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Biomedical subjects

John H Gennari

Publications and source records attributed to John H Gennari.

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↗
PubMed2005

Integrating genomic knowledge sources through an anatomy ontology.

Modern genomic research has access to a plethora of knowledge sources. Often, it is imperative that researchers combine and integrate knowledge from multiple perspectives. Although some technology exists for connecting data and knowledge bases, these methods are only just beginning to be successfully applied to research in modem cell biology. In this paper, we argue that one way to integrate multiple knowledge sources is through anatomy--both generic cellular anatomy, as well as anatomic knowledge about the tissues and organs that may be studied via microarray gene expression experiments. We present two examples where we have combined a large ontology of human anatomy (the FMA) with other genomic knowledge sources: the gene ontology (GO) and the mouse genomic databases (MGD) of the Jackson Labs. These two initial examples of knowledge integration provide a proof of concept that anatomy can act as a hub through which we can usefully combine a variety of genomic knowledge and data.

Anatomy↗
PubMed2005

Of mice and men: design of a comparative anatomy information system.

In previous work, we proposed an approach called the Structural Difference Method (SDM) to correlating the anatomy of Homo sapiens with selected species, using the Foundational Model of Anatomy (FMA) as a framework and graph matching as a method, for determining similarities and differences between species. In this paper, we present the design of a comparative anatomy information system that utilizes the SDM and allows users to issue queries to determine the similarities and differences between two species. Our system will serve as a pilot project for cross-species anatomical information collection, storage, and retrieval. The underlying data structure of a mapping, and the syntax and semantics of the system's query language, are presented.

Anatomy↗
PubMed2005

Approach for analysis of order check overrides in a computerized practitioner order entry system.

While it has been established that electronic order entry systems can prevent transcription errors and check orders for severe drug allergies and interactions, continuous monitoring of the effectiveness of order checks is important. The goal of this study is to examine the rate at which high severity order checks generated in the electronic medical record at VA Puget Sound are overridden by clinicians. We compare our results to those of a previous study that found high override rates for Critical Drug Inter-action and Allergy-Drug Interaction order check categories. We are interested in determining whether system changes addressing these high rates have been successful in reducing the overall override rate in these categories. Because the method used previously to extract orders is no longer available, the first step in our study was to develop a new procedure to gather order entry data. This procedure is the subject of our report.

Clinical Pharmacy Information Systems↗
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↗