Development and usability of an EHR-driven hypertension disparities dashboard in primary care: A qualitative study

Hypertension disparities persist and remain high among racial and ethnic minority populations in the United States (US). Data-driven approaches based on electronic health records (EHRs) in primary care are seen as a strong opportunity to address this situation. This qualitative study evaluated the development, sustainability, and usability of an EHR-integrated hypertension disparities dashboard for health care professionals in primary care. Ten semi-structured interviews, exploring the approach and sustainability, as well as eight usability interviews, using the think aloud protocol were conducted with quality improvement managers, data analysts, program managers, evaluators, and primary care providers. For the results, dashboard development steps include having clear goals, defining a target audience, compiling data, and building multidisciplinary teams. For sustainability, the dashboard can enhance understanding of the social determinants of health or to inform QI projects. In terms of dashboard usability, positive aspects consisted of the inclusion of summary pages, patient's detail pages, and hover-over interface. Important design considerations were refining sorting functions, gender inclusivity, and increasing dashboard visibility. In sum, an EHR-driven dashboard can be a novel tool for addressing hypertension disparities in primary care. It offers a platform where clinicians can identify patients for culturally tailored interventions. Factors such as physician time constraints, data definitions, comprehensive patient demographic information, end-users, and future sustenance, should be considered before implementing a dashboard. Additional research is needed to identify practices for integrating a dashboard into clinical workflow for hypertension.