Abstract
This chapter presents results and experiences from the MOBEL (MOBile ELectronic patient record) project at the Norwegian University of Science and Technology (NTNU) in Trondheim, Norway. MOBEL was a multidisciplinary research project established in 2000. The problem area of the project was communication and information needs in hospital wards, and the aim of the project was to develop and explore methods and prototypes for point of care clinical information systems (PoCCS) that support clinicians in their patient-centered activities. The chapter summarizes four sub studies performed during the project. Each study presents different approaches to user-centered design of PoCCS. Findings from these studies confirm the need for mobile information and communication technology (ICT) in hospitals. Furthermore, the studies demonstrate how more user involvement and complementary approaches to traditional requirements engineering (RE) and system development methods can be useful when developing mobile information and communication systems for clinicians.
TopThe Mobel Project
The MOBEL project was established in 2000 as an interdisciplinary research project under the strategic area of medical technology at the Norwegian University of Science and Technology (NTNU).1 The basic insight motivating the project was that clinical work has some specific characteristics that distinguish it from what can be referred to as ‘office work’. The most prominent of these characteristics are:
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It is inherently mobile: Clinicians have to move between patients who are physically distributed and interact with colleagues at different locations. There is not one, stable workplace.
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It is information intensive: Doing clinical work requires a lot of information. This involves information about the nature and stages of the patient’s disease(s), his clinical condition, the actions taken and the actions planned. Furthermore, a lot of information is produced as a result of clinical work.
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It is highly collaborative: Clinicians work in teams. Their work involves shared responsibilities, collective planning, team decision making, multidisciplinary work, and continuous negotiation of responsibilities for actions.
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It is inherently multi-tasking: A clinician is normally involved in providing care for more than one patient at a time. Often they are interrupted in their work and have to change their attention to another patient or clinical task.
Key Terms in this Chapter
User-centered design approach: A collection of methods where knowledge about users and their involvement in the design process is central.
Usability: The extent to which a product can be used by specific users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use (ISO 9241).
User-centered design approach: A collection of methods where knowledge about users and their involvement in the design process is central.
Point of care clinical systems (PoCCS): Information systems that support clinicians by allowing easy input and retrieval of information as close as possible to where care takes place (Westbrook & Gosling, 2002).
Role Play: In this chapter, role play is defined as the acting of relevant and representative scenarios from everyday work situations by prospective end users. The users either play their usual role or a role they know very well. As soon as the role play participants have agreed on setting, main actors, and most important plot, a scenario is improvised.
Socio-technical approach: An approach that recognizes the interrelatedness of social and technical aspects of an organization. Socio-technical insights may be used to inform the design of computer systems.
Low-fidelity prototype: A prototype that is sketchy and simple and often is created with foam models and drawings on paper. It has some characteristics of the target product, but may differ in interaction style, visual appearance or level of detail. Low-fidelity prototypes are often developed to visualize or test early design ideas.
Point of care clinical systems (PoCCS): Information systems that support clinicians by allowing easy input and retrieval of information as close as possible to where care takes place (Westbrook & Gosling, 2002).
Role Play: In this chapter, role play is defined as the acting of relevant and representative scenarios from everyday work situations by prospective end users. The users either play their usual role or a role they know very well. As soon as the role play participants have agreed on setting, main actors, and most important plot, a scenario is improvised.
Low-fidelity prototype: A prototype that is sketchy and simple and often is created with foam models and drawings on paper. It has some characteristics of the target product, but may differ in interaction style, visual appearance or level of detail. Low-fidelity prototypes are often developed to visualize or test early design ideas.
Ubiquitous Computing: A human-computer interaction model introduced by Mark Weiser (Weiser 1991), where computer technology to a high degree allows itself to reside silently into the background of the users’ attention. A central notion in the ubiquitous computing paradigm is to integrate computers seamlessly into our everyday activities and physical environments. By enabling these embedded computers to automatically sense and adapt to their use context, ubiquitous computing seeks to render the computer “invisible” in use.
Structured observation: The planned watching and recording of behavior and events as they occur within a well-known or predefined environment
Usability: The extent to which a product can be used by specific users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use (ISO 9241).
Ubiquitous Computing: A human-computer interaction model introduced by Mark Weiser (Weiser 1991), where computer technology to a high degree allows itself to reside silently into the background of the users’ attention. A central notion in the ubiquitous computing paradigm is to integrate computers seamlessly into our everyday activities and physical environments. By enabling these embedded computers to automatically sense and adapt to their use context, ubiquitous computing seeks to render the computer “invisible” in use.
Socio-technical approach: An approach that recognizes the interrelatedness of social and technical aspects of an organization. Socio-technical insights may be used to inform the design of computer systems.
Structured observation: The planned watching and recording of behavior and events as they occur within a well-known or predefined environment