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.
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.
Objectives: Ubiquitous computing with multiple interaction devices requires new interface models that support user-specific modifications to applications and facilitate the fast development of active workspaces.
Methods: We have developed NOSTOS, a computer-augmented work environment for clinical personnel to explore new user interface paradigms for ubiquitous computing. NOSTOS uses several devices such as digital pens, an active desk, and walk-up displays that allow the system to track documents and activities in the workplace.
Results: We present the distributed user interface (DUI) model that allows standalone applications to distribute their user interface components to several devices dynamically at run-time. This mechanism permit clinicians to develop their own user interfaces and forms to clinical information systems to match their specific needs. We discuss the underlying technical concepts of DUIs and show how service discovery, component distribution, events and layout management are dealt with in the NOSTOS system.
Conclusion: Our results suggest that DUIs - and similar network-based user interfaces - will be a prerequisite of future mobile user interfaces and essential to develop clinical multi-device environments. © 2005 Elsevier Ireland Ltd. All rights reserved.
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.
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.
Cognitive behavioral therapy (CBT) for psychological disorders is becoming increasingly popular on the Internet. However when using this workstation approach, components such as training and learning relaxation skills, problem solving, exposure exercises, and sleep management guidance must be done in the domestic environment. This paper describes design concepts for providing spatially explicit CBT with mobile phones. We reviewed and analyzed a set of treatment manuals to distinguish elements of CBT that can be improved and supported using mobile phone applications. The key advantage of mobile computing support in CBT is that multimedia can be applied to record, scale, and label anxiety-provoking situations where the need arises, which helps the CBT clients formulate and convey their thoughts and feelings to relatives and friends, as well as to therapists at subsequent treatment sessions.
Self-directed learning denotes that the individual is in command of what should be learned and why it is important. In this study, guidelines for the design of Web 2.0 systems for supporting diabetic adolescents every day learning needs are examined in light of theories about information behaviour and social learning. A Web 2.0 system was developed to support a community of practice and social learning structures were created to support building of relations between members on several levels in the community. The features of the system included access to participation in the culture of diabetes management practice, entry to information about the community and about what needs to be learned to be a full practitioner or respected member in the community, and free sharing of information, narratives and experience-based knowledge. After integration with the key elements derived from theories of information behaviour, a preliminary design guideline document was formulated.
Using time geographic theory for representation of population mixing, we set out to analyze the relative impact from precautionary behaviors on outbreaks of pandemic influenza in Europe and Asia. We extended an existing simulator environment with behavioral parameters from a population survey to model different behaviors. We found that precautionary behaviors even among a minority of the population can have a decisive effect on the probability of the outbreak to propagate. The results also display that assumptions strongly influences the outcome. Depending on the interpretation of how many "children" are kept from "school", R(0) changes from a range where outbreak progression is possible to a range where it is improbable in both European (R(0)=1.77/1.23) and Asian (R(0)=1.70/1.05) conditions. We conclude that unprompted distancing can have a decisive effect on pandemic propagation. An important response strategy can be to promote voluntary precautionary behavior shown to reduce disease transmission.
The resulting protocol (NCT01205191 at clinicaltrials.gov) for use in frontline clinical practice in which effectiveness, adherence, and the role of the therapists are analyzed, provides evidence for what are truly valuable cell phone-supported CBT treatments and guidance for the broader introduction of CBT in health services.
Computer simulations have emerged as important tools in the preparation for outbreaks of infectious disease. To support the collaborative planning and responding to the outbreaks, reports from simulations need to be transparent (accessible) with regard to the underlying parametric settings. This paper presents a design for generation of simulation reports where the background settings used in the simulation models are automatically visualized. We extended the ontology-management system Protégé to tag different settings into categories, and included these in report generation in parallel to the simulation outcomes. The report generator takes advantage of an XSLT specification and collects the documentation of the particular simulation settings into abridged XMLs including also summarized results. We conclude that even though inclusion of critical background settings in reports may not increase the accuracy of infectious disease simulations, it can prevent misunderstandings and less than optimal public health decisions.
An ontology is a powerful way of representing knowledge for multiple purposes. There are several ontology languages for describing concepts, properties, objects, and relationships. However, ontologies in information systems are not primarily written for human reading and communication among humans. For many business, government, and scientific purposes, written documents are the primary description and communication media for human knowledge communication. Unfortunately, there is a significant gap between knowledge expressed as textual documents and knowledge represented as ontologies. Semantic documents aim at combining documents and ontologies, and allowing users to access the knowledge in multiple ways. By adding annotations to electronic-document formats and including ontologies in electronic documents, it is possible to reconcile documents and ontologies, and to provide new services, such as ontology-based searches of large document databases. To accomplish this goal, semantic documents require tools that support both complex ontologies and advanced document formats. The Protégé ontology editor, together with a custom-tailored documentation-handling extension, enables developers to create semantic documents by linking preexisting documents to ontologies. © 2007 Elsevier Ltd. All rights reserved.
