While routinely ordered, the electrocardiogram (EKG) is an incredibly well designed way to gather useful clinical data for cardiac and non-cardiac conditions. With new devices such as the AliveCor, EKGs are becoming more accessible on a mobile basis instead of requiring a full machine. There are many upsides to its use, including that it is non-invasive, cheap and visual.
On a cardiology rotation this summer I’ve had the opportunity to learn more about the use of EKGs than ever before. My attending consistently reports that the EKG is the only vital sign we need. Over the last several weeks, I’ve diagnosed a myriad of cardiac conditions via EKG but also have diagnosed pathology of the brain, liver, and lungs. A distinct reminder that, while our specialists treat diseases as if isolated entities, our hearts (and hence the rest of our physical self) nearly always know what’s going on. When asking the right questions and exploring the right details, one can discover even when the patient breathes or coughs. This same attending uses the consistent mistakes that the computer makes in interpreting EKGs -it’s rarely right anyways- to lead to the right diagnosis. With that, here are some concepts that can be extrapolated from the design of the EKG.
Principles of effective medical device design learned from the EKG:
1. Medical devices should report information in a visual way. From a designers perspective this is the area I think needs the most work and is the area that has shown the most growth recently. We are intensely visual animals and should use that to our advantage in learning and synthesizing data.
2. Medical device design should correlate with physiology. This seems like a no brainer, but perfecting the EKG took a long time, as tweaking its accuracy and how to process the data it provided require careful mathematics. Sensitivity and specificity are important markers to consider.
3. Medical device design should be easy to use with basic instructions. Complexity is overrated. We’re going smaller, quicker and easier with our designs so making the device accessible is a must. An EKG just requires putting it on right to gather the data (sometimes a feat in it’s own), which is straightforward.
4. Medical device design should be non-invasive. Some of our best and most accurate tests require invasive data collection (think cardiac catheterization or biopsies) but while it requires a little more thinking to get answers from an EKG, the risks are substantially less.