-- Seth Powsner (email)

Graphical Diabetic Information.
It would be of great personal significance and utility to see how daily information relevant to newly diagnosed Type I diabetics might be recorded graphically and displayed for use by doctor and patient. The initial diagnostic and treatment period is comprised of puzzle solving, but only after the puzzle pieces have been located, not an easy chore. Diet is key. Additional puzzle pieces can be, specifically, blood sugar levels at every two hours, (with special categories for Fasting or Awakening, Lunch, Supper, Bedtime) carbohydrate totals at each of three meals, insulin dosages in units and at what time (made more complicated when more than one type of insulin is used, which is not uncommon). This is perhaps a simple task for those skilled and schooled in making medical charts understandable in a graphic way. Or are the components too varied to handle in a coherent way...words, numbers, comments, data points?

-- Peter Pehrson (email)

I recently (as in yesterday) attended one of your one-day courses and feel I walked away with an expanded sense of how things can be done better. I also walked away with a feeling of relief in that I was not alone in my interpretation of the situation in regards to presentation of information in general, and in the medical setting in particular. In the medical environment, we as "informatacists" have failed catastrophically to improve the situation. I believe one could easily argue that the electronic medical records have made things worse in many regards. The vast, vast majority of those systems have adopted the ODTAA ("One damn thing after another") method of interface design. A colleague of mine once quipped that what we have here is the product of much development, but not much in the way of design. A catastrophe is another way of putting it.

I have read two of the 3 articles you referenced above and noted with a wry smile that you and your co-author, Dr. Pownser, were able to predict the future in your conclusions in the "Graphical Summary of Patient Status" article:

"Our proposal for a graphical summary should encourage doctors and nurses to reshape, perhaps re-invent, the medical record before computer programmers cast institutional convenience into silicon."

The statement would have been perfect if you had stated it thusly:

"...before computer programmers, hospital administrators, and 3rd party payors cast institutional convenience into silicon."

This is exactly what has happened so far. Perhaps you should add "Clairvoyance" to your CV. Perhaps it was because you had a sparkline and could project into the future based on trend data...

Thank you for taking the time to study, and write down your findings in the field of effective display of data and information. At least some of us are listening and hoping to effect a change.

Best regards,

-- Stephen L. Jones, MD (email)

Fascinating article about how checklists save lives in the Medical field.

http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande

-- Bill Paton (email)

^^^ Thanks for that Bill! The accomplishments of many of the famous faces, and institutions in the linked article are significant and substantial. The beauty is the simplicity.

-- Stephen L. Jones, MD (email)

A report from Epocrates showed 1/3rd of physicians plan to purchase the iPad Mini, as the size of the device fits well into a doctor's lab coat. An increasing likelihood (and hope) that the medical interfaces you describe can become real-world examples.

-- Will Oswald (email)