Visual Thinking, Metaphors, and Inspiration to Improve Electronic Medical Records (EMRs)
I would like to share with you one of the most inspiring books for me.
Perhaps you have heard of it? Its by Colin Ware, "Visual Thinking for
Design", a free preview can be found on google books:http://books.google.com/books?id=WBlUgKhMbdsC&lpg=PP1&dq=visual%20thinking%20for%20design&pg=PP1#v=onepage&q=&f=false I draw inspiration from the book. One is the idea that most humans are at a basic level fundamentally designed to receive and interpret visual information in the same manner. The steps higher up in cognition, such as "what" is that object, what to "do" with the object can be different for different people. Due to these similarites, products and interfaces can be designed and optimized for human use. Elegant design by an engineer can help decrease mental workload and make a task actually more enjoyable & effortless. The current hospital environment and design of EMRs have loads of room for optimizing workflow, visualization of data, and for distributing workload between humans as well as human-computer. Specifically, the tasks for which the computers are able to accomplish (data storage, continuous monitoring, information retrieval, and communication) can be interfaced with the human's strength (prioritization, problem solving, decision making, interpretation and adding meaning to data). The interface can provide a powerful end product (see computer/device alerts in the critical care setting for when a patient is getting ill, the amount of data
the cllinician is able to review on a daily basis during "rounds", or the human maintaining a medical problem list for a patient).Clinicans, when combined with elegant design of computerized systems is safer and more effective than the clinician without any tools. Dr. Friedman's "Fundamental Theorem" of informatics elegantly describes this idea:
http://www.jamia.org/cgi/content/full/16/2/169/FIG1 A current problem in health care that much of the electronic medical record (EMR) is not objectified. Humans evolved and succeeded in their environment due to the ability to manipulate objects. It can even be an enjoyable experience (see the iPhone). The difficult to use interface and navigation of clinical data that is commonplace in the currently availabe EMRs has much room for improvement. Coln Ware's book offers a reference to my other academic hero, Dr. George Lakoff. page 62-63, "Even when we talk about abstract, inherently non-spatial ideas, phrases such as connected to, built on, contained within, are so common that we do not even think of them as metaphoric. According to Lakoff, these kinds of spatial analogies are fundamental to human reasoning, which is ultimately grounded in human experience gained by interacting with the environment." In other words the lower levels of visual processing are fundamental and fixed, but the higher levels offer for a much more malleable situation. The human is "programmed" via narratives and metaphors.One feeling I get in engineering these days is that conceptual models can be very complex, and I wonder if they could be simplified a bit. One possibility would be if these models could actually be tied more directly to some of the fundamental metaphors and narratives for which many of us are familiar. Perhaps these ideas and concepts which are written on papers and journals are essentially in "the cloud". I wonder if there is an opportunity to bring it back to earth, to the world in which we live, to be more applicable to our everyday lives.
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