LifeLines for Visualizing Patient Records

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Related HCIL page: Juvenile Justice Project (94-96): The project were LifeLines were "born".

Related HCIL workshop: Visualizing Personal Histories: a Workshop (July 21-22, 1997)

Related HCIL workshop: Personal Medical Devices Workshop: Increasing Patient Healthcare Participation (June 3, 2004)

Related HCIL workshop: Interactive Visual Exploration of Electronic Health Records (May 30, 2008)

Other Related page: HealthInfoDesign Resources on design and medical informatics.

Project description:

Computerized medical records pose tremendous problems to system developers. Infrastructure and privacy issues need to be resolved before physicians can even start using the records. Non-intrusive hardware is required for physicians to do their work (e.g. interview patients) away from their desk. But all the efforts to solve these problems will only succeed if appropriate attention is also given to the user interface design. Long lists to scroll, clumsy searches, endless menus and lengthy dialogs will lead to user rejection. But techniques are being developed to summarize, filter and present large amounts of information, leading us to believe that rapid access to needed data is possible with careful design.

In our past project for the Maryland Department of Juvenile Services we have developed a new technique called Life-Lines to visualize personal history records. We are now working with IBM Watson Research Center to extend the technique to medical records. LifeLines provides a general visualization environment for personal histories. A one screen overview of the record using timelines provides direct access to the data. For a patient record, medical problems, hospitalization and medications can be represented as horizontal lines, while icons represent discrete events such as physician consultations, progress notes or tests. Line color and thickness can illustrate relationships or significance. Rescaling tools and filters allow users to focus on part of the information, revealing more details.

LifeLines can: 1) reduce the chances of missing information, 2) facilitate the spotting of anomalies and trends 3) streamline the access to details (as LifeLines act as large menus) and 4) remain simple and tailorable to various applications.

We believe that LifeLines have applicability to a number of the health care projects.

Participants:

Catherine Plaisant, Assistant Research Scientist
Ben Shneiderman, Professor Computer Science
Jia Li, Graduate Student Computer Science
Past participants:
Anne Rose, Faculty Research Assistant
Dan Heller, Undergraduate Student
Richard Mushlin, IBM Watson Research Center
Aaron Snyder, Kaiser Permanente Colorado
Partha Ghosh, Graduate Student ISR

Related Publications:

Plaisant, C., Mushlin, R., Snyder, A., Li, J., Heller, D., Shneiderman, B.
LifeLines: Using Visualization to Enhance Navigation and Analysis of Patient Records
Revised version appeared in 1998 American Medical Informatic Association Annual Fall Symposium (Orlando, Nov. 9-11, 1998) AMIA, Bethesda MD, pp. 76-80

Plaisant, C., Shneiderman, B., Mushlin, R.
An Information Architecture to Support the Visualization of Personal Histories
CS-TR-3855, UMIACS-TR-97-87. Revised version appeared in Information Management and Processing, 34, 5, pp. 581-597, 1998.

Lindwarm D., Rose, A., Plaisant, C., Norman, K. (May 1997)
Viewing personal history records: A comparison of tabular format and graphical presentation using LifeLines
CS-TR-3795, UMIACS-TR-97-45. Revised version appeared in Behavior and Information Technology, 17, 5, 1998, 249-262

Plaisant, C., Rose, A. (March 1996)
Exploring LifeLines to visualize patient records , CS-TR-3620, CAR-TR-819
A short version of this report appeared as a poster summary in 1996 American Medical Informatic Association Annual Fall Symposium (Washington, DC, Oct. 26-30, 1996), pp 884, AMIA, Bethesda MD.

Plaisant, C., Milash, B., Rose, A., Widoff, S., Shneiderman, B. (Sept. 1995)
Life Lines: Visualizing personal histories
ACM CHI '96 Conference Proc. (Vancouver, BC, Canada, April 13-18, 1996) 221-227, color plate 518. See ACM digital library

Videos:

A 1998 video demonstratating LifeLines for Medical Patient Records is available as part of the 1998 HCIL Video Report, 103 MB

An older video demonstrates LifeLines in the Maryland department of Juvenile Justice application. It is available from HCIL (HCIL 1996 Video Report , 86 MB) or through ACM-SIGCHI as part of the CHI'96 video.

Prototypes:

Source Code: The java 1.0 code of LifeLines is now open source, DownLoad Source Code

Live prototypes Note: they were planned for 1024x768 minimum resolution and 32 MB memory
Last compiled in 1998: Works with Explorer 4.0 and Netscape 4.5 (note that with newer version of Java some bugs may appear. For example with Java 1.4, the area representing the future has become transparent...)

Example based on real patient data (developed with the assistance of Aaron Snyder, Kaiser Permanente Colorado)
Demo with imaginary samples - uses richer display attributes
Older demos: Fall 1997 , Summer 1997 , May 1997

Screen prints of underlying data LLD format documentation Screen samples of early explorations of patient record visualization. And in a different domain: a customer record for ebusiness (!!Attention sample data only - Chauffeured demo!!)

Sponsors and Partners:

The work on LifeLines was originally supported by the State of Maryland Department of Juvenile Justice (94-96). In 97 and 98 HCIL received some support from the University of Maryland (CMPS) to work on medical records in collaboration with IBM as part of the IBM SUR program which provided equipment to the University. Ben Shneiderman also received an IBM faculty award, allowing us to explore how LifeLines could also be used in ebusiness and other applications.
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