Inside

Dr Dave Pao

PhD Work

Electronic Medical Records: data visualisation for a liminal space

My research investigates the evolution of the medical record, with particular emphasis on the shift from paper to Electronic Medical Records (EMR).

It is not sufficient simply to convert paper records to digital format, because their potential benefits require harnessing in different ways. In a health informatics world vulnerable to technological determinism, paper versus digital is a complex comparison that warrants attention.

Whilst paper has limitations, its natural affordances – such as writing, sketching or annotating – are intuitive and easy to exploit. Digital promises so much but any affordance beyond typing, storing and retrieving text needs to be designed explicitly – deep clinical relevance is rarely realised.

EMR are primarily designed for administration, or derived from similar models, yet expected to be clinically meaningful. Designers and evaluators of conventional EMR interfaces typically view the consultation as workflow – pre-defined steps to achieve a task or outcome.

In response, I first argue for a radical re-envisioning of the clinical consultation itself – as a messy, unfolding, unpredictable conversation that is first about thinking and only subsequently about task or outcome.

Secondly, I assert that the machinic [interface] aesthetic is ideally suited to this viewpoint, being associated with process rather than object, dynamics rather than finality, instability rather than permanence, communication rather than representation, and with action.

With this coupling, I use design methodology to demonstrate that the accessibility, relevance and flow of clinical information impacts upon the intimate, liminal space of the consultation.

I then draw on established theory from graphic design, visual analytics, information architecture and UX/UI design to create prototype interfaces that present complex patient data rich in clinical context and functionality.

I aim to demonstrate that an increased sense of connection between clinician and patient comes from matching clinical thinking to a navigable landscape of clinical information.

Info

  • PhD

    School

    School of Design

    Programme

    Innovation Design Engineering, 2013–2018

  • Dave is a practising doctor in the field of sexual health and HIV medicine, with a clinical research MD from University College London (2012). Alongside his medical work, he is undertaking a PhD-by-practice in Innovation Design at the Royal College of Art.

    Dave's research at the RCA acknowledges the critical influence of the medical record on the quality of the clinician-patient consultation. He is exploring the impact of the shift from paper to digital records, through the affordances inherent to these very different media.

    His longer-term research view acknowledges the rapid rise in patient-held health records, and he envisions a landscape where patient and clinician involvement in medicine will begin to merge, played out though shared interfaces.

    How can such interfaces best represent the patient history from both medical and narrative perspectives, and what would they look like?

  • Degrees

  • Medicine (MBBS), University of London, 1995; Member of the Royal College of Physicians (MRCP), London, 1999; Research MD [Infection], University College London, 2012
  • Experience

  • Internal Medicine, NHS, 1995–9; Genitourinary / HIV Medicine, NHS, 1999 – present
  • Exhibitions

  • Artifact, Imperial College, 2013