Abstract
In this paper we describe the process of a multi-disciplinary medical team meeting (MDTM), its functions and operation in colocated and teleconference discussions. Our goal is to identify the elements and mechanics of operation that enhance or threaten the dependability of the MDTM as a “system” and propose technologies and measures to make this system more reliable. In particular, we assess the effect of adding teleconferencing to the MDTM, and identify strengths and vulnerabilities introduced into the system by the addition of teleconferencing technology. We show that, with respect to the system’s external task environment, rhythms of execution of pre-meeting and post-meeting activities are critical for MDTM success and that the extension of the MDTM to wider geographic locations with teleconferencing might disrupt such rhythms thereby posing potential threats to dependability. On the other hand, an analysis of vocalisation patterns demonstrates that despite difficulties related to coordination and awareness in video-mediated communication (evidenced by increased time spent in case discussion, longer turns, decreased turn frequency and near lack of informal exchanges) the overall case discussion structure is unaffected by the addition of teleconferencing technology into proceedings.
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References
AJCC. (1992): Manual for Cancer Staging. American Joint Committee on Cancer, 4th edn.
Michael Alberts, W., G. Bepler, T. Hazelton, J.C. Ruckdeschel and J.H. Williams (2003): Practice Organization. Chest 123(1 Supplement), 332S–337S
Arnaudova A., Jakubowski E. (2005) Eigth Futures Forum on governance of patient safety. WHO, Copenhagen, Denmark
Aviužienis A., Laprie J.C., Randell B., Landwehr C. (2004) Basic Concepts and Taxonomy of Dependable and Secure Computing. IEEE Transactions on Dependable and Secure Computing 1:11–33
Bannon, L. and S. Bødker (1997): Constructing Common Information Spaces. In: Proceedings of the Fifth European Conference on Computer-Supported Cooperative Work, pp. 81–96
Bly S. (2003) Talking about Talking about Things. Human-Computer Interaction 18:181–191
Bossen, C. (2002): The Parameters of Common Information Spaces: The Heterogeneity of Cooperative Work at a Hospital Ward. Proceedings of the CSCW ’02
Calman K., Hine D. (1995) A Policy Framework for Commissioning Cancer Services. Department of Health, Welsh Office
Cohen, K.M. (1982): Speaker Interaction: Video Teleconferences versus Face-to-Face Meetings. In: Proceedings of Teleconferencing and Electronic Communications
Crabtree A. (2003) Designing Collaborative Systems A Practical Guide to Ethnography. Springer, Verlag
Dabbs J.J., Ruback R. (1987) Dimensions of Group Process: Amount and Structure of Vocal Interaction. Advances in Experimental Social Psychology 20:123–169
Dourish, P. (2004) What We Talk about When we Talk about Context. Pers Ubiquit Comput (8):19–30
Elan. Elan-eucido Linguistic Annotator. Max-Planck-Institute for Psycholinguistics, http://www.mpi.nl/tools/elan.html, March 2005.
Finn, K.E., A.J. Sellen and S.B. Wilbur (1997): Video-Mediated Communication. Lawrence Erlbaum Associates, Inc.
Goodwin C. (1994) Professional Vision. American Anthropologist 96(3):606–633
Hackman, R.J. (1980): Work Redesign. Addison Wesley
Hardstone, G., M. Hartswood, R. Proctor, R. Slack and A. Voss (2004): Supporting Informality: Team Working and Integrated Care Records. In: CSCW Chicago
Harper R.H.R. (2000) The Organization in Ethnography. Computer Supported Cooperative Work (CSCW), 9:239–264
Hartswood M., Proctor R., Rouncefield M., Slack R. (2003) Making a case in Medical Work: Implications for the Electronic Patient Record. Computer Supported Cooperative Work, 12:241–266
Hollywood D.P. (2003) The Development of Radiation Oncology services in Ireland. Department of Health and Children. The Stationary Office, Dublin
Housley W. (2000) Category work and knowledgeability within multidisciplinary team meetings. Text and Talk, 20(1):83–108
Howell, W.C. (1991): Handbook of Industrial and Organizational Psychology, Vol 2 Chapt. Human Factors in the Workplace, Consulting Psychologists Press
Jaffe, J. and S. Feldstein (1970): Rhythms of Dialogue. Academic Press
Jordan B., Henderson A. (1995) Interaction Analysis: Foundations and Practice. The Journal of the Learning Sciences 4(1):39–103
