Designing a Substance Misuse Data Dashboard for Overdose Fatality Review Teams: User-Centered Design Approach

Overdose fatality review (OFR) is a public health process in which cases of fatal overdose are carefully reviewed to identify prevention strategies. Current OFR requires review of multiple unconnected data sources, which is a manually intensive process. The Substance Misuse Data Commons (SMDC) was created to link electronic health record data with data from local and state agencies into a single, cloud-based e-platform but does not currently have a data visualization tool.

We aimed to use human factors design principles to develop a comprehensive dashboard for the SMDC that could facilitate enhanced processes to support OFR.

We first surveyed OFR leaders in Wisconsin using the National Aeronautics and Space Administration-Task Load Index to understand the cognitive workload of 3 tasks: (1) analysis of population-level overdose trends, (2) selection and preparation of individual cases for review, and (3) abstraction of data from individual causes. We then conducted semistructured interviews to identify targets for workflow optimization. Next, we developed a prototype dashboard for evaluation using a synthetic dataset built with GPT-4. We subsequently performed iterative design sessions with heuristic evaluations and collected end-user feedback on the final prototype via a second round of semistructured interviews and targeted surveys, including the Unified Theory of Acceptance and Use of Technology and the Perceived Usefulness Questionnaire.

The National Aeronautics and Space Administration-Task Load Index revealed a moderately high mental workload with the current workflow for all 3 tasks, with mean scores of 12.60 (SD 3.31), 11.90 (SD 3.57), and 12.43 (SD 5.41) for tasks 1, 2, and 3, respectively. Interviews pointed to causes including technological challenges and a reliance on manual processes. The prototype dashboard addressed these concerns by integrating multiple data sources to generate population-level visualizations and patient-level event timelines. End users reported the potential for improved efficiency and data accessibility compared to antecedent processes. The Unified Theory of Acceptance and Use of Technology results indicated the dashboard would likely be adopted if made available, with a mean of 4.07 out of 5.00 (SD 0.65). The Perceived Usefulness Questionnaire results suggested moderate usefulness for both the aggregate and individual-level data, with means of 3.61 (SD 0.82) and 3.64 (SD 0.85) out of 5.00, respectively.

OFR is a data-intensive process that traditionally demands substantial cognitive and manual effort, and there are multiple barriers to efficiently collecting data and presenting them for review. The dashboard offers a user-centered, informatics-based approach to streamline data aggregation and presentation, potentially enhancing the efficiency of case reviews. Implementing a dashboard that consolidates and visualizes disparate data sources has the potential to alleviate the manual workload in OFR. Ultimately, our aim is to deliver a finalized data dashboard with real-world SMDC data, giving OFR leaders additional tools to aid in their rigorous work shaping interventions to reduce overdose fatalities.