Jane Li

Physical space and information space: studies of collaboration in distributed multi-disciplinary medical team meetings

We conducted field studies with three multi-disciplinary cancer teams at three hospitals. We investigated distributed multi-disciplinary team meetings (MDTMs) at each setting focusing on the organisational context, existing collaboration technology facilities and the use and availability of digital medical information systems. Our results highlight how factors such as room size, team size, seating arrangements, display configuration and variations in preparing and presenting medical information clearly influence the dynamics of the conversation and information sharing in distributed MDTMs. Our analysis shows how these configurations, arrangements and practices arise and the implications they have for any technical interventions that might be introduced. We discuss how to configure a collaborative work space to support information sharing and communication in distributed MDTMs, such as a shared physical space facilitating interaction, a shared information space affording varied styles of medical information interaction and, importantly, configuring available technologies and resources to support collaboration in shared spaces without compromising local contexts.

A study of gestures in a video-mediated collaborative assembly task

This paper presents the results of an experimental investigation of two gesture representations (overlaying hands and cursor pointer) in a video-mediated scenario--remote collaboration on physical task. Our study assessed the relative value of the two gesture representations with respect to their effectiveness in task performance, users satisfaction, and users perceived quality of collaboration in terms of the coordination and interaction with the remote partner. Our results show no clear difference between these two gesture representations in the effectiveness and user satisfaction. However, when considering the perceived quality of collaboration, the overlaying hands condition was statistically significantly higher than the pointer cursor condition. Our results seem to suggest that the value of a more expressive gesture representation is not so much a gain in performance but rather a gain in users experience, more specifically in users perceived quality of collaborative effort.

Collaboration Within Different Settings: A Study of Co-located and Distributed Multidisciplinary Medical Team Meetings

This paper reports our findings from a study of multidisciplinary team meetings for the treatment and ongoing management of breast cancer patients. The focus of the fieldwork was the meetings within and between a large group of multidisciplinary health professionals from two hospitals in Sydney, a large public teaching hospital and a much smaller private hospital. The paper examines the common work of the meetings and the variation within and between local practices and sites in the doing of this work, both in the local settings of each hospital and in the video-mediated setting when the local meetings are linked. Variations in the physical setup of the meetings, the presentation of the patient cases and the preparation of images used in patient discussion are identified, traced to their various sources and examined within their particular sociotechnical context. This is followed by a discussion of how local variation contributed to the particular challenges of the video-mediated meetings as experienced by the participants and how they might be addressed. Our motivations are to contribute both to the growing case studies of multidisciplinary team meetings within healthcare settings and to the important work being done to generate conceptual and design approaches that can support the development and successful use of CSCW technologies across highly variable local settings.

Supporting interaction and collaboration on large displays using tablet devices

In this paper, we present an interaction technique that supports the use of tablet devices for interaction and collaboration with large displays. Users can interact with a subset of the large workspace on their tablet, while the same area is visualized on the large display as a rectangular frame. We propose an efficient management and navigation interface through the use of an interactive world-in-miniature view and multitouch gestures. Users can intuitively manage their views on their tablets, navigate between different areas of the workspace, or enlarge them for a closer look. Additionally, they can quickly jump to the same view that their collaborators are looking at.

Design of a multi-site multi-state clinical trial of home monitoring of chronic disease in the community in Australia

BackgroundTelehealth services based on at-home monitoring of vital signs and the administration of clinical questionnaires are being increasingly used to manage chronic disease in the community, but few statistically robust studies are available in Australia to evaluate a wide range of health and socio-economic outcomes. The objectives of this study are to use robust statistical methods to research the impact of at home telemonitoring on health care outcomes, acceptability of telemonitoring to patients, carers and clinicians and to identify workplace cultural factors and capacity for organisational change management that will impact on large scale national deployment of telehealth services. Additionally, to develop advanced modelling and data analytics tools to risk stratify patients on a daily basis to automatically identify exacerbations of their chronic conditions.Methods/DesignA clinical trial is proposed at five locations in five states and territories along the Eastern Seaboard of Australia. Each site will have 25 Test patients and 50 case matched control patients. All participants will be selected based on clinical criteria of at least two hospitalisations in the previous year or four or more admissions over the last five years for a range of one or more chronic conditions. Control patients are matched according to age, sex, major diagnosis and their Socio-Economic Indexes for Areas (SEIFA). The Trial Design is an Intervention control study based on the Before-After-Control-Impact (BACI) design.DiscussionOur preliminary data indicates that most outcome variables before and after the intervention are not stationary, and accordingly we model this behaviour using linear mixed-effects (lme) models which can flexibly model within-group correlation often present in longitudinal data with repeated measures. We expect reduced incidence of unscheduled hospitalisation as well as improvement in the management of chronically ill patients, leading to better and more cost effective care. Advanced data analytics together with clinical decision support will allow telehealth to be deployed in very large numbers nationally without placing an excessive workload on the monitoring facility or the patients own clinicians.Trial registrationRegistered with Australian New Zealand Clinical Trial Registry on 1st April 2013. Trial ID: ACTRN12613000635763

