06 Jan The Medical Icons of Vernon Smith, M.D.

A sample of computer icons created by Vernon Smith, M.D., Mayo Clinic. These icons are used in the "YES Board", a communication device created with assistance and funding from the Mayo Clinic Center for Innovation.

A hospital emergency room is just about the last place one would expect to find a very particular, highly sophisticated, ancient form of art hanging on the walls – much less hanging every 15 feet or so, much less being watched constantly by everyone.

But look closer: affixed just a few inches above eye-level throughout the St. Marys emergency rooms are 21-inch, black-framed computer screens. Each screen is filled with parallel rows of rectangular boxes glowing red, green, yellow, white and blue.

The screens are an electronic patient tracking system created by Dr. Vernon Smith, a St. Marys emergency physician with a passion for combining computers and medicine. 

Designed with financial help from the CoDE awards program of Mayo Clinic’s Center for Innovation, the “YES Patient Locator Boards” offer a real-time, at-a-glance overview of emergency department patients including what rooms they are in, their vital signs, whether they are trending towards dangerous status, and a great deal more.

Now look closer still: each of the several dozen brightly-colored rectangles on a YES screen represents a patient’s room, and each box contains a vertical row of tiny works of art, each one only about ¼ inch high. These tiny images connect the walls of St. Marys to prehistoric cave walls displaying hand-drawn artistic images of human hands, fish, spears and bison, and the great halls, too, of the Louvre, the Prado and the Metropolitan museums -- all great catalogs of images of human and natural life.

So what are these miniature objets d’art?

Computer icons -- modern, digital kin to all works of art that throughout history have merged aesthetics with information, sensory delight with practical guidance, artistic form with actionable function.

Computer icons are more inspired, certainly, by comic books than by Caravaggio, but nevertheless constitute a deep and indelible part of 21st century visual culture.

On today’s ubiquitous computer screens – such as the one you are doubtless reading this article on -- we are talking about icons of tumbling hour glasses, ticking clocks, speech bubbles, calendar pages, camera lenses, butterflies, clipboards, compasses, diskettes, notepads, checklists, paperclips, bowties, wine glasses, umbrellas, globes spinning around and crumpled wads of paper flying into the trash.

On the wall-mounted computer canvases at St. Marys, Dr. Smith paints his world using icons such as valentine-style hearts, sets of lungs, C-clamps, ZZZZ’s, “Closed for Cleaning” sandwich boards, discussion bubbles, spinning biohazard symbols, mortars and pestles, nurses’ caps, pulsing airborne droplets and flashing geometric shapes. 

“My goal is to make the symbols obvious to the untrained eye,” Dr. Smith says. “I want the information imparted by the icons to change what you were going to do. I try to limit the use of words as it requires a separate subprocessor from your mind to make the interpretation, whereas a picture requires only recognition.”

Initially designed for the Emergency Department, the YES patient tracking system is now used as well in St. Marys units. Dr. David Klocke, a Mayo hospital medicine specialist, is collaborating with Dr. Smith to install the system in many more. 

A half-dozen or fewer icons per patient gives practically all the at-a-glance information an emergency caregiver needs to know about that patient’s medical status.

An icon depicting a tiny set of lungs indicates a patient on a ventilator. A rotating biohazard symbol indicates a patient susceptible to whole-body inflammation, or “sepsis.” A heart placed inside a C-clamp indicates a patient being treated with a “pressor,” i.e. a drug to keep blood pressure from crashing. Meanwhile, a flashing heart indicates a patient with critically abnormal vital signs and thus in need of quick attention; and a series of ZZZZ’s floating skyward says that patient is on sedation.

To make his YES Board icons, Dr. Smith uses a combination of pen and paper, digital camera and graphic design software. Sometimes he borrows clip art form public domain collections on the web. Other times, starting with a photograph, he’ll use Photoshop to create a more stylized, simplified shape.

To indicate a hospital room that is closed for cleaning, the YES icon shows the bright yellow sandwich board placed in rooms that are getting swept and mopped. To make the icon, Dr. Smith took a photograph of an actual sandwich board, stylized it, typed in the “Closed for Cleaning” text and – as a final artistic flourish – drew a teeny-tiny mop.

His most complex creation is the icon that indicates “patient is on a ventilator” -- a pair of tiny lungs with a set of tiny mechanical gears superimposed. He used two photos, one of lungs and one of gears, then used photoshop to stylize and superimpose them.

Like any artist, Dr. Smith struggles to find just the right image. Sometimes, a solution eludes him for months or longer. Showing in icon form which specific doctors, nurses and other staffers are on duty at any given moment is proving to be such a challenge.   

“I would like to show staffing as a picture, but I can’t find a way to do it,” Dr. Smith says. “I also want to show the waiting room as a meter, but the gauge would change too rapidly, so I have to resort to using a number. And I’m still looking for the right model for an icon to show how many ambulances are on their way to the ED.”

