Anja Perlich

Smart Documentation with Tele-Board MED

Documentation is a field of active research both for the community of design thinkers and medical practitioners. One major challenge is to combine the advantages of analogue and digital documentation. Since documentation needs are particularly similar in the fields of design thinking and behaviour psychotherapy, an intense collaboration has emerged among these disciplines. The design thinking tool Tele-Board has been adapted for documentation purposes in behaviour psychotherapy, yielding a first medical application of the new tool Tele-Board MED. In the course of tool adaptation, additional features have been developed such as an automatic protocol function. These new features are not only useful for therapists but beneficial for design thinkers too. This chapter explains why collaborative work on documentation tools is particularly promising at the intersection of design thinking and behaviour psychotherapy. We outline the development and empirical evaluation of the new protocol function. Furthermore, this chapter discusses how Tele-Board MED supports documentation in behaviour psychotherapy on the one hand and documentation of design thinking projects on the other hand.

Redesigning Medical Encounters with Tele-Board MED

The roles and perspectives of the patient and the health care provider could hardly be more different, yet both pursue the common goal of restoring or preserving the patient’s health. The path to a satisfying health care outcome is manifold, and the quality of the patient-provider relationship is an impactful factor. We discuss different models for the classification of patient-provider interaction as well as for patient empowerment. On this theoretical basis we elaborate on how patient-provider interaction can be enhanced in practice by means of the medical documentation system Tele-Board MED. This system is a collaborative eHealth application designed to support the interaction between patient and provider in clinical encounters. Simultaneously, it aims at making case documentation more efficient for providers and more valuable for patients. As a research paradigm, the Tele-Board MED project has used a design thinking approach to understand and support fundamental stakeholder needs. Psychotherapy has been chosen as a first field of application for Tele-Board MED research and interventions. This chapter shares insights and findings from empathizing with users, defining a point of view, ideating and testing prototypes. We found that a joint, transparent case documentation was very well received by patients. This documentation increased the acceptance of diagnoses and encouraged a team feeling between patient and therapist.

Implementation of Data Security Requirements in a Web-based Application for Interactive Medical Documentation

Keeping data confidential is a deeply rooted requirement in medical documentation. However, there are increasing calls for patient transparency in medical record documentation. With Tele-Board MED, an interactive system for joint documentation of doctor and patient is developed. This web-based application designed for digital whiteboards will be tested in treatment sessions with psychotherapy patients and therapists. In order to ensure the security of patient data, security measures were implemented and they are illustrated in this paper. We followed the major information security objectives: confidentiality, integrity, availability and accountability. Next to technical aspects, such as data encryption, access restriction through firewall and password, and measures for remote maintenance, we address issues at organizational and infrastructural levels as well (e.g., patients’ access to notes). With this paper we want to increase the awareness of information security, and promote a security conception from the beginning of health software research projects. The measures described in this paper can serve as an example for other health software applications dealing with sensitive patient data, from early user testing phases on.

Automatic Treatment Session Summaries in Psychotherapy – A Step towards Therapist-Patient Cooperation

Abstract Therapeutic documentation is a crucial part in psychotherapy and should first and foremost support the patients therapy progress. Yet, the notes taken throughout a therapy, mainly serve the use of therapists. In line with the movement of patient empowerment, the calls for patients’ access to their records are growing louder and were incorporated into the German patients’ rights law. Hence, with Tele-Board MED, an interactive system for joint documentation of therapist and patient was developed. In this paper, we introduce one of its many features: the automatic creation of treatment session summaries. Our contribution also consists of the evaluation of its potential for practical use by psychotherapists. The aim of our work is twofold, namely the involvement of patients in the documentation, and the support of therapists with their documentation duties. The aspects of investigation include the therapists’ documentation habits (regarding time, amount, and method), their purposes to manually create session summaries and opinion about the automatically created summaries. It was discovered that the bigger part of the motivation for treatment session documentation lies in the therapists’ personal purposes, such as remembering a case right before the next session. Nevertheless therapists are willing to turn documentation in a cooperative activity if they had effective and efficient tools at hand. With the system presented, they can well imagine summarizing important issues together with the patient at the end of a session and also handing out printed summaries to them.

Tele-Board MED: Supporting Twenty-First Century Medicine for Mutual Benefit

Tele-Board MED is a medical documentation system designed to support patient-doctor cooperation at eye level. In particular, it tackles the challenge of turning medical documentation from a necessity, which disturbs the treatment flow, into a curative process by itself. With its focus on cooperative documentation, Tele-Board MED embraces a call uttered by many scientists and politicians nowadays for twenty-first century medicine and patient empowerment. At the same time, the project is deeply rooted in the culture of design thinking. Accordingly, the benefit for patients should not be at the expense of doctors. Rather, the needs of all stakeholders shall be discerned and served. Behaviour psychotherapy has been chosen as a first field of application for Tele-Board MED. Using quantitative and qualitative methods, an initial feedback study was launched with 34 behaviour psychotherapists. It showed that many therapists are skeptical towards digital documentation and record transparency in general. Nonetheless, Tele-Board MED is considered helpful and promising. In particular, therapists estimate to save one third of their normal working time when assembling case reports with the system. The vast majority of therapists can well imagine using Tele-Board MED with patients. Apart from that, quantitative methodological strategies—though seldom used in the design thinking community—proved to be potent tools for carving out needs and insights that will inspire the next generation of Tele-Board MED.

New Ways of Data Entry in Doctor-Patient Encounters

Maintenance and restoration of human well-being is healthcare’s central purpose. However, medical personnel’s everyday work has become more and more characterized by administrative tasks, such as writing medical reports or documenting a patient’s treatment. Particularly in the healthcare sector, these tasks usually entail working with different software systems on mostly traditional desktop computers. Using such machines to collect data during doctor-patient encounters presents a great challenge. The doctor wants to gather patient data as quickly and as completely as possible. On the other hand, the patient wants the doctor to empathize with him or her. Capturing data with a keyboard, using a traditional desktop computer, is cumbersome. Furthermore, this setting can create a barrier between doctor and patient. Our aim is to ease data entry in doctor-patient encounters. In this chapter, we present a software tool, Tele-Board MED, that allows recording data with the help of handwritten and spoken notes that are transformed automatically to a textual format via handwriting and speech recognition. Our software is a lightweight web application that runs in a web browser. It can be used on a multitude of hardware, especially mobile devices such as tablet computers or smartphones. In an initial user test, the digital techniques were rated as more suitable than a traditional pen and paper approach that entails follow-up content digitization.

Learning from Success and Failure in Healthcare Innovation: The Story of Tele-Board MED

Tele-Board MED is a digital documentation system for medical encounters. It is used as an adjunct to talk-based mental health interventions. Having reported study results on Tele-Board MED a number of times—which always reflected the favorable aspects of the system—audiences have also been interested in any failures along the way. Indeed, there are two good reasons why such occasional failures are more than an entertaining footnote to a project. First, design thinking holds that they are critical for learning. Second, innovations in the healthcare sector are known to be particularly challenging. In this chapter, we thus reanalyze the Tele-Board MED project, focusing on both successes and failures along the way and tracing their role for the development of the project.