Drawing on Your Own Experience
Can Graphic Design save your life? — The answer to this question posed by a major exhibition at the Wellcome Collection is yes, In so many ways! Whether it is the effectiveness of a campaign to stop you smoking, the clarity of communication of vital clinical information, or the visual mapping of a cholera outbreak in Victorian London.
Inspiration: Transitions of care
The Helix Centre was approached by the Wellcome Collection to contribute to the programme of live events accompanying this exhibition. On an inspiration gathering mission to the show we were particularly struck by an exhibit that depicted how people had responded to being asked to draw their pain. Graphic designer Yin You had superimposed different people’s responses to create incredibly powerful images that reflect experiences of different symptoms from headache to flu, and this got us thinking about clinician-patient communication in the digital age…
While planning our public engagement at the Wellcome Collection, we were approached by Dr Leigh Warren, a clinical colleague at the start of his PhD. He was interested in how Helix might be able to help with the challenge of visualising patient’s medical histories so that patients could more effectively communicate their story with care providers during the time-pressured encounters of modern healthcare practice. Recognising that patients are increasingly faced with ‘transitions of care’ between providers and settings, he is asking the question; when you meet a new healthcare professional for the first time, what do they need to know about you in order to treat you as an individual, and not as a statistic with symptoms? And when your care puts you in front of many professionals, how do you avoid repeating your story over and over again? These are challenges that come up in many of our patient-facing healthcare innovation projects, from cancer patient experience, to patient activation and end-of-life care.
The context — seeing the whole patient
The challenge of getting to know your patient in a quick timeframe is exacerbated by the current move within the NHS from paper notes to electronic patient records. Electronic notes are now accessed through unwieldy text-based interfaces on aging desktop computers, or “COWS” (computers on wheels). The design of these interfaces often resembles a spreadsheet, with no visual indication of the person they represent or the complexity of the person’s healthcare needs. The shortcoming of this was powerfully illustrated to me by a palliative care consultant I worked with recently. She told me that in the days of paper notes, when you picked up the folder for a new patient, and the notes were as thick as an encyclopedia and disintegrating under their own weight, then that prepared you for a complex and fragile patient who would need extra time and consideration. There is no equivalent to the volume and weight of patient notes when you log on to the electronic patient record. We also heard anecdotally of the value in associating different doctors’ handwriting with the quality of the advice or notes contained within. The electronic upgrade to patient notes, while both inevitable and crucially important to future efficiency has neglected some of the more nuanced elements of the old way of doing things. The ‘whole person’ is absent in the way the data is presented to the healthcare workers.
Exploring ideas through cutting and sticking
This challenge became the basis of two workshops we led with members of the public at the Wellcome Collection. We asked people to work in small groups of strangers to design a prototype interface to graphically represent a patient history as part of an electronic health record. It would be something that both patients and doctors could view and interpret Participants were asked to study a short written summary of a fictional person’s medical history, and from that decide what was important information that doctors should be able to access and understand from a glance of a graphical interface on a tablet or smartphone screen.
Through this exercise, we hoped to see a range of responses that challenged our preconceived ideas for the solution, and the participants did not disappoint. We had nearly fifty people join our two workshops, from design students to medical professors, experts and people with little connection to design and healthcare. They worked in teams of three to five people to create prototypes with coloured card, scissors and glue sticks.
Within a short ninety minute workshop, including introduction and brief, teams produced visual timelines, body maps, and abstract interfaces drawn from metaphors such as the rings inside an oak tree, and then shared their ideas to the wider group. They started the exercise through individually considering the appropriate use of colour, shape and size to represent healthcare events within the interface. They then worked together to agree a coherent approach and used their origami skills to demonstrate dynamic touch screen gestures.
Designers, clinicians and the public working together
These creative workshops were a microcosm of a Helix project, combining clinical expertise with a design-led methodology, with public and patient involvement at the core of the exercise to uncover solutions to a healthcare challenge. We even prototyped the workshop with some trainee doctors before unleashing it on the public. Naturally in this ninety minute timeframe, we didn’t resolve the optimum solution to market-ready satisfaction, but the workshop itself was a prototype for continued engagement which Dr Warren will take forward into his PhD research in “transitions of care”.
“The highlight was the group work, it’s amazing how people can see things from different angles” — Participant
The feedback from participants and the Wellcome Collection was overwhelmingly positive, with the main criticism being a desire for more time, especially in discussing the solutions afterwards. The challenge was fairly abstract and ambitious, but participants told us that they enjoyed learning both about the clinical challenge, and the role of design within healthcare more generally.
For the Helix team, is was a wonderful way to do a short, sharp interaction with a new public, drawn to the event through the Wellcome Collection and the exhibition. Engaging public in the methods of our work is always valuable and rewarding, helping us to remember how lucky we are to have a job that is so creative in an industry that is so important to people’s’ lives, and making sure that we remain focussed on, and accountable to the people we are designing for.
Drawing On Your Experience was held at the Wellcome Collection, London on 10th November 2017