Whether the YES Boards offer “too much information,” overloading instead of simplifying life for its users, is something Dr. Smith keeps his eye on.

But he’s seen no evidence for it yet. “I get two or three requests a week to add more information,” he says, with no complaints of TMI so far. “Think about air traffic control displays, or stock market tickers, or the cockpit of a 747. We are nowhere near that yet.”

The biggest challenge created by the icon-based YES system is patient privacy, a sacrosanct value at Mayo Clinic. Some privacy protections are built in, such as restricting access to personal data on more publicly-accessible screens. But at some point it is recognized that most people would decide to trade off some degree of privacy, for example, to avert a permanently debilitating condition or to save a life.

“It’s a tough balancing act,” Dr. Smith says. “On the one hand, you want to make the data as easy as possible to get for those who need it. But on the other hand, make it impossible for those who don’t. The trick lies in determining who needs to know what.”

It seems a trick well worth mastering since, when it comes to Dr. Smith’s gallery of medical icons, art doesn’t only imitate life. It can also save it.

By Doug McGill

  • Sarah Jenkins
    Posted at 03:46h, 11 January

    What is the Mayo Clinic?

  • Medical Alert System
    Posted at 15:28h, 15 January

    I really enjoy how Dr Vernon combined medicine and computers. I think it represents what technology can do for the medical field in the future.

  • jennifer the wine ga
    Posted at 19:58h, 17 January

    thank you for this write-up. good read

  • clark boots
    Posted at 23:16h, 17 January

    Great post,Thanks for info about computer icons..

  • Val Garner
    Posted at 12:49h, 19 January

    I also was wondering about patient privacy with a system like this. I’m not sure I’d want everyone who walked by to know this information about me or loved ones. It sounds like anyone would know.

  • Colorado tinnitus
    Posted at 04:28h, 20 January

    I really enjoyed reading this artice. Dr Vernon represets what technology can do for the medical field in the future.

  • Colorado tinnitus
    Posted at 06:47h, 20 January

    Considerably, the article is in reality the greatest on this noteworthy topic. I agree with your conclusions and will eagerly look forward to your next updates.

  • Foto Preimanis
    Posted at 07:39h, 20 January

    Great story, can I use this material for my photography lectures?

  • xenadrine reviews
    Posted at 12:49h, 24 January

    I agree with Dr Smith, art doesn’t only imitate life, it can also save it. It will not be long that other hospitals will adapt this kind of system.

  • curso guion
    Posted at 01:11h, 26 January

    The efforts of Dr. Vernon, Dr Smith and Dr. Klocke to connect art, technology and the medical world in order to enhance life are an example for the medical profession. The challenge of patient privacy created by the icon-based YES system requires wit, but the game is outstanding.

  • FABP
    Posted at 08:55h, 27 January

    Very enjoyable read. The future is certainly going to involve computers more and more and Dr.Vernon has made some very relevany pointers.

  • Andy Uppole
    Posted at 05:02h, 28 January

    I definitely agree that “Computer icons — modern, digital kin to all works of art that throughout history have merged aesthetics with information, sensory delight with practical guidance, artistic form with actionable function.” Without icons we would get lost driving to work or driving in an ambulance to save someones life.

  • sports compression s
    Posted at 06:36h, 28 January

    I have learned interesting things from your posts…

  • Jacquelyn Dunn
    Posted at 18:48h, 30 January

    Great idea but I am not sure about what it says about privacy

    • francescad
      Posted at 18:43h, 31 January

      At Mayo Clinic, we always protect patient’s privacy.

  • mark the camcorder man
    Posted at 09:30h, 31 January

    Vernon Smith is not only a doctor, but also a fine artist…

  • Flight Tips
    Posted at 12:45h, 02 February

    Great article, I agree the biggest challenge created by the icon-based YES system is patient privacy.

  • Digital Photography
    Posted at 23:47h, 06 February

    I really liked Dr Smith’s comment above about limiting the use of words and maximizing the use of images and pictures. Dr Smith said that words require a separate sub-processor to process, whereas images and pictures only require recognition.
    I have found this same thing in my own life. I find images and pictures take a lot less energy and thought processing to understand. Whenever I am able I use pictures to help convey my message.

  • Power Tools Ireland
    Posted at 07:18h, 10 February

    Do you feel additional security would be required on computer systems if this technology is adopted? Patient privacy really is the number 1 priority.

  • Cars Dublin
    Posted at 09:08h, 11 February

    Computers are the way forward in every walk of life here we see a combination of medical, art and IT.

  • Carole Book
    Posted at 09:12h, 11 February

    Love the combination of old and modern, medicine and art and creative and scientific

  • Mason
    Posted at 08:19h, 27 October

    Great post, interesting to see how medical science and technology can merge into a common good for mankind for now. I agree with a previous post about privacy, I don’t think I’d want this type of information made public.