Toward a Framework for Computer-Mediated Collaborative Design in Medical Informatics

Abstract

The development and implementation of enabling tools and methods that provide ready access to knowledge and information are among the central goals of medical informatics. The need for multi-institutional collaboration in the development of such tools and methods is increasingly being recognized. Collaboration involves communication, which typically involves individuals who work together at the same location. With the evolution of electronic modalities for communication, we seek to understand the role that such technologies can play in supporting collaboration, especially when the participants are geographically separated. Using the InterMed Collaboratory as a subject of study, we have analyzed their activities as an exercise in computer- and network-mediated collaborative design. We report on the cognitive, sociocultural, and logistical issues encountered when scientists from diverse organizations and backgrounds use communications technologies while designing and implementing shared products. Results demonstrate that it is important to match carefully the content with the mode of communication, identifying, for example, suitable uses of E-mail, conference calls, and face-to-face meetings. The special role of leaders in guiding and facilitating the group activities can also be seen, regardless of the communication setting in which the interactions occur. Most important is the proper use of technology to support the evolution of a shared vision of group goals and methods, an element that is clearly necessary before successful collaborative designs can proceed.

Keywords

Computer-Mediated Collaboration - Clinical Guidelines - Distributed Cognition - Communication Technologies - Internet-based Collaboration

• References

• 1 Cerf V. Committee on a National Collabora-tory CSaTBN. National Collaboratories Applying Information Technology for Scientific Research . Washington, DC: National Academy Press; 1993
• 2 Kouzes RT, Myers JD, Wulf WA. Collaboratories: Doing science on the Internet. IEEE Comp 1996; 229: 40-6.
• 3 Grosz BJ. Collaborative systems. AI Mag 1996; 17: 67-85.
• 4 Wulf WA. The collaboratory opportunity. Science 1993; 13: 854-5.
• 5 Smith JB. Collective Intelligence in Computer-Based Collaboration . Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers; 1994
• 6 Sudweeks F, Rafaeli S. How do you get a hundred strangers to agree: Computer mediated communication and collaboration. In: Harrison TM, Stephen TD. eds. Computer Networking and Scholarship in the 21st University: . SUNY Press; 1996: 115-36.
• 7 Shortliffe EH, Barnett GO, Cimino JJ, Greenes RA, Huff SH, Patel VL. In: James J. Cimino ed. Proceedings of Collaborative medical informatics research using the Internet and the World Wide Web, American Medical Informatics Association Annual Fall Symposium,. Washington, D.C.: Hanley & Belfus; 1996: 125-9.
• 8 Oliver DE, Barnett GO, Chueh HC. et al. InterMed: An Internet-based medical collaboratory. In: Reed M. Gardner, ed. Proceedings of the Nineteenth Annual Symposium on Computer Applications in Medical Care . New Orleans: Hanley & Belfus; 1995: 1023.
• 9 Patel VL, Allen VG, Arocha JF, Shortliffe EH. Representing clinical guidelