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Case-based presentation in medical multidisciplinary team meetings: Applied research in CSCW and IxD
KTH, School of Computer Science and Communication (CSC), Media Technology and Interaction Design, MID.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Advanced medical technology is widely used in modern healthcare, as more and more specialised examinations and treatments are performed on patients. In the case of particularly complex diseases, a number of medical specialists, each an expert in their own field, must collaboratively make diagnoses and plan for treatment. In multidisciplinary team meetings (MDTM), the medical specialists present their pieces of the puzzle, stitch them together and in consensus make a decision. A large amount of information from several sources must be taken into account, but the digital tools to support this decision-making are lacking.

This thesis describes research in which engineers and medical specialists have cooperatively developed such a tool. The main research question concerns improving patient information visualisation to support the collaborative work in MDTMs; a secondary question concerns the role of interaction design in medical work. Several design activities have been conducted together with the medical specialists by utilising research methods derived from computer- supported cooperative work (CSCW) and interaction design (IxD). The new tool has been evaluated in two simulated MDTMs and even though it was developed with the users, the results cut both ways.

Case-based presentation of patients in MDTMs has a positive effect, as more information can be displayed during discussions. It helps the participants keep a shared focus on the patient, her medical history, results from examinations, and decisions made in the meeting. It is a new and aggregated view of the patient and an example of how patient information visualisation can be improved. On the other hand introducing new technology and new ways of interacting with information, in the meetings was not considered entirely positive. The participants have different roles and tasks in the meeting, and the tools should support these without distracting the shared focus.

This practical way of working (conducting field studies, design activities and evaluations) together with ingenious medical specialists can make a difference. By exploring and concretising stakeholders’ needs and making long-term commitments, the interaction designer can take a central position in the deve- lopment of digital, collaborative tools for medical work.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2013. , viii, 77 p.
Series
Trita-CSC-A, ISSN 1653-5723 ; 2013:04
National Category
Human Computer Interaction
Identifiers
URN: urn:nbn:se:kth:diva-119810ISBN: 978-91-7501-680-1 (print)OAI: oai:DiVA.org:kth-119810DiVA: diva2:612612
Public defence
2013-04-19, Kollegiesalen, Brinellvägen 8, KTH, Stockholm, 13:15 (English)
Opponent
Supervisors
Funder
Vinnova
Note

QC 20130326

Available from: 2013-03-26 Created: 2013-03-22 Last updated: 2013-03-26Bibliographically approved
List of papers
1. Efficiency in Treatment Discussions: A Field Study of Time Related Aspects in Multi-Disciplinary Team Meetings
Open this publication in new window or tab >>Efficiency in Treatment Discussions: A Field Study of Time Related Aspects in Multi-Disciplinary Team Meetings
Show others...
2009 (English)In: 2009 22ND IEEE INTERNATIONAL SYMPOSIUM ON COMPUTER-BASED MEDICAL SYSTEMS   , 2009, 88-95 p.Conference paper, Published paper (Refereed)
Abstract [en]

We present a field study of multi-disciplinary team meetings where decisions on treatment of patients with diseases in the upper part of the abdomen are made. These meetings are important for knowledge dissemination and learning. We have studied how different time related aspects affect the efficiency during these meetings. Time is relevant because several physicians attend these meetings, and they have tight schedules as it is. Our analysis focuses on the conversation during the team meetings, and on how aspects such as indistinct discussions, lack of relevant competence and information, and the structuring of medical information affect time efficiency.

Series
IEEE International Symposium on Computer-Based Medical Systems, ISSN 1063-7125
National Category
Computer Science Medical Laboratory and Measurements Technologies
Identifiers
urn:nbn:se:kth:diva-29686 (URN)000278974800016 ()2-s2.0-70449657721 (Scopus ID)978-1-4244-4879-1 (ISBN)
Conference
22nd IEEE International Symposium on Computer-Based Medical Systems
Note
QC 20110218Available from: 2011-02-18 Created: 2011-02-11 Last updated: 2013-03-26Bibliographically approved
2. Medicine meets engineering in cooperative design of collaborative decision-supportive system
Open this publication in new window or tab >>Medicine meets engineering in cooperative design of collaborative decision-supportive system
2010 (English)In: IEEE 23rd International Symposium on Computer-Based Medical Systems (CBMS), Perth, WA: IEEE conference proceedings, 2010, 116-121 p.Conference paper, Published paper (Refereed)
Abstract [en]

Researchers in Human-Computer Interaction have worked together with physicians to specify and create prototypes of a system to be used primarily during multi-disciplinary team meetings. Physicians will use the system to aggregate and present relevant patient information during discussions on diagnosis and treatment, and also to coordinate the cases during the patient care pathway. In this paper we present the cooperative design process and activities conducted within the project. The results are two-fold; we report on the progress of creating the decision-supportive system, and describe how the physicians experience the design process. The design activities have made the physicians reflect on: the lack or loss of patient information, how patient information can be improved, break-downs in their work process, how they learn from each other, and the design methodology itself.

