Document Type : Research articles


1 Assistant Professor, Department of Health Information Technology, School of Paramedical Sciences and Rehabilitation, Mashhad University of Medical Sciences, Mashhad, Iran

2 Associate Professor, Department of Health Economics and Management Science, Mashhad University of Medical Sciences, Mashhad, Iran; Associate Professor, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 MSc in Health Information Technology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran


Background: Information dashboards are useful tools for up-to-date decision-making by visualizing data.
Objectives: This study aimed to report the development of a dashboard in the emergency department (ED) during COVID-19 in a big hospital in Iran.Methods: The authors developed a dashboard by user-centered design (UCD) methodology in four phases, namely specification of the context of use, specification of the requirements, creation of design solutions, and evaluation. Indicators were determined by reviewing previous studies and interviewing focus groups with an expert panel. The Power BI Desktop software was used for the development of the dashboard. Users' comments about the dashboard were collected. The dashboard was then developed and revised according to the users' feedback and suggestions. Finally, user satisfaction was evaluated.Results: The authors identified 30 indicators for COVID-19 ED, classified as input, output, and process indicators. The final version of the dashboard was implemented in 2021, and then 28 ED and managerial staff participated in the evaluation of the dashboard. The average score of the system usability scale of the dashboard was 84.10 points, and the situation awareness index was 3.97, which indicates "good" usability and situation awareness.Conclusion: This dashboard presented key managerial and clinical indicators for decision-making in ED. Future studies can be designed to develop dashboards for accidents and burns EDs and create emergency information dashboards for several hospitals for better management in times of crisis.


  1. Yousef M, Fazaeli S, Masoudi S, Arfae-Shahidi N, Ebrahimi Z, Shokoohizade M, et al. Comparative study of the physician specialty and laboratory services requested for patients with COVID-19: evidence from a large hospital. J Isfahan Med Sch. 2021;39(610):2021.
  2. Mantica G, Riccardi N, Terrone C, Gratarola A. Non-COVID-19 visits to emergency departments during the pandemic: the impact of fear. Public Health. 2020;183:40-1. doi: 10.1016/j.puhe.2020.04.046. [PubMed: 32417567].
  3. [internet].2022 [cited oct 10, 2022].
  4. Sayadi M, Moghbeli F, Mehrjoo H, Mahaki M. A Linear Study of the Spread of COVID19 in China and Iran. J Frontiers in Health Informatics. 2020;9(1):32.
  5. Yousefi M, Arani AA, Sahabi B, Kazemnejad A, Fazaeli S. Household health costs: Direct, indirect and intangible. Iran J Public Health. 2014;43(2):202-9. [PubMed: 26060744].
  6. Bong C-L, Brasher C, Chikumba E, McDougall R, Mellin-Olsen J, Enright A, et al. The COVID-19 pandemic: effects on low-and middle-income countries. Anesth Analg. 2020;131(1):86-92. doi: 10.1213/ANE.0000000000004846. [PubMed: 32243287].
  7. Hartnett KP, Kite-Powell A, DeVies J, Coletta MA, Boehmer TK, Adjemian J, et al. Impact of the COVID-19 pandemic on emergency department visits—United States, January 1, 2019–May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699-704. doi: 10.15585/mmwr.mm6923e1. [PubMed: 32525856].
  8. Ebrahimipour H, Olyani S, Rezazadeh A, Khorsand Vakilzadeh A, Fazaeli S, Jafari M, et al. Effect of" Iran's health system evolution" and" tariff change" based on relative values book on performance of obstetrics and gynecology department: a case study in a big hospital. Iran J Obstet Gynecol Infertil. 2017;20(8):15-25. doi: 10.22038/IJOGI.2017.9586.
  9. Fazaeli S, Khodaveisi T, Vakilzadeh AK, Yousefi M, Ariafar A, Shokoohizadeh M, et al. Development, Implementation, and User Evaluation of COVID-19 Dashboard in a Third-Level Hospital in Iran. Appl Clin Inform. 2021;12(05):1091-100. doi: 10.1055/s-0041-1740188. [PubMed: 34879405].
