly diabetic eye exams can be organized and displayed.
- When not being actively used, the TimeBar can be reduced to thumbnail size, minimizing its screen footprint while still orienting the user.
- Additional information can be conveyed visually by modification of the icons and/or use of initials. For instance, the 2 icons below designate abdominal MRI and head CT scan respectively.
- Color coding can be used to group icons by category. For instance, the same purple background color is used below to designate these icons as consults — generic, cardiology, pulmonary, and surgical respectively.
- While the TimeBar design presented here was created with office-based EHR programs in mind, the design works equally well for hospital-based EHRs, using time scales appropriate for acute care.
- If the EHR supports a patient portal, a patient and clinician can share information using the TimeBar. For example, a patient could enter a blood pressure reading from home as an event on the TimeBar.
Rick Weinhaus practices clinical ophthalmology outside Boston. He trained at Harvard Medical School, the Massachusetts Eye and Ear Infirmary, and the Neuroscience Unit of the Schepens Eye Research Institute.