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Computing at the speed of paper: ubiquitous computing environments for healthcare professionals
Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Despite the introduction of computers in most work environments, the anticipated paperless workplace has not yet emerged. Research has documented that material objects are essential in the organization of thought and that they support everyday collaborative processes performed by staff members. However, modern desktop computing systems with abstract graphical user interfaces fail to support the tangible dimension. This work presents a novel approach to clinical computing that goes beyond the traditional user-interface paradigm and relieves clinicians of the burden of the mouse and keyboard.

The activities of people working in an emergency room were examined empirically to ascertain how clinicians use real paper objects. The results showed that the professionals arranged their workplaces and created material structures that increased cognitive and collaborative performance. Essential factors in these strategies were the availability of physical tools such as paper-based patient records and forms that could be spatially positioned to constitute reminders and direct the attention of the team, and to form shared displays of the work situation.

NOSTOS is an experimental ubiquitous computing environment for co-located healthcare teams. In this system, several interaction devices, including paper-based interfaces, digital pens, walk-up displays, and a digital desk, form a workspace that seamlessly blends virtual and physical objects. The objective of the design was to enhance familiar workplace tools to function as user interfaces to the computer in order to retain established cognitive and collaborative routines.

A study was also conducted to compare the tangible interaction model for clinical computing with a traditional computer-based patient record system with a graphical user interface. The analysis suggests that, in ordinary clinical environments, cognitive and collaborative strategies are better supported by the tangible augmented paper approach and a digital desk than the traditional desktop computing method with its graphical user interfaces. In conclusion, the present findings indicate that tangible paper-based user interfaces and basic augmented environments will prove to be successful in future clinical workplaces.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 2004. , 98 p.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 883
National Category
Computer Science
Identifiers
URN: urn:nbn:se:liu:diva-23116Local ID: 2513ISBN: 91-7373-971-5 (print)OAI: oai:DiVA.org:liu-23116DiVA: diva2:243430
Public defence
2004-06-03, Visionen, Hus B, Linköpings Universitet, Linköping, 13:15 (Swedish)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2013-01-10
List of papers
1. Groupware for case management and inter-organizational collaboration: the virtual rehabilitation team
Open this publication in new window or tab >>Groupware for case management and inter-organizational collaboration: the virtual rehabilitation team
2001 (English)In: Studies in Health Technology and Informatics, Volume 84: MEDINFO 2001 / [ed] V.L. Patel, R. Rogers, R. Haux, 2001, 3-7 p.Conference paper, Published paper (Refereed)
Abstract [en]

This paper presents LINDA, a prototype system designed to support virtual rehabilitation teams. LINDA enables professionals from different welfare-state agencies to collaborate in case management. Our approach to supporting teamwork involves the sharing of minimal case sets across organizational borders needed to provide a shared situation assessment among team members. The system provides a shared workspace for the team; a lightweight client-database, visualization of case histories and plans, and means to communicate effectively in the team using yellow sticker-notes. We present LINDA and discuss how we approached the problem to design groupware to support work under changing and uncertain conditions.

National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-60333 (URN)10.3233/978-1-60750-928-8-3 (DOI)978-1-58603-194-7 (ISBN)
Conference
10th World Congress on Medical Informatics, 2001, September 2-5, London, England
Available from: 2010-10-11 Created: 2010-10-11 Last updated: 2013-09-05
2. Supporting cognition in inter-organizational collaborative systems
Open this publication in new window or tab >>Supporting cognition in inter-organizational collaborative systems
2002 (English)In: Proceedings of the Fifth International Conference on the Design of Cooperative Systems, 2002, 14-17 p.Conference paper, Published paper (Refereed)
Abstract [en]

LINDA is a tool designed to support inter-organizational collaboration in small health-service teams. We approached the design of LINDA by examining how clinicians worked with documents, markers, and other physical objects in an emergency room. We found that spatial arrangements of patient folders on a desk supported workplace cognition and collaboration in several ways. In the design of LINDA, we tried to capture some of the supporting cognitive properties of the physical collaborative system. For example, virtual case files can be arranged spatially on a desktop, sticker-notes can be glued onto different parts of the system, and annotations can be made on forms. We discuss how we approached the problem of designing a system that allows users to form their own flexible coordination mechanisms to support cognition and collaboration.

