Fall 2017 Recap 3 – Semiotics of Pain

Visual Analogue Scale (VAS)

One of the most common medical symptoms is a pain, and the differences between various pains can be very slight and very difficult to describe or explain. For patients with Limited English Proficiency (LEP), it is even more difficult to communicate different kinds of pain to language discordant providers. To help LEP patients, I visualized different kinds of pain.


It is difficult to explain and describe pain especially for non-English speaker


Help non-English speaking patients to communicate their pain with healthcare providers easily






  • Color is very important
  • Animation can add more details and dimensions to the visualization
  • Drawing or painting can be therapeutic
  • Asking patients to draw the pain can reveal more about the pain they are experiencing
  • It is difficult to distinguish between kinds of pains
    EX) tugging vs pulling, burning vs searing

Fall 2017 Recap 2 – American Healthcare System

“Healthcare quality is emotion and experience-driven rather than fact-driven” 

Emily Friedman

The iron triangle of the healthcare includes Quality, Access, and Cost. These are also the main goals of healthcare, but only two of them exist together at the same time.


American Healthcare System is complicated and hard to navigate to English proficient Americans. We can only imagine how hard it would be for ones with Limited English Proficiency (LEP). In America, more than 20% of Americans speak languages other than English at home.


And about half of Texas has more than 35% county speaks a language other than English at home (see picture below).FA2017_semester.025.jpeg

This means about half of Texans are at the risk of adverse effects of the language barrier in different medical situations.

Adverse effects of language barrier

  • Makes harder to access care
  • Lowers patient satisfaction
  • Worsens conditions by not getting appropriate care at the right time
  • Decreases health literacy
  • Lowers utilization of care both preventive care and regular care
  • Raises non-compliance
  • Heightens risk of being misunderstood by their physicians
  • Increases medical errors and drug complications

Medical Interpretation in the U.S.

    • Title VI of the U.S. Civil Rights
    • The law requires physicians to offer ‘qualified’ interpreters and translators to patients with limited English proficiency (LEP) when doing so is necessary


    • Even telephone interpretation services about
      $2-3 per minute without a contract


  • Patient speaks different languages. More than 100 different languages are spoken in the U.S.
  • Language services are not reimbursed
  • Lack of professional medical interpreter services

Medical interpreter or language line services are current solutions to language barrier in the medical situation but with the emergence of technology such as AI, virtual health and telehealth, government, insurance companies and other healthcare enterprises need to spend more effort, time and resources to improve and develop solutions to this serious and prevalent issue.

Possible solutions

  • Better utilization of interpreters
    • Arrange contracted hours per week for most prominent language
    • Community-based providers and a shared interpreter bank
  • Training and utilization of medical staffs
    • Bilingual PA/RN special interpretation training
    • Training physicians to work effectively with interpreters- by speaking in short, clear sentences and avoiding medical jargon, also improves communication and increases time available for patients to ask questions or make statement
  • Technology
    • Translation apps: Canopy Speak, Canopy Quest and Canopy Learn
    • Meducation : allow access to a database of translated written prescriptions to be deployed in pharmacy applications
    • Telehealth/ Virtual visits

Fall 2017 Recap 1 – Social Science Method

In Fall 2017 semester, I focused on gaining more knowledge in American Healthcare System and narrowing down and solidifying my thesis topic.

One of the key problems I identified and want to improve is adverse effects of a language barrier in Healthcare. Langauge barrier worsens social and racial disparities, health literacy and self-agency of patients with Limited English Proficiency (LEP).


Effects of Language Barrier

  • Disparities – Language barrier limits the access to the healthcare, lowers the utilization of preventive services, as a result, worsens health outcomes.
  • Language concordance/Discordance – Language discordant patient more likely to visit ER (Manson, 1988) and lowers patient’s satisfaction.
  • Health Literacy is a capacity to obtain, process and understand basic health information and services to make appropriate health decisions. LEP patients have much lower health literacy due to the limited access to health education.
  • Patient-Provider Communication – Lack of fluid communication in the medical situation impacts LEP patients’ health outcomes. Language barrier increases the risk of adverse medication reaction (Wilson, 2005).
  • Self-Agency is a capacity of individuals to act independently and to make their own free choices. LEP patients tend to have lower self-care agency.

Just having English-only options on important and resourceful websites such as patient portal, insurance website and patient education websites, can contribute to the exacerbation of the language barrier yet in digital space as well, where translation technology already exists.

