Simple Visuals Enable Improved Vitals Monitoring

By Matt Phillion

A new, innovative solution combines simple design with need-to-know patient status information to help anesthesiologists process complex patient information at a glance.

In modern operating rooms, clinicians must contend with significant information overload that can contribute to poor situational awareness. This potential for misinterpretation of data is responsible for over 80% of anesthesia-related mistakes. And while modern monitoring tools provide an abundance of data to interpret and calculate, this abundance also opens the door to human error.

To combat this challenge, Philips has launched the Visual Patient Avatar. This monitoring solution is designed to convey critical information about the patient’s condition using simple design, distinct colors, movements, and shapes, designed to be readable within an anesthesiologist’s peripheral vision. The intent is to cut back on the cognitive overload faced by decision makers so they can process patient data efficiently and provide precise care.

“When you’re picking up someone’s vital signs, there’s a decision that flows from that: do I need to intervene or not?” says Christoph Pedain, general manager of hospital patient monitoring with Philips. “Good outcomes hinge on these decisions being made the right way in the right time so those outcomes can be optimized.”

The ability to make those right decisions are at the core of any improvement to patient monitoring and support.

“The vital signs need to present the information the clinicians need to make a proper decision, whether through early warnings or after-action reviews,” says Pedain. “It should enable the clinician to analyze what has happened and how to optimize the procedure.”

Since monitoring vital signs was first digitized in the 1970s, a lot has changed. The population has evolved, people live longer, therapies have vastly increased, and so the amount of information that can be made available about an individual patient has also increased. Combine that information overload with staffing shortages or new technologies, and we find that it has truly become a high-tech job that can overburden staff trying to do right by their patients.

“With the human brain, more data doesn’t necessarily mean more information,” says Pedain.

Tools like the Visual Patient Avatar are designed to address this problem.

“It takes what was disparate information displayed as numbers into a visual representation that, with one glance, shows the status of the patient. Is everything all right with the ranges? Is something trending outside the range or is it already there? All of these things are easily shown with one glance,” says Pedain. “This improves what we call situational awareness.”

Learning from pilots

The initial inspiration came from a pair of Philips’ partners out of Zurich, who both happened to be pilots.

“One day, they had the chance to fly a plane using augmented reality, which really replaced that big dashboard where everything was one parameter, one measurement,” says Pedain. “It offered a way for the pilot to easily determine if everything is all right or not—all in one visual.”

Pedain compares the Visual Patient Avatar as the difference between how you can look at the numeric coordinates on a GPS which tell you exactly where you are—but as a set of numbers, they don’t tell you anything in the moment. By comparison, a map with visual representations of landmarks, streets, and so forth gives you more immediate, actionable data about your location. The solution offers a similar benefit, a visual, striking representation rather than numeric values to be processed without context.

“With patient monitoring, we have discreet numbers for each measurement. We’re looking for parameter numbers, for trends and curves. Is there a way to combine that into a situational picture?” Pedain says.

The actual design representing the patient in the Virtual Patient Avatar is deliberately simplistic to make it easy to view and understand.

“There’s an art to it,” says Pedain. “It’s got to be coherent but also abstract, such that we understand in one glance what the situation is. We don’t want to get too locked into certain details, and so the depiction of a human that’s more detailed is less useful than an abstract version that uses distinct shapes and colors to make it more immediately readable.”

The colors chosen to identify changes in status are intentional to stand out against less striking colors on screen to catch the clinician’s eye more rapidly.

“We went through a lot of experimentation and usability testing and came away with something that’s strikingly simple,” says Pedain.

Anecdotally, the impact among users has been distinctively positive.

“I had a conversation with one anesthesiologist who found he’s able to concentrate on the surgical field and the team more,” says Pedain. “It enables him to better pick up on when something may be going sideways with the patient, as in the corner of his eye he has the Patient Avatar visible. An expanding, blinking alert or change of color in his peripheral vision alerts him that something needs attention, whereas previously he’d have to concentrate on the monitor and could not look at the team or field in this way.”

The solution can be configured as needed for blinks or alarms when something changes to maximize its usefulness in the setting.

Another clinician noted that a tool such as this can have significant impact on stress and fatigue in the OR.

“Another anesthesiologist I’ve spoken with works with many smaller cases across the day, lots of changeover,” says Pedain.

Over long days, alert fatigue can begin to set in, he says. And while the anesthesiologist knows he can do his job and do it well, a tool that is designed to work against alert fatigue by using the right kinds of visual elements can help prevent that level of burnout over long days in the OR.

“People sometimes see the anesthesiologist as the person who puts patients to sleep, but what they do is ensure people stay alive,” says Pedain. “They need to have a grasp of the entire ebb and flow in the OR while the surgeon and other clinicians are doing their work.”

Pedain notes that they’ve seen various setups using the Visual Avatar depending on the OR. Sometimes the monitors are set up just for the anesthesiologist, but others arrange it so anyone in the room can see, or even project it on the wall.

“Doctors appreciate the simplicity and accessibility,” he says. “It’s really about that situational awareness: it supports the task and helps with interpretation, displaying heart rate, blood pressure, lung function, all in a way that makes immediate sense and makes for easier interpretation.”

Pedain says the vision of the future is that this kind of display will become more commonplace: sophisticated but not requiring a huge amount of interpretation on the spot across medicine.

“It’s really something we feel has applicability everywhere for people monitoring vital signs,” he says. “What’s really important is making the right decision for the right patient, 24/7 in all locations. How can it be standardized and optimized?”

Patient Avatar is intended to help improve recognition of specific situational awareness, decrease the cognitive load but increase the confidence in interpreting patient data, Pedain explains.

“Ultimately it’s all about timely and accurate decision making,” says Pedain. “We want to enable improved outcomes as well as a better staff experience and enable hospital systems to overcome these limitations.”

Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at