  10. Selck FW, Decker SL. Health information technology adoption in the emergency department. Health Serv Res. 2016;51(1):32-47. doi: 10.1111/1475-6773.12307. [PubMed: 25854423].
  11. Hu Z, Ge Q, Li S, Boerwinkle E, Jin L, Xiong M. Forecasting and Evaluating Multiple Interventions for COVID-19 Worldwide. Front Artif Intell. 2020;3:1-11. doi: 10.3389/frai.2020.00041. [PubMed: 33733158].
  12. Dong E, Du H, Gardner LJTLid. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20(5):533-4. doi: 10.1016/S1473-3099(20)30120-1. [PubMed: 32087114].
  13. Guarrera TK, McGeorge NM, Clark LN, LaVergne DT, Hettinger ZA, Fairbanks RJ, et al. Cognitive engineering design of an emergency department information system. Cognitive systems engineering in healthcare Boca Raton, FL: CRC Press, Taylor & Francis; 2015.
  14. Wang X, Kim TC, Hegde S, Hoffman DJ, Benda NC, Franklin ES, et al. Design and evaluation of an integrated, patient-focused electronic health record display for emergency medicine. Appl Clin Inform. 2019;10(04):693-706. doi: 10.1055/s-0039-1695800. [PubMed: 31533171].
  15. Almasi S, Rabiei R, Moghaddasi H, Vahidi-Asl M. Emergency department quality dashboard; a systematic review of performance indicators, functionalities, and challenges. Arch Acad Emerg Med. 2021;9(1):e47-e. doi: 10.22037/aaem.v9i1.1230. [PubMed: 34405145].
  16. Yoo J, Jung KY, Kim T, Lee T, Hwang SY, Yoon H, et al. A real-time autonomous dashboard for the emergency department: 5-year case study. JMIR Mhealth Uhealth. 2018;6(11):e10666. doi: 10.2196/10666. [PubMed: 30467100].
  17. Randell R, Alvarado N, McVey L, Ruddle RA, Doherty P, Gale C, et al., editors. Requirements for a quality dashboard: Lessons from National Clinical Audits. AMIA Annu Symp Proc. 2020;2019:735-44. [PubMed: 32308869].
  18. Mukhtar H, Ahmad HF, Khan MZ, Ullah N. Analysis and Evaluation of COVID-19 Web Applications for Health Professionals: Challenges and Opportunities. Healthcare (Basel). 2020;8(4):1-26. doi: 10.3390/healthcare8040466. [PubMed: 33171711].
  19. Ivanković D, Barbazza E, Bos V, Brito Fernandes Ó, Jamieson Gilmore K, Jansen T, et al. Features Constituting Actionable COVID-19 Dashboards: Descriptive Assessment and Expert Appraisal of 158 Public Web-Based COVID-19 Dashboards. J Med Internet Res. 2021;23(2):e25682-e. doi: 10.2196/25682. [PubMed: 33577467].
  20. Dixit RA, Hurst S, Adams KT, Boxley C, Lysen-Hendershot K, Bennett SS, et al. Rapid development of visualization dashboards to enhance situation awareness of COVID-19 telehealth initiatives at a multihospital healthcare system. J Am Med Inform Assoc. 2020;27(9):1456-61. doi: 10.1093/jamia/ocaa161.
  21. Dixit RA, Hurst S, Adams KT, Boxley C, Lysen-Hendershot K, Bennett SS, et al. Case report: rapid development of visualization dashboards to enhance situation awareness of Covid-19 telehealth initiatives at a multi-hospital healthcare system. Journal of the American Medical Informatics Association. 2020;27(9).
  22. Setyawan MYH, Awangga RM, Afriyanti R. Dashboard settings design in SVARA using user-centred design method. J Telkomnika. 2019;17(2):615-9.