The JessTab project contributes to the understanding of how ontology editors and performance systems can work together. This understanding includes the mapping from the Protege knowledge representation to the jess representation and the use of Jess definitions as system classes in Protege ontologies. The JessTab also supports the Jess community by allowing the use of Protege as an object-oriented extension to Jess and by providing a tool for using Protege as a graphical front end to Jess.
This paper describes recent work on visualization of simulation results from simulating Modelica models in Open-Modelica. A new 3D graphics package with interactive animation and a new flexible programmable 2D graphicshave been added to OpenModelica. The 2D graphics package provides very flexible usage, either directly from asimulation, from the electronic book client OMNotebook, or programmable graphics, called directly from aModelica model.
Simulation of outbreaks of infectious disease is an important tool for understanding the dynamics of the outbreak process, the impact of disease and population properties, and the potential effect of interventions. However, the interpretation of the simulation results requires a clear understanding of the assumptions made in the underlying model. Typical simulation tasks, such as exploring the space of different scenarios for population and disease properties, require multiple runs with varying model parameters. For such complex tasks, the management of the assumptions made becomes a daunting and potentially error-prone undertaking. We report explicit assumptions management as an approach to capture, model, and document the assumptions for simulator runs. It was found possible to extend ontology-based simulation, which uses an ontological model to parameterize the simulator, to incorporate an assumptions model in the ontology. We conclude that explicit assumptions modeling should be part of any infectious disease simulation architecture from start.
Computer-based simulation of influenza outbreaks in local communities can help researchers, epidemiologists, and decision makers better understand the impact of the community structure on the reproduction rate of disease, and the relative benefits of different types of prevention and interventions. The goal of scenario modeling is to develop a description of scenario components, such us the disease, the community and interventions. An ontology-based representation of the scenario model together with a modeling tool, which is based on an extension to Protege assist scenario developers in formulating simulation specifications. This approach allows the exploration of new ideas by rapidly formulating and reconstructing scenarios from novel components.
High-fidelity simulations of pandemic outbreaks are resource consuming. Cluster-based solutions have been suggested for executing such complex computations. We present a cloud-based simulation architecture that utilizes computing resources both locally available and dynamically rented online. The approach uses the Condor framework for job distribution and management of the Amazon Elastic Computing Cloud (EC2) as well as local resources. The architecture has a web-based user interface that allows users to monitor and control simulation execution. In a benchmark test, the best costadjusted performance was recorded for the EC2 H-CPU Medium instance, while a field trial showed that the job configuration had significant influence on the execution time and that the network capacity of the master node could become a bottleneck. We conclude that it is possible to develop a scalable simulation environment that uses cloud-based solutions, while providing an easy-to-use graphical user interface.
Smart homes promise to make the lives of elderly people more comfortable and safe. Today, there is a significant interest from industry and policy makers in developing these technologies. In theory, the emerging technologies make it possible to provide a new range of services. So far, however, the goal has often been to develop new services for young people rather than assisting old people to improve their quality of life. Especially important is the potential for using these technologies to promote safety and prevent injury among old people because this group is at home more than the other age groups. Networked devices can collect data from sensors and aid decision-making on intervention and other measures. Furthermore, these devices can instruct and remind individuals about safety-related issues.
Pandemic simulation is a useful tool for analyzing outbreaks and exploring the impact of variations in disease, population, and intervention models. Unfortunately, this type of simulation can be quite time-consuming especially for large models and significant outbreaks, which makes it difficult to run the simulations interactively and to use simulation for decision support during ongoing outbreaks. Improved run-time performance enables new applications of pandemic simulations, and can potentially allow decision makers to explore different scenarios and intervention effects. Parallelization of infection-probability calculations and multicore architectures can take advantage of modern processors to achieve significant run-time performance improvements. However, because of the varying computational load during each simulation run, which originates from the changing number of infectious persons during the outbreak, it is not useful to us the same multicore setup during the simulation run. The best performance can be achieved by dynamically changing the use of the available processor cores to balance the overhead of multithreading with the performance gains of parallelization.