Kane, B. and S. Luz (2006): Probing the Use and Value of Video for Multi-Disciplinary Medical Teams in Teleconference. In: Proceedings of the 19th IEEE International Symposium on Computer-Based Medical Systems
Kane, B., S. Luz, G. Menezes, and D.P. Hollywood (2005): Enabling Change in Healthcare Structures through Teleconferencing. In: Proceedings of the 18th IEEE International Symposium on Computer-Based Medical Systems, pp. 76–81, IEEE Computer Society, 2005. doi: http://www.dx.doi.org/10.1109/CBMS.2005.51
Kempner K.M., Chow D., Choyke P., Cox J.R., Elson J.E., Johnson C.A., Okunieff P., Ostrow H., Pfeifer J.C., Martino R.L. (1997) The Development of an ATM-based Radiology Consultation workstation for Radiotherapy Treatment Planning. Medical Imaging 1997 Image Display, 3031:550–511
Masoodian M., Apperley M., Frederickson L. (1995) Video Support for Shared Work-Space Interaction: An Empirical Study. Interacting with Computers 7(3):237–253
McAleer J., O’Loan D., Hollywood D. (2001) Broadcast Quality Teleconferencing for Oncology. Oncologist 6 (5):459–462
McGrath, J.E. (1988): The Social Psychology of Time. Sage Publications
NCCAC. (2005): The Diagnosis and Treatment of Lung Cancer. National Institute for Clinical Excellence (NICE)
O’Conaill B., Whittaker S., Wilbur S. (1993) Conversations Over Video Conferences: An Evaluation of the Spoken Aspects of Video-Mediated Communication. Human-Computer Interaction 8(4):389–428
O’Connell F. (2004): Guidelines for the Clinical Management of Lung Cancer. Irish Medical Journal, vol. 97, no. 2 (Supplement)
Olson, J. S., G.M. Olson and D. Meader (2000): Distance Matters. In: K.E. Finn, A.J. Sellen and S.B. Wilbur (eds.): Video-Mediated Communication. ACM Press, Chapt. Face-to-Face Group Work compared to Remote Group Work with and without Video.
Øvretveit, J. (1999): Integrated Quality Development for Public Healthcare. Norwegian Medical Association.
Øvretveit J. (2000) System negligence is at the root of medical error. International Journal of Health Care Quality Assurance, 13(3):103–105
Paterno F. (1999) Model-Based Design and Evaluation of Interactive Applications. Applied Computing, Springer Verlag
Pinelle D., Gutwin C., Greenberg S. (2003) Task Analysis for Groupware Usability Evaluation: Modeling Shared-Workspace Tasks with the Mechanics of Collaboration. ACM Transactions on Compututer-Human Interaction 10(4): 281–311
Reddy, M. and P. Dourish (2002): A Finger on the Pulse: Temporal Rhythms and Information Seeking in Medical Work. CSCW ’02 pp. 344–353
Sacks H., Schegloff E.A., Jefferson G. (1974) A simplest systematics for the organization of turn taking in conversation. Language, 50(4):696–735
Schmidt K., Bannon L. (1992) Taking CSCW Seriously: Supporting Articulation Work. Computer Supported Cooperative Work 1(1/2): 7–40
Sellen, A. J. (1992): Speech Patterns in Video-mediated Conversations. In: ACM (ed.): Proceedings of the Computer Human Interactions (CHI) ’92
Shannon C.E., Weaver W. (1949). The Mathematical Theory of Communication. University of Illinois Press, Urbana Il
Star S.L., Griesemer J.R. (1989) Institutional Ecology, Translations and Boundary Objects: Amateurs and Professionals in Berkeley’s Museum of Vertebrate Zoology, 1907–1939. Social Studies of Science 19:387–420
Symon G., Long K., Ellis J. (1996) The Coordination of Work Activities: Cooperation and Conflict in a Hospital Context. Computer Supported Cooperative Work (CSCW), 5(1):1–31
van der Veer G., Lenting B., Bergevoet B. (1996) GTA: Groupware Task Analysis – Modeling Complexity. Acta Psychologica 91:297–322
Whittaker S. (2003) Things to talk about when talking about things. Human-Computer Interaction 18:149–170
Acknowledgements
Our thanks to Dr. Finbarr O’Connell and all the members of the multidisciplinary team at the respiratory MDTM in St James’s Hospital, Dublin, for their cooperation in this on-going study. We also thank Dr. D. S. O’Briain, and all of the staff in pathology. We also thank the staff at the Academic Unit of Clinical and Molecular Oncology, Trinity College Dublin. This research is supported by funding from the Irish Research Council for the Humanities and Social Sciences.
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Kane, B., Luz, S. Multidisciplinary Medical Team Meetings: An Analysis of Collaborative Working with Special Attention to Timing and Teleconferencing. Comput Supported Coop Work 15, 501–535 (2006). https://doi.org/10.1007/s10606-006-9035-y
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DOI: https://doi.org/10.1007/s10606-006-9035-y