Abstractions, accounts and grid usability

The vision of the Grid is one of seamless, virtual and constantly changing resources where users need not concern themselves about details, such as exactly where an application is running or where their data is being stored. However, seamless and virtual often imply a lack of control that users may be wary of, or even opposed to. Drawing upon our studies of HCI and of collaborative work, this paper examines whether the Grid development community should be taking this vision literally and argues for the need for accountability of systems ‘in interaction’. We give examples of an alternative approach that seeks to provide ways in which administrators, technical support and user communities can make sense of the behaviour of the complex socio-technical ensembles that are the reality of Grids

Clinical Data from Home to Health Centre: the Telehealth Curation Lifecycle

This case study has been produced for the Digital Curation Centre (DCC) SCARP project, funded by the Joint Information Systems Committee (JISC) to investigate disciplinary attitudes and approaches to data deposit. The study looks at the data curation lifecycle in Telehealth research. Telehealth, or telecare, is an emerging sub-domain of eHealth, and the report profiles current practices in several telehealth pilot projects. Data curation is at an embryonic stage but can draw on related eHealth initiatives and clinical data management practices, and the report considers the infrastructure needed for data curation in this field of research and practice

Aligning people, processes and technology: recurring issues in the design and implementation of eLearning, eHealth and eBusiness infrastructure

This PhD by published works explores recurring issues in the design and implementation of eLearning, eBusiness and eHealth infrastructure at scale. It takes a socio-technical systems perspective on recurring issues in design/implementation, drawing on qualitative and collaborative research over a decade.The topic is relevant to policy and practice in an increasingly digitally-mediated economy where costs and risks are high, and where the scaling of systems across multiple distributed communities reconfigures work practices in ways which have implications for implementation, for policy, for research and for professional development.The thesis reviews design and implementation problems that cut across these three domains and some of their implications in these areas. It draws conclusions about the importance of involving users more inclusively in the research, redesign and management process (a) as a means of ensuring more cost-effective design, and (b) as a vehicle for managing a change process that reconfigures, roles, risks and resource allocation.It contextualises the research in an extensive review of the literature, showing how evolving visions / paradigms have shaped the way technical and human infrastructures are aligned in system design - from closed systems through to more generative and open systems that leverage the local knowledge and agency of user communities to greater advantage.The publications contribute to the emerging body of literature on the alignment of the social and the technical in digital systems, the evolution of different paradigms, and the development of strategy in this regard. It is also intended to have more direct practical applied value in flagging the recurring socio-technical and socio-political issues that impact on the success of investments in IT in the public sector, and the potential for transfer of these experiences across domains and across regions

Experiences of patients and professionals participating in the HITS home blood pressure telemonitoring trial: a qualitative study: Table 1

Objectives To explore the experiences of patients and professionals taking part in a randomised controlled trial (RCT) of remote blood pressure (BP) telemonitoring supported by primary care. To identify factors facilitating or hindering the effectiveness of the intervention and those likely to influence its potential translation to routine practice. Design Qualitative study adopting a qualitative descriptive approach. Participants 25 patients, 11 nurses and 9 doctors who were participating in an RCT of BP telemonitoring. A maximum variation sample of patients from within the trial based on age, sex and deprivation status of the practice was sought. Setting 6 primary care practices in Scotland. Method Data were collected via taped semistructured interviews. Initial thematic analysis was inductive. Multiple strategies were employed to ensure that the analysis was credible and trustworthy. Results Prior to the trial, both patients and professionals were reluctant to increase the medication based on single BP measurements taken in the surgery. BP measurements based on multiple electronic readings were perceived as more accurate as a basis for action. Patients using telemonitoring became more engaged in the clinical management of their condition. Professionals reported that telemonitoring challenged existing roles and work practices and increased workload. Lack of integration of telemonitoring data with the electronic health record was perceived as a drawback. Conclusions BP telemonitoring in a usual care setting can provide a trusted basis for medication management and improved BP control. It increases patients’ engagement in the management of their condition, but supporting telemetry and greater patient engagement can increase professional workloads and demand changes in service organisation. Successful service design in practice would have to take account of how additional roles and responsibilities could be realigned with existing work and data management practices. The embedded qualitative study was included in the protocol for the HITS trial registered with ISRCTN no. 7261427

Curating Complex, Dynamic and Distributed Data: Telehealth as a Laboratory for Strategy