The purpose – Creative Chain Reaction

This blog is my personal endeavor to gather my inspirations in one place where I can also group and organize similar images, concepts, thoughts, and ideas. I think ideas result from series of chain reactions of inspirations.

I find myself stumble upon numerous websites, images, articles, books, and inspirations in different formats before arriving at a solution. These detours I take can be vital and useful later projects. I want to log my thinking journey so that I can archive and come back to my process whenever I need.

Texas Sky: Math Perspective

We tend to think that the color of the sky is sky blue, but the color of the sky displays different colors through the day. Texas Sky painting includes some unusual colors for the sky.

I dissected this painting into distinctive colors and created a mathematical representation of the painting. Based on the pixel amount of color/

Today, it is very common to represent color in numbers. We categorize colors with Pantone systems and hexadecimal. These methodologies allow us to differentiate one color from the other. Hexadecimal was created so that we can easily identify and refer to a color.

The hex code and pixel count of colors on Texas Sky:

Name HEX Pixel Count
White ffffff 180,468
Ochre a37a2a 44933
Medium Gray 8e8b87 40892
Warm Gray cfc8b9 38952
Dark Gray 83827d 38952
Sky Blue 4f91c5 32536
Mint a7beaa 17198
Blue Gray 7888a1 13753
Black 181713 12803
Red d12523 8252
Orange e88527 4651
Yellow e1cd6a 3555

Pie chart showing the pixel count of colors on Texas Sky


Texas Sky by Ali Akbar. Davidow Collection



Texas Sky: Art Perspective


Like landscapes and seascapes, artists were interested in the sky as a subject of their expression. Traditionally, artists used the watercolor oil or acrylic paints to visualize skies, but today’s world some artists used drones and 360-degree cameras to capture the beauty of the sky.

I created my own skyscape by manipulating photographs of Texas sky, I took over the years. I utilized a grid of different panels to change colors different sections; These sections to represent various faces of Texas Sky.

Texas Sky in a grid by Kelly Park

“My greatest dream is the projection of light into the vast night sky, the probing of the universe as it meets the light, untouched, without obstacles—the world of space is the only one to offer man practically unlimited freedom.”—Otto Piene

Here are some skyscape paintings from various artists.

Vista del Golfo II by Julio Larraz
Untitled by Carlos Narino
ZHAOMING WUSamsara, 2015.jpg
Samsara by Zhaoming Wu
Cloud and Power Line by Maurizio Lanzillotta
Work 1 by Yumiko Kinoshita




Texas Sky: Engineering Perspective

I started this project by creating a mind map, which helped me jot down thoughts quickly and visually brainstorm ideas. Often this process inspires new research topics and the concept of the project. I thought this process is vital for engineering because before you create something, you want to understand what it is.

Mind map


Later, I created a concept map, which is more focused on the artwork, Texas Sky. This methodology helps you carefully observe the artwork longer, discover new meanings and expand your perspective.

Concept Map of Texas Sky by Ali Akbar

Texas Sky: Technology Perspective

How can I capture the vast sky?

We are living in the age of technological advancements where we capture images from the satellites in the universe and do have a better understanding of the atmosphere. But I think capturing the whole sky is quite impossible, but I thought I can mimic the unfathomable and perpetual quality of the sky by looping the animation.

I used my iPad to capture the sky. As I turned 360 degrees, I took 12 photographs in the different angles. Then, I edited photos into monotone photographs. Later, I looped the images to mimic the perceptual quality of the sky. I used some crazy colors to represent the fickle and random quality of Texas sky. Also, each gif animation has different speed, which represent the wind.






Texas Sky: Science Perspective


Meteorology, a science of atmosphere, is closely related to climate changes and weather. Texas is known for its fickle and unexpected weather.

When I first moved to Texas, I noticed that Texas sky is vast. It was because I lived in the big cities like Seoul and New York, where you are surrounded by skyscrapers. In Soul and New York, my view was hindered by skyscrapers, but in Texas, there are very few buildings go up higher than three stories. The sky is wide open for you to observe. It is interesting to observe Texas sky because of  fickle and sporadic weather. This month, different parts of Texas experienced very discrete weather. Houston got flood, Rowlett got softball-sized hail. It is Texas when it pours down one moment and later all dried up and sunny.

The sky in the painting, Texas Sky, seems like it’s ready to change at any moment. Based on the weather I experienced living Texas, I created a gif animation that mimics the precipitation radar. Different colored areas are selected; in motion, it looks like the cloud is dancing.

image2-1024x994     dancingcloud.gif