National Category
Computer Science
Identifiers
urn:nbn:se:liu:diva-60326 (URN)
Conference
5th International Conference on the Design of Cooperative Systems, 2002 June 4-7, Saint Raphaël, France
Available from: 2010-10-11 Created: 2010-10-11 Last updated: 2013-09-05
3. Cognitive tools in medical teamwork: the spatial arrangement of patient records
Open this publication in new window or tab >>Cognitive tools in medical teamwork: the spatial arrangement of patient records
2003 (English)In: Methods of Information in Medicine, ISSN 0026-1270, Vol. 42, no 4, 331-336 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: As a preliminary for the design of Computer- Based Patient Records, the aim of this paper is to build an understanding of the roles physical artifacts like paper-based patient records play in support-ing cognition and collaboration in the healthcare settings. Method: A small ethnographically-informed study was conducted in the emergency room at a 250-bed hospital in Sweden from the perspective of Distributed Cognition. Results: To track work-in-progress, clinicians placed patient records on a desk to form a shared public display that represented the current problem state for the health-care team. The results of the study suggest that the patient records and other physical artifacts are used by clinicians in different ways to form cognitive tools that offload memory tasks and support joint attention and collaboration. Conclusion: To design Computer-Based Patient Records that more appropriately support cognition and teamwork, it is important to investigate how clinicians make use of the paper-based patient records. Practitioners take advantage of existing tools frequently to deal with cognitively demanding tasks and collaboration issues.

Keyword
Distributed Cognition, Cognitive artifacts, information systems design, computer-based patient records, cooperative work
National Category
Computer Science
Identifiers
urn:nbn:se:liu:diva-23119 (URN)14534630 (PubMedID)2516 (Local ID)2516 (Archive number)2516 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2013-09-05
4. NOSTOS: a paper-based ubiquitous computing healthcare environment to support data capture and collaboration
Open this publication in new window or tab >>NOSTOS: a paper-based ubiquitous computing healthcare environment to support data capture and collaboration
2003 (English)In: AMIA Annual Symposium Proceedings, Volume 2003;  2003, 2003, 46-50 p.Conference paper, Published paper (Refereed)
Abstract [en]

In this paper, we present a new approach to clinical workplace computerization that departs from the window–based user interface paradigm. NOSTOS is an experimental computer–augmented work environment designed to support data capture and teamwork in an emergency room. NOSTOS combines multiple technologies, such as digital pens, walk–up displays, headsets, a smart desk, and sensors to enhance an existing paper–based practice with computer power. The physical interfaces allow clinicians to retain mobile paper–based collaborative routines and still benefit from computer technology. The requirements for the system were elicited from situated workplace studies. We discuss the advantages and disadvantages of augmenting a paper–based clinical work environment.

National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-60321 (URN)14728131 (PubMedID)
Conference
2003 AMIA Annual Symposium, 2003 Nov 8-12, Washington DC, USA
Available from: 2010-10-11 Created: 2010-10-11 Last updated: 2013-01-10
5. Design requirements for ubiquitous computing environments for healthcare professionals
Open this publication in new window or tab >>Design requirements for ubiquitous computing environments for healthcare professionals
2004 (English)In: Studies in Health Technology and Informatics, Volume 107: MEDINFO 2004, San Francisco: AMIA , 2004, 1416-1420 p.Conference paper, Published paper (Refereed)
Abstract [en]

Ubiquitous computing environments can support clinical administrative routines in new ways. The aim of such computing approaches is to enhance routine physical work, thus it is important to identify specific design requirements. We studied healthcare professionals in an emergency room and developed the computer-augmented environment NOSTOS to support teamwork in that setting. NOSTOS uses digital pens and paper-based media as the primary input interface for data capture and as a means of controlling the system. NOSTOS also includes a digital desk, walk-up displays, and sensor technology that allow the system to track documents and activities in the workplace. We propose a set of requirements and discuss the value of tangible user interfaces for healthcare personnel. Our results suggest that the key requirements are flexibility in terms of system usage and seamless integration between digital and physical components. We also discuss how ubiquitous computing approaches like NOSTOS can be beneficial in the medical workplace.

Place, publisher, year, edition, pages
San Francisco: AMIA, 2004
National Category
Computer Science
Identifiers
urn:nbn:se:liu:diva-23117 (URN)10.3233/978-1-60750-949-3-1416 (DOI)2514 (Local ID)978-1-58603-444-3 (ISBN)2514 (Archive number)2514 (OAI)
Conference
11th World Congress on Medical Informatics. MEDINFO 2004. 2004 September 2-5, San Fransisco, USA
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2013-01-10

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