Distributed User Interfaces (DUIs) provide new degrees of freedom to the distribution of systems. This work presents a seamless way for developers to handle the event communication structure much in the same way as in traditional applications. Our framework Marve is the externalization experience of developing several DUI systems. To evaluate our framework we developed a DUI system together with SAAB Aerosystem Human-Machine Interaction division. Using our approach to develop the sample application we show that the current model for development of UIs can be extended to incorporate support for DUI development
The Protégé project has come a long way since Mark Musen first built the Protégé meta-tool for knowledge-based systems in 1987. The original tool was a small application, aimed at building knowledge-acquisition tools for a few specialized programs in medical planning. From this initial tool, the Protégé system has evolved into a durable, extensible platform for knowledge-based systems development and research. The current version, Protégé-2000, can be run on a variety of platforms, supports customized user-interface extensions, incorporates the Open Knowledge-Base Connectivity (OKBC) knowledge model, interacts with standard storage formats such as relational databases, XML, and RDF, and has been used by hundreds of individuals and research groups. In this paper, we follow the evolution of the Protégé project through three distinct re-implementations. We describe our overall methodology, our design decisions, and the lessons we have learned over the duration of the project. We believe that our success is one of infrastructure: Protégé is a flexible, well-supported, and robust development environment. Using Protégé, developers and domain experts can easily build effective knowledge-based systems, and researchers can explore ideas in a variety of knowledge-based domains. © 2002 Elsevier Science Ltd. All rights reserved.
Web-based simulation can be a powerful tool in education and training. The nature of simulation-based learning combined with the availability of the web make learning supported by web-based simulation a powerful strategy. In simulation-based learning, learners can experience environments that would be too costly, time-consuming, complex or dangerous to provide through other means. This article discusses some basic properties of learning using web-based simulation with the focus on different types of learning goals (instructional goals) and on proper instructional strategies (pedagogical strategies) for web-based simulation. We exemplify the classifications discussed with three web-based systems, developed by the authors, that represent different types of web-based simulation. Chernobyl — a nuclear power plant simulation. C3Fire — a micro-world supporting command and control training. ERCIS — a group distance-exercise system supporting equipment handling, action-protocol performance and group interaction.
There are many psychosocial aspects of chronic diseases, such as diabetes. Educational multimedia can support patients with chronic diseases and their families by communicating narratives based on social realism. The production of such socio-realistic interactive health dramas requires systematic methods, especially for the identification of significant stories. The aim of this study is to explore the use of self-documentary video in the design of an Interactive Health Drama environment to support diabetic adolescents and their families. In particular, the potential of the self-documentary video for story development in combination with qualitative interviews were explored. The proposed approach, when further developed, is intended to enable all types of chronic disease patients to work with their specific psychosocial problems in a supportive and stimulating environment adapted to their personality and preferences.
We examined clinicians' and researchers' experiences from participation in collaborative research on the introduction of Internet and mobile information systems (mHealth systems) in psychotherapeutic routines. The study used grounded theory methodology and was set in a collaboration that aimed to develop and evaluate mHealth support of psychotherapy provided to young people. Soundness of the central objects developed in the design phase (the collaboration contract, the trial protocol, and the system technology) was a necessary foundation for successful collaborative mHealth research; neglect of unanticipated organizational influences during the trial phase was a factor in collaboration failure. The experiences gained in this study can be used in settings where collaborative research on mHealth systems in mental health is planned.
The objective of this study was to develop a Quality Function Deployment (QFD) model for design of information systems in health-care environments. Consecutive blocked-subject case studies were conducted, based on action research methods. RESULTS: Starting with a QFD model for software development, a model for information system design, the Medical Software Quality Deployment (MSQD) model, was developed. The MSQD model was divided into the pre-study phase, in which the customer categories and their power to influence the design are determined; the data collection phase, in which the voice of customers (VoC) is identified by observations and interviews and quantified by Critical. Incident questionnaires; the need specification phase, where the VoC is specified into ranked customer needs; and the design phase where the customer needs are transformed stepwise to technical requirements and design attributes. QFD showed to be useful for integrating the values of different customer categories in software development for health-care settings. In the later design phases, other quality methods should be used for software implementation and testing.
Chronic diseases do not only manifest themselves as sets of pathophysiological factors. They bring about an equally important psychosocial impact. Unfortunately, it is difficult to account for this impact in the development of supportive technologies. This study describes and explores a method for elicitation of requirements on technologies supporting self-management including emotional aspects. The method takes advantage of a self-documentary media kit for collection of data from the everyday context of chronic disease. The resulting contextual data can contribute new insights to multi-disciplinary teams in the design of supporting technologies.
A large part of the health promotion in today's society is performed as peer-to-peer empowerment in voluntary organisations such as sports clubs, charities, and trade unions. In order to prevent work-related illness and long-term sickness absence, the aim of this study is to explore computer network services for empowerment of employees by peer-to-peer communication. The 'technique trade-off' method was used for the analysis of the system design. A Critical Incident Technique questionnaire was distributed to a representative sample of trade union shop stewards (n = 386), and focus-group seminars were arranged where a preliminary set of requirements was discussed. Seven basic requirements were identified and matched to a set of 12 design issues for computer network services, allocating a subset of design issues to each requirement. The conclusion is that the systems design displays an inexpensive and potentially feasible method for peer-to-peer computing in voluntary health-promoting organisations. © 2005 Springer Science+Business Media, Inc.