Place, publisher, year, edition, pages
Perth, WA: IEEE conference proceedings, 2010
Keyword
Collaboration, Conferences, Hospitals, Human computer interaction, Prototypes, Surgery
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:kth:diva-48755 (URN)10.1109/CBMS.2010.6042625 (DOI)2-s2.0-80055071299 (Scopus ID)
Conference
CBMS 2010
Note
Copyright 2010 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other users, including reprinting/ republishing this material for advertising or promotional purposes, creating new collective works for resale or redistribution to servers or lists, or reuse of any copyrighted components of this work in other works. QC 20120110Available from: 2012-01-10 Created: 2011-11-23 Last updated: 2013-03-26Bibliographically approved
3. References to personal experiences and scientific evidence during medical multi-disciplinary team meetings
Open this publication in new window or tab >>References to personal experiences and scientific evidence during medical multi-disciplinary team meetings
2011 (English)In: Behavior and Information Technology, ISSN 0144-929X, E-ISSN 1362-3001, Vol. 30, no 4, 455-466 p.Article in journal (Refereed) Published
Abstract [en]

We present a field study of medical multi-disciplinary team meetings (MDTMs) where decisions are made concerning the diagnosis and treatment of patients suffering from diseases in the upper abdomen. The study shows how evidence is referred to during weekly team meetings; this evidence is related both to scientific studies and to personal experiences of similar cases. We focus on the conversations during the meetings, on the complicated nature of the cases and on the details in the discussions that led the meeting participants to refer to scientific evidence or previous cases. We identify possibilities for improving the use of already documented information from medical records, in order to identify clinically relevant similarities and to bring additional information into the treatment discussion.

Keyword
computer supported cooperative work (CSCW), medical multi-disciplinary team meetings, evidence-based medicine. decision-making
National Category
Computer and Information Science
Identifiers
urn:nbn:se:kth:diva-36256 (URN)10.1080/0144929X.2011.553746 (DOI)000291971300003 ()2-s2.0-79960362122 (Scopus ID)
Note
QC 20110711Available from: 2011-07-11 Created: 2011-07-11 Last updated: 2017-12-11Bibliographically approved
4. Design and Evaluation of Interaction Technology for Medical Team Meetings
Open this publication in new window or tab >>Design and Evaluation of Interaction Technology for Medical Team Meetings
2011 (English)In: 13th IFIP TC 13 International Conference, Lisbon, Portugal, September 5-9, 2011, Proceedings, Part I, Springer, 2011, 505-522 p.Conference paper, Published paper (Refereed)
Abstract [en]

Multi-disciplinary team meetings (MDTMs) are essential in health-care, where medical specialists discuss diagnosis and treatment of patients. We introduce a prototype multi-display groupware system, intended to augment the discussions of medical imagery, through a range of input mechanisms, multi-user interfaces and interaction techniques on multi-touch devices and pen-based technologies. Observations of MDTMs, as well as interviews and observations of surgeons and radiologists, serve as a foundation for guidelines and a set of implemented techniques. We present a detailed analysis of a study where the techniques’ potential was explored with radiologists and surgeons of different specialties and varying expertise. The results show that the implemented technologies have the potential to bring numerous benefits to the team meetings with minimal modification to the current workflow. We discuss how they can augment the expressiveness and communication between meeting participants, facilitate understanding for novices, and improve remote collaboration.

Place, publisher, year, edition, pages
Springer, 2011
Series
Lecture Notes in Social Networks, 6946
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:kth:diva-55292 (URN)10.1007/978-3-642-23774-4_42 (DOI)2-s2.0-80052815101 (Scopus ID)
Conference
INTERACT 2011. 13th IFIP TC13 Conference on Human-Computer Interaction, Lisbon, Portugal, September, 5-9, 2011
Note

QC 20120102. QC 20130326

Available from: 2012-01-02 Created: 2012-01-02 Last updated: 2013-03-26Bibliographically approved
5. Interaction design in a complex context: medical multi-disciplinary team meetings
Open this publication in new window or tab >>Interaction design in a complex context: medical multi-disciplinary team meetings
2012 (English)In: The 7th Nordic Conference on Human-Computer Interaction: Making Sense Through Design, New York, NY, USA, 2012, 341-350 p.Conference paper, Published paper (Refereed)
Abstract [en]

In order to improve collaboration on, and visualisation of, patient information in medical multi-disciplinary team meetings, we have developed a system that presents information from different medical systems to be used as a support for the decision process. Based on field studies, we have implemented a high-fidelity prototype on tablet-sized displays, and tested it in a realistic setting. Our evaluation proved that more patient information can efficiently be displayed to all meeting participants, compared to the current situation. Interaction with the information, on the other hand, proved to be a complicated activity that needs careful design considerations; it should ultimately be based on what roles the meeting participants have, and what tasks they should complete. Medical decision-making is a complex area, and conducting interaction design in this area proved complex too. We foresee a great opportunity to improve medical work, by introducing collaborative tools and visualisation of medical data, but it requires that interaction design becomes a natural part of medical work.

Place, publisher, year, edition, pages
New York, NY, USA: , 2012
National Category
Interaction Technologies Human Aspects of ICT Other Medical Engineering Human Computer Interaction
Identifiers
urn:nbn:se:kth:diva-108084 (URN)10.1145/2399016.2399070 (DOI)2-s2.0-84871603873 (Scopus ID)978-1-4503-1482-4 (ISBN)
Conference
NordiCHI '12
Funder
Vinnova
Note

© ACM, 2012. This is the author's version of the work. It is posted here by permission of ACM for your personal use. Not for redistribution. The definitive version was published in The 7th Nordic Conference on Human-Computer Interaction: Making Sense Through Design, http://doi.acm.org/10.1145/2399016.2399070

QC 20130110

Available from: 2013-01-10 Created: 2012-12-19 Last updated: 2014-02-21Bibliographically approved

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