David Ingram

Published On


Page Range

pp. 193–258


  • English

Print Length

66 pages

3. Observation and Measurement

From Cubits to Qubits

  • David Ingram (author)
The story now moves on to consider observation and measurement, and their relationship to number, symbol, code, logic and ethics. Once again, this chapter starts from a broad historical context, setting the scene for discussion of the connection of life science and clinical practice with science and engineering of the past one hundred and fifty years, and information technology of the past seventy-five years.

The chapter visits large- and small-scale measurement and tells stories of people, devices and systems that have revolutionized science and health care in the computer era. It spans between worlds in which yesterday’s largest computers are now exceeded in computational capacity by devices built into a wristwatch or handheld device, monitoring, communicating and advising about vital signs. It describes the growing dependence of scientific enquiry on computer technology and software methods, and the new measurement modalities that have grown from these connections, in support of everyday health care. It reflects on the challenge to computation posed by the orders of magnitude increases in variety, scale and volume of measured data and the curation of care records based on these.

As an example, the chapter tracks a century of research, starting with the story of X-ray diffraction methods for the study of crystals, in piecing together the structures of proteins. It describes how databases of such structures began to be organized and shared in the founding era of bioinformatics. It discusses the juxtaposition of measurements with theoretical models, and computational methods that search databases of known structures, to assist interpretation of data about newly studied protein molecules. The chapter concludes with a reflection on the challenges to balance, continuity and governance of health care services. These challenges arise from the explosion of new methods of observation and measurement in the Information Age, and the numerous, huge and disparate silos of data accumulating—containing data about individual citizens that is often non-coherent, proprietary and increasingly impossible to anonymize.


David Ingram


David Ingram’s career from 1967 spanned posts in industry, the NHS and University Medical Schools. After undergraduate physics at Oxford and several years in the medical engineering industry, he studied computer science and completed doctoral research on the mathematical modelling of biological systems, at University College London. His first academic post was at The Medical College of St Bartholomew’s Hospital, London, from 1975, where he was appointed Professor of Medical Informatics in 1990. From 1995-2011, he was the founding Director of the UCL Centre for Health Informatics and Multiprofessional Education (CHIME). David participated as partner and reviewer in UK Research Council, NHS, national e-Science and EU Health Informatics programmes and projects, including leading the EU GEHR Project (1991-94). This laid the foundations for the ISO-adopted openEHR specifications for a novel, vendor and technology neutral method for standardising the design of electronic health records, now being taken forward internationally by the openEHR.Foundation, of which he is the Founding President and Chairman of the Board of Governors. He is a founding Trustee of the OpenEyes Foundation, which is developing and marketing opensource software for ophthalmology, now providing the care record for 40% of UK patients. In retirement since 2010, he is focused on keeping well – eg by learning and using a new language, tracking lively grandchildren, following new physics, and learning to dance properly! Recently, he has become active in promoting a novel new technology to provide prescription glasses at very low cost for the developing world, where their lack causes extreme hardship.