  23. Pal D, Vanijja V. Perceived usability evaluation of Microsoft Teams as an online learning platform during COVID-19 using system usability scale and technology acceptance model in India. Child Youth Serv Rev. 2020;119:1-13. doi: 10.1016/j.childyouth.2020.105535. [PubMed: 33020676].
  24. Nadj M, Maedche A, Schieder C. The effect of interactive analytical dashboard features on situation awareness and task performance. Decision Support Systems. 2020;135:1-13. doi: 10.1016/j.dss.2020.113322.
  25. Bangor A, Kortum P, Miller J. Determining what individual SUS scores mean: Adding an adjective rating scale. J Usability Stud. 2009;4(3):114-23.
  26. Ponce M, Sandhel A. covid19. analytics: An R Package to Obtain, Analyze and Visualize Data from the 2019 Coronavirus Disease Pandemic. J Open Source Softw. 2021;6(60):1-5. doi: 10.21105/joss.02995
  27. Vijay Anand V, Arunkumar Yogaraj G, Priya S, Priya Raj P, Brinda Priyadharshini C, Sridevi PN. A cross-sectional study on COVID19 mortality among people below 30 years of age in Tamilnadu-2020. Clin Epidemiol Glob Health. 2021;12:1-6. doi: 10.1016/j.cegh.2021.100827. [PubMed: 34230902].
  28. Florez H, Singh S. Online dashboard and data analysis approach for assessing COVID-19 case and death data. F1000Res. 2020;9:1-13. doi: 10.12688/f1000research.24164.1. [PubMed: 32884676].
  29. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. The Lancet infectious diseases. 2020;20(5):533-4.
  30. Campbell TC, Mistry ZS, Gorelick-Feldman GN, Hodanics CJ, Babin SM, Lewis SH. Development of the respiratory disease dashboard for the identification of new and emerging respiratory pathogens. Johns Hopkins APL Tech Dig. 2014;32(4):726-34.
  31. Yoo J, Jung KY, Kim T, Lee T, Hwang SY, Yoon H, et al. A real-time autonomous dashboard for the emergency department: 5-year case study. JMIR mHealth and uHealth. 2018;6(11):e10666.
  32. Buttigieg SC, Pace A, Rathert C. Hospital performance dashboards: a literature review. J Health Organ Manag. 2017;31(3):385-406. doi: 10.1108/JHOM-04-2017-0088. [PubMed: 28686130].
  33. Rouhani S, Zamenian S. An architectural framework for healthcare dashboards design. Journal of Healthcare Engineering. 2021;2021:1-12. doi: 10.1155/2021/1964054.
  34. Cornet VP, Toscos T, Bolchini D, Ghahari RR, Ahmed R, Daley C, et al. Untold stories in user-centered design of mobile health: Practical challenges and strategies learned from the design and evaluation of an app for older adults with heart failure. JMIR Mhealth Uhealth. 2020;8(7):e17703. doi: 10.2196/17703. [PubMed: 32706745].
  35. Fareed N, Swoboda CM, Jonnalagadda P, Griesenbrock T, Gureddygari HR, Aldrich A. Visualizing opportunity index data using a dashboard application: a tool to communicate infant mortality-based area deprivation index information. Appl Clin Inform. 2020;11(04):515-27. doi: 10.1055/s-0040-1714249. [PubMed: 32757202].
  36. Bersani K, Fuller TE, Garabedian P, Espares J, Mlaver E, Businger A, et al. Use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor EHR. Appl Clin Inform. 2020;11(01):034-45. doi: 10.1055/s-0039-3402756.
  37. Anantham D, Chai-Lim C, Zhou JX, Phua GC. Operationalization of critical care triage during a pandemic surge using protocolized communication and integrated supportive care. J Intensive Care. 2020;8(1):1-9.
  38. Aristizabal-Torres D, Peñuela-Meneses CA, Barrera-Rodriguez AM. An interactive web-based dashboard to track COVID-19 in Colombia. Case study: five main cities. Rev Salud pública. 2020;22(2):214-9.