How the Visual Design of Electronic Patient Records Impacts Medical Practices

Lara Varpio
PhD Candidate,
Department of English
University of Waterloo

April 13, 2005
3:30 PM - 5:00 PM
Davis Centre 1304, University of Waterloo

View Video of Presentation in HI Alive Archive: Research Seminars Archive 2004-2005

Abstract
Research investigating the effects of advanced information systems on the representation and understanding of medical problems has established that the coordination of medical professionals’ activities through pre-structured forms affects the decisions made by these professionals, and the course patient-trajectories take. Electronic Patient Records (EPRs) are a version of such pre-structured forms. While significant evidence has established that the use of EPRs is facilitating communication in healthcare, other recent research has found that EPRs have problematic effects on the day-to-day organization and execution of medical work, on the collection of patient data, and on physicians' reasoning strategies. Therefore, investigation is required into the effects of EPRs on healthcare delivery. However, this analysis should not treat EPRs as standardized monoliths; instead, analysis must focus on EPR components to identify which aspects of these programs exert influence on specific elements of healthcare practice. One such component of EPR design that has not been addressed by research is the EPR's visual interface with users. This is a significant omission since EPRs rely heavily on visual organizational elements and cues to guide user interactions. This study illustrates that analysis of the visual rhetorical design of EPRs provides important measures for understanding how "the form in which information is contained is inseparably entangled with the content of work activities".

In order to demonstrate this, this seminar presents a visual rhetorical analysis of two EPR systems used at a Canadian pediatric hospital. The analysis demonstrates how visual elements of EPRs are coded and carry meaning. The analysis is confirmed by qualitative data collected during an interdisciplinary study at this hospital. Results show that visual design of EPRs is influential on medical professionals' practices.

About the Speaker
Lara Varpio is a PhD student in the Department of English at the University of Waterloo. Her work centres around investigating the role and impact of Medical Information and Communication Technologies (MICTs) on the daily work practices of medical professionals. Currently, she is conducting her dissertation research, at the Hospital for Sick Children, employing theories of Visual and Textual Rhetoric to explore the impact of changing Electronic Patient Record interface designs on the practices of healthcare professionals. Lara also holds two Research Fellowships with two research communities at the University of Toronto. She is a PhD Fellow at the Wilson Centre for Research in Education, at the University of Toronto's Faculty of Medicine, and a PhD Fellow with Health Care, Technology and Place (HCTP), a CIHR Strategic Research and Training Initiative.