A novel epistemic interface for the Electronic Health Record by Royal College of Art

The Electronic Health Record (EHR) interface is the cornerstone tool of the medical consultation, through which clinicians review, collect, interpret and curate patient data. Widespread criticism of EHR interfaces concerns ‘clinical usability’: the extent to which clinician users can achieve specified goals with effectiveness, efficiency and satisfaction
Most EHR interfaces do not yet benefit from visualisation. If they do, their visual elements are dictated by characteristics inherent to the data, resulting in conventional graph formats that do not fully leverage vision's potential to support cognition in a way that is relevant to clinical practice.
The Sexually Transmitted Infection Query Interface (STIQI) was first conceived by David, a practising doctor, as a provocative prototype, or provotype – a research interface to engage with his clinician community. This provotype helped articulate their intuitive sense of clinical usability in the speciality of Integrated Sexual Health (ISH).
This iteration, the STIQI prototype, is shaped by that engagement. It is unique in taking an 'epistemic' approach to visualisation, meaning that it preserves the conceptual framework of clinical reasoning – or ‘how clinicians think’ - within its visual structure. This is achieved by considering the inter- and intra- relationships between the following aspects of clinical data: Taxonomy; Property; Evaluation; Time; and Interaction.
Diana brought David's design blueprint of the STIQI prototype to life with code. Visualisation and interaction techniques are used to represent patient data in an intuitive graphical format that supports pattern recognition, insights and data salience. A Timeline (high level overview) sits alongside Detail Panels (fully granular data), which are synchronised in time. Her custom logic encodes the visual interactivity of the glyphs and labels to reveal complex hierarchical, temporal and evaluative aspects of the data.
The STIQI prototype has been a success. It has been put forward as the exemplar interface for future EHR procurement, and clinical usability concepts embedded within it have been integrated within the national EHR specification document for ISH.