Telehealth monitoring data is now being collected across large populations of patients with chronic diseases such as stroke, hypertension, COPD and dementia. These large, complex and heterogeneous datasets, including distributed sensor and mobile datasets, present real opportunities for knowledge discovery and re-use, however they also generate new challenges for curation. This paper uses qualitative research with stakeholders in two nationally-funded telehealth projects to outline the perceptions, practices and preferences of different stakeholders with regard to data curation. Telehealth provides a living laboratory for the very different challenges implicit in designing and managing data infrastructure for embedded and ubiquitous computing. Here, technical and human agents are distributed, and interaction and state change is a central component of design, rather than an inconvenient challenge to it. The authors argue that there are lessons to be learned from other domains where data infrastructure has been radically rethought to address these challenge

Report of the user requirements and web based access for eResearch workshops

The User Requirements and Web Based Access for eResearch Workshop, organized jointly by NeSC and NCeSS, was held on 19 May 2006. The aim was to identify lessons learned from e-Science projects that would contribute to our capacity to make Grid infrastructures and tools usable and accessible for diverse user communities. Its focus was on providing an opportunity for a pragmatic discussion between e-Science end users and tool builders in order to understand usability challenges, technological options, community-specific content and needs, and methodologies for design and development. We invited members of six UK e-Science projects and one US project, trying as far as possible to pair a user and developer from each project in order to discuss their contrasting perspectives and experiences. Three breakout group sessions covered the topics of user-developer relations, commodification, and functionality. There was also extensive post-meeting discussion, summarized here. Additional information on the workshop, including the agenda, participant list, and talk slides, can be found online at http://www.nesc.ac.uk/esi/events/685/ Reference: NeSC report UKeS-2006-07 available from http://www.nesc.ac.uk/technical_papers/UKeS-2006-07.pd

Help4Mood: avatar-based support for treating people with major depression in the community

BACKGROUND: The Help4Mood consortium, comprising partners from Scotland, Spain, Romania, and Italy, aims to develop a system for supporting the treatment of people with major depressive disorder in the community. The Help4Mood system consists of three parts: (1) A Personal Monitoring System that collects activity and sleep data; (2) a Virtual Agent (avatar) that interacts with the patient in short, structured sessions that involve mood checks, psychomotor tests, and brief therapy-related exercises; (3) a Decision Support System that controls the interaction between user and Virtual Agent, extracts relevant information from the monitoring data, and produces reports for clinicians. In this paper, we report the results of focus groups that were conducted to gather user requirements for Help4Mood. These involved two core stakeholder groups, patients with depression and clinicians. AIMS AND OBJECTIVES: We invited comments on all aspects of system design, focusing on the nature and intensity of monitoring; the interaction between the Virtual Agent and patients; and the support patients and clinicians would wish to receive from Help4Mood. METHODS: Ten focus groups were conducted in Scotland, Spain, and Romania, one each with patients and 2–3 each with psychiatrists, clinical psychologists, and psychiatric nurses. Following a presentation of a sample Help4Mood session, the discussion was structured using a set of prompts. Group sessions were transcribed; data were analysed using framework analysis. RESULTS: Regarding the overall Help4Mood system, participants raised three main issues, integration with treatment; configurability to support local best practice; and affordability for health services. Monitoring was discussed in terms of complexity, privacy in shared spaces, and crisis. Clinicians proposed physiological, mood, and neuropsychomotor variables that might be monitored, which would yield a complex picture of the patient’s state. Obtrusiveness (of monitors) and intrusiveness (to routines and environment) were raised as important barriers. Patients felt that Help4Mood should provide them with tailored resources in a crisis; clinicians were clear that Help4Mood should not be used to detect acute suicide risks. Three main design characteristics emerged for the Virtual Agent—ease of use, interaction style, and humanoid appearance. The agent should always react appropriately, look and behave like a good therapist, and show positive or neutral emotion. Core functions of the decision support system were characterized by the themes adaptation, informing treatment, and supporting clinician-patient interaction. The decision support system should adapt the patient’s session with the Virtual Agent in accordance with the patient’s mood and stamina. Monitoring data should be presented as a one-page summary highlighting key trends to be discussed with the patient during a consultation. CONCLUSIONS: Consulting with patients and clinicians showed that Help4Mood should focus on tracking recovery in the community in a way that informs and supports ongoing treatment. The design of the Virtual Agent will be crucial for encouraging adherence to the Help4Mood protocol. To ensure uptake of the system, Help4Mood needs to be flexible enough to fit into different service delivery contexts