Asynchronous Remote Medical Consultation for Ghana

Computer-mediated communication systems can be used to bridge the gap between doctors in underserved regions with local shortages of medical expertise and medical specialists worldwide. To this end, we describe the design of a prototype remote consultation system intended to provide the social, institutional and infrastructural context for sustained, self-organizing growth of a globally-distributed Ghanaian medical community. The design is grounded in an iterative design process that included two rounds of extended design fieldwork throughout Ghana and draws on three key design principles (social networks as a framework on which to build incentives within a self-organizing network; optional and incremental integration with existing referral mechanisms; and a weakly-connected, distributed architecture that allows for a highly interactive, responsive system despite failures in connectivity). We discuss initial experiences from an ongoing trial deployment in southern Ghana.Comment: 10 page

Activity Theory Analysis of Heart Failure Self-Care

The management of chronic health conditions such as heart failure is a complex process emerging from the activity of a network of individuals and artifacts. This article presents an Activity Theory-based secondary analysis of data from a geriatric heart failure management study. Twenty-one patients' interviews and clinic visit observations were analyzed to uncover eight configurations of roles and activities involving patients, clinicians, and others in the sociotechnical network. For each configuration or activity pattern, we identify points of tension and propose guidelines for developing interventions for future computer-supported healthcare systems

The design with intent method: A design tool for influencing user behaviour

The official published version can be found at the link below.Using product and system design to influence user behaviour offers potential for improving performance and reducing user error, yet little guidance is available at the concept generation stage for design teams briefed with influencing user behaviour. This article presents the Design with Intent Method, an innovation tool for designers working in this area, illustrated via application to an everyday human–technology interaction problem: reducing the likelihood of a customer leaving his or her card in an automatic teller machine. The example application results in a range of feasible design concepts which are comparable to existing developments in ATM design, demonstrating that the method has potential for development and application as part of a user-centred design process

Designing Traceability into Big Data Systems

Providing an appropriate level of accessibility and traceability to data or process elements (so-called Items) in large volumes of data, often Cloud-resident, is an essential requirement in the Big Data era. Enterprise-wide data systems need to be designed from the outset to support usage of such Items across the spectrum of business use rather than from any specific application view. The design philosophy advocated in this paper is to drive the design process using a so-called description-driven approach which enriches models with meta-data and description and focuses the design process on Item re-use, thereby promoting traceability. Details are given of the description-driven design of big data systems at CERN, in health informatics and in business process management. Evidence is presented that the approach leads to design simplicity and consequent ease of management thanks to loose typing and the adoption of a unified approach to Item management and usage.Comment: 10 pages; 6 figures in Proceedings of the 5th Annual International Conference on ICT: Big Data, Cloud and Security (ICT-BDCS 2015), Singapore July 2015. arXiv admin note: text overlap with arXiv:1402.5764, arXiv:1402.575

"A manager in the minds of doctors" : a comparison of new modes of control in European hospitals

Background: Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals. Methods: The research is explorative and was carried out as part of the FP7 COST action IS0903 Medicine and Management, Working Group 2. Comprising seven European countries, the focus is on doctors and public hospitals. We use a comparative case study design that primarily draws on expert information and document analysis as well as other secondary sources. Results: The findings reveal that managerial control is not simply an external force but increasingly integrated in medical professionalism. These processes of change are relevant in all countries but shaped by organisational settings, and therefore create different patterns of control: (1) ‘integrated’ control with high levels of coordination and coherent patterns for cost and quality controls; (2) ‘partly integrated’ control with diversity of coordination on hospital and department level and between cost and quality controls; and (3) ‘fragmented’ control with limited coordination and gaps between quality control more strongly dominated by medicine, and cost control by management. Conclusions: Our comparison highlights how organisations matter and brings the crucial relevance of ‘coordination’ of medicine and management across the levels (hospital/department) and the substance (cost/quality-safety) of control into perspective. Consequently, coordination may serve as a taxonomy of emergent modes of control, thus bringing new directions for cost-efficient and quality-effective hospital governance into perspective

Using cultural probes to inform the design of assistive technologies

This paper discusses the practical implications of applying cultural probes to drive the design of assistive technologies. Specifically we describe a study in which a probe was deployed with home-based carers of people with dementia in order to capture critical data and gain insights of integrating the technologies into this sensitive and socially complex design space. To represent and utilise the insights gained from the cultural probes, we created narratives based on the probe data to enhance the design of assistive technologies.This work was supported by the Arts and Humanities Research Council (AH/K00266X/1) and RCUK through the Horizon Digital Economy Research grant (EP/G065802/1)