Using display walls for improved treatment of patients with chronic diseases

As medical- or patient records are gradually developing into an electronic health record, the paper-based records; the individual documents, the collections of patient documents are broken up into small fragments of (medical-) knowledge and information in terms of clinical data . This is done through the system-development process. The computable atoms of medical information are later re-assembled into suitable information for health care purposes. The data are stored in databases and the document viewed is the computer extract of these data; the predefined selection-process that present the data to the users who generally are healthcare workers. The issue of assembling the data into a suitable form is regarded as a human-computer interaction / graphical user interface (HCI/GUI) task; how to create the perfect, or more correctly, the adequate interface to the information and medical knowledge so as to give the healthcare worker best possible ground to make correct medical/treatment decisions.

Background

Advances in ultra high resolution displays, like the display wall projects at Princeton University and the University of Tromsø , enable new ways of presenting and organizing health care data. At UC Davis the virtual care center opens for unique real time experiments with simulating robotic patients. This also calls for a more fundamental understanding of the underlying health records and medical documents. One of the promising areas of use is team-based treatment, which needs a thorough understanding of computer-supported cooperstive work (CSCW).

The underlying assumption for this work is that by employing the theoretical framework from the fields of humanities and social sciences, notably media and documentation studies, we can analyze future use of patient data, i.e. as it appears on the displays of ultra high resolution computer screens, typical 2,5 x 6 meters, with a resolution above 4000 x 10000 pixels. In our research, we seek to investigate how to make the EHR capable for cooperation between healthcare workers, for example using display-wall technology; we want to facilitate them in terms of ‘continuity of care’, ‘shared care’ of the patient and especially to support teamwork arrangements. We are further motivated by claims such as those made by Dichter , who argues that teamwork improves the care of hospitalized patients and states that hospitals in the future will be more dependant than ever upon efficient teamwork to coordinate care.

Our assumption is that the way to augment patient care, and healthcare in general, is by augmenting the most valuable resources – the human minds and decision-makers; the healthcare professionals. This is more than to say that two heads think better that one. Today, and in the future even more so, the patient will not be treated by one person alone, but a chain of caregivers. It is in this context crucial that the systems that aid these people in their task do so in a way that not only support their basal needs for sharing information, but also adds to their abilities to cooperate to give the most proper care. CSCW is a field of study dedicated to finding the requirements for systems that allow for cooperative work arrangements. In technical terms we wish to CSCW-enable the electronic health record (EHR).

The project will cooperate with and use resources and technologies from the two NFR and UiT funded SHARE and Display Wall projects at the High Performance Distributed Computing (HPDC) group at the Department of Computer Science, University of Tromsø. The HPDC group has built a wall-sized high-resolution tiled display with three clusters of computers driving and producing content for the display wall. The groups research includes support for collaborative work, human-computer interfaces, and the fundamental systems for parallell and distributed computations. The group comprises three tenured faculty (Otto J. Anshus, Tore Larsen, John Markus Bjørndalen), one post. doc (Phuong H. Ha) and five Ph.D. students".

Goals

• Develop models for cooperation between healtcare workers, based on the use of ultra high resoulution displays (display walls).
• Construct a prototype system that give the healthcare worker best possible ground to make correct medical/treatment decisions about patients with chronical diseases

Problems

• How can a distributed electronic health record support CSCW-functionality?
• How can we enable the EHR capable for cooperation between healthcare workers, for example using display-wall technology; we want to facilitate them in terms of ‘continuity of care’, ‘shared care’ of the patient and especially to support teamwork arrangements.
• How to create the perfect, or more correctly, the adequate interface to the information and medical knowledge so as to give the healthcare worker best possible ground to make correct medical/treatment decisions
• How may a document/documentation approach to the electronic health record help us develop and create better, or even (more) complete computer/information systems?”
• How to make realistic experiments with EHR?

Methods

The project will be based on research methods from medicine, medical informatics, social science, and computer science.
Work method includes systems engineering and specifically prototyping. Augmented environments for healthcare workers using very large, high resolution displays, i.e. display wall technology is an area of research.
The project will be divided into 5 phases:
1. Discussion of
    a. Existing solutions for organizing health data
    b. Different kinds of health data (physiological values) from patients suffering from chronic diseases
    c. Different models for construction of systems for cooperation using display wall technology
2. Collection and presentation of different kind of health data from patient with chronic diseases
3. Specification of experiments and prototype system
4. Experimental part in which a prototype is constructed and tested.
5. The prototype system will be tested by health care professionals (through different scenarios in the lab)

Project manager

Gunnar Hartvigsen, UiT / Niels W. Lund, UiT

Project members from the partners

1 PhD position at UiT (already financed by UiT), NST

Researchers

Bernt-Ivar Olsen, UiT, Niels W. Lund, UiT, Gunnar Hartvigsen, UiT, Otto J. Anshus, UiT, J. Gustav Bellika, NST, Per Hasvold, NST, Jermiah Scholl, NST, medical doctor

Project start/stop

1.1.2007 – 31.12.2011

Contribution to health care

With an increasing amount of medical data, the presentation of medical data becomes increasingly important. The project is expected to contribute to new ways of presenting such data.

Contribution to new industry

The knowledge developed in this project will be of interest for several other TTL projects.

Contact info

e-mail: Gunnar Hartvigsen, mobile phone: +47 906 57 785

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