Multidisciplinary medical team meetings: a field study of collaboration in health care

We present an observational study that was conducted to guide the design of an enhanced collaboration platform to support distributed multidisciplinary team meetings between two hospitals. Our goal was to find out how the breast cancer multidisciplinary team collaborates in their face-to-face meetings and in their discussions using an existing video-conferencing system and to identify obstacles and issues to their primary tasks. We identified a set of concerns around the way visibility and audibility affect the social cohesion of the group and impede communication and situation awareness between the distributed team. We also identified a parallel set of concerns around the difficulty of preparing and interacting around the medical images used in the meetings. These issues exposed a complex matrix of technical, social, procedural and organisational factors that affect the collaboration. We suggest potential directions for technical interventions in this setting.

Telehealth Trends and the Challenge for Infrastructure

BACKGROUND As telehealth takes advantage of improved networks, there is a growing need to understand the infrastructure needs of future telehealth developments. This work aims to predict such needs based on current trends and research. MATERIALS AND METHODS We conducted a literature review of telehealth with a focus on advanced network infrastructure. We drew inferences from our previous demonstrator projects in advanced telehealth, but the most important findings emerged from interviews with a panel of thought leaders. RESULTS Our results show that there will be simultaneous and coupled evolution of telehealth through the space spanned by three axes: care models, clinical applications, and technology. We also consider a two-dimensional model of reach and complexity to describe future applications. Universal access to advanced networks will drive fundamental changes in healthcare deliver. The biggest change will be seen in home and mobile health care delivery, forming part of a trend toward patient-centric models. Other aspects of decentralization in healthcare systems will include networks of caregivers. Besides this reach trend, the complexity trend will include integrating multiple-channel applications and seamlessly moving large datasets in real time among hospitals, other medical facilities, and homes. There is a need to provide infrastructure that does not have an upper limit on quality of service and allows telehealth to address mobility, usability, interoperability, intelligence, and adaptability in a systematic way.

Understanding distributed collaboration in emergency animal disease response

There is an increasing interest in CSCW systems for supporting emergency and crisis management. In this paper we explore work practices in emergency animal disease management focusing on the high-level analysis and decision making of the Australian Consultative Committee for Emergency Animal Disease (CCEAD) - a geographically distributed committee established to recommend action plans during animal disease outbreak. Our findings explore the ways in which they currently share and analyse information together, focusing in particular on their teleconferencing mediated meetings. Our findings highlight factors relating to the time pressure of the task, diverse configuration of the group and asymmetrical settings and how these influence the groups information sharing and communication. We use the findings to discuss implications for collaboration technologies that could support the group and broader implications for similarly structured work groups.

Distributed scientific group collaboration across biocontainment barriers

This paper reports the findings from a field study of distributed scientific collaboration within a national animal health laboratory. Collaboration in this setting is challenged by the need for biosecurity - there are physical containment barriers between scientists and work groups and movement of people and other physical objects across the barriers requires extensive security procedures. The aim of the field study was to understand how the scientists communicate across the barriers, particularly how they share information and collaborate on its analysis. The findings reveal that the collaboration issues relate not just to the challenges caused by the containment barriers but also to the need for collaboration support between the scientists and their work groups irrespective of the barriers. The paper explains how these findings informed the design of the collaboration platform being installed and how more generic requirements of supporting collaboration over distance were configured and extended to meet the specific requirements of a very particular local setting.

Designing for Distributed Scientific Collaboration: A Case Study in an Animal Health Laboratory

We have been exploring the design of an advanced collaboration platform to support scientists in a national animal health laboratory to work collaboratively across a physical containment barrier. This paper describes the design considerations based on the findings from a field study of the collaboration processes in this particular environment. We emphasize the need of providing flexible support for various information sharing practices. The major component of the platform - a collaboration environment which integrates life-size video conferencing and a large shared digital workspace - has been under routine use. Our preliminary results from a user study of the distributed group meetings supported by the platform have shown the value of high quality audio-video communication in combination with the feature of allowing access and simultaneously sharing multiple data resources.