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Biomedical subjects

David W McDonald

Publications and source records attributed to David W McDonald.

9 recordsLinked to original sources
PubMed2006

Participatory design of a collaborative clinical trial protocol writing system.

OBJECTIVE: To explore concrete approaches to socio-technical design of collaborative healthcare information systems and to design a groupware technology for collaborative clinical trial protocol writing. METHOD: We conducted "quick and dirty ethnography" through semi-structured interviews, observational studies, and work artifacts analysis to understand the group work for protocol development. We used participatory design through evolutionary prototyping to explore the feature space of a collaborative writing system. Our design strategies include role-based user advocacy, formative evaluation, and change management. RESULTS: Quick and dirty ethnography helped us efficiently understand relevant work practice, and participatory design helped us engage users into design and bring out their tacit work knowledge. Our approach that intertwined both techniques helped achieve a "work-informed and user-oriented" design. This research leads to a collaborative writing system that supports in situ communication, group awareness, and effective work progress tracking. The usability evaluation results have been satisfactory. The system design is being transferred to an organizational tool for daily use.

Clinical Protocols↗
PubMed2005

Asynchronous communication among clinical researchers: a study for systems design.

Group work is an essential part of modern health care. Although there have been advances in the technology of communication, these have not necessarily led to efficient and effective communication among collaborating health-care professionals. Instead, barriers such as varied organizational cultures, different training backgrounds, and varied time schedules can overwhelm technological solutions and impede efficient communication. We focus on one particular sort of collaboration, that of group work around a clinical trial protocol, where the collaboration is asynchronous and the participants are geographically distributed. In this work setting, we have applied a computer-supported cooperative work (CSCW) approach in two distinct ways. First, we used observational methods to uncover and understand a complex set of communication behaviors and needs. Second, we used participatory design and iterative prototyping to design a system that aims to improve communication and work flow among these collaborators. We found that these methods work well in tandem-our observational study helped better inform our design, and our prototyping cycles provided additional insight into the work. More specifically, we were able to identify a set of communication problems in the work that led us to specify a set of design desiderata for systems that support asynchronous collaboration around an evolving medical document.

Biomedical Research↗
PubMed2004

Technology, work, and information flows: lessons from the implementation of a wireless alert pager system.

The combination of collaborative work practices and information technology affect the flow of information in clinical settings. The introduction of a new technology into these settings can change not only established work practices but also the information flows. In this paper, we examine the introduction of a wireless alerts pager in a surgical intensive care unit (SICU). Through a qualitative study, we analyze the effects that this new information tool had on both the work practices in the SICU and the information flow in the unit. We describe four challenges that SICU staff members faced with respect to the alerts pagers. We found that the pager provided new routes of information to SICU staff but in doing so disrupted existing work practices and information flows.

Attitude of Health Personnel↗
PubMed2004

Incorporating ideas from computer-supported cooperative work.

Many information systems have failed when deployed into complex health-care settings. We believe that one cause of these failures is the difficulty in systematically accounting for the collaborative and exception-filled nature of medical work. In this methodological review paper, we highlight research from the field of computer-supported cooperative work (CSCW) that could help biomedical informaticists recognize and design around the kinds of challenges that lead to unanticipated breakdowns and eventual abandonment of their systems. The field of CSCW studies how people collaborate with each other and the role that technology plays in this collaboration for a wide variety of organizational settings. Thus, biomedical informaticists could benefit from the lessons learned by CSCW researchers. In this paper, we provide a focused review of CSCW methods and ideas-we review aspects of the field that could be applied to improve the design and deployment of medical information systems. To make our discussion concrete, we use electronic medical record systems as an example medical information system, and present three specific principles from CSCW: accounting for incentive structures, understanding workflow, and incorporating awareness.

Artificial Intelligence↗
PubMed2004

An ethnographic study of collaborative clinical trial protocol writing.

Clinical trial protocol documents play an important role in clinical research. However, clinical protocol writing remains a complex and relatively un-studied process. Protocols are often written by teams of people, yet little prior research has captured the problems or analyzed the collaboration support needs of protocol writers. Here we present the results of an initial ethnographic study into the clinical trial protocol writing processes at a representative cooperative clinical trial group funded by National Cancer Institute (NCI). We analyzed the collaborative nature of the writing process, identified common problems, derived information and communication support needs of collaborative clinical protocol writers, and provided recommendations to streamline the process. We believe that this paper contributes useful implications for the design of future collaborative clinical protocol writing tools.

Anthropology, Cultural↗
PubMed2004

A collaborative clinical trial protocol writing system.

Increasing complexity in medicine has caused clinical trial experts with disparate backgrounds from multiple organizations to collaborate when developing clinical trial protocols. Although many protocol-authoring tools provide computerbased decision support to assist in protocol writing, few of them provide sufficient collaboration support for a group of protocol writers. The iterative group writing activities among interdisciplinary clinical trial experts call for advanced tool support. Here we present a web-based protocol writing system with integrated support for collaborative reviewing and collaborative editing. The system uses a shared database to store threaded review comments and version information for electronic protocols. It also captures rich group event information to provide cross-activity awareness and to facilitate self-coordination within the collaborative writing team. We believe that our system can help streamline collaborative clinical trial protocol writing processes.

Clinical Protocols↗
PubMed2003

Challenges to physicians' use of a wireless alert pager.

Pagers, personal data assistants (PDAs) and other devices that have wireless connectivity are becoming a popular method for delivering patient related information to medical decision makers. Although medical informatics research has emphasized the design, and implementation of pagers as event notification mechanisms, researchers have not paid as much attention to how this technology impacts medical work. We present a case study of physicians in a Surgical Intensive Care Unit (SICU) using wireless alert pagers. The pagers provide a variety of alphanumeric clinical alert messages and are widely used by SICU physicians. However, the use of the pagers has created unanticipated challenges to the physicians' traditional work practices. These challenges include: (1) flattening of hierarchical workflows, (2) coping with information overload and missing context, and (3) lack of feedback. These challenges are tied to both the specific technical design of the system and the traditional structure of medical work.

Attitude of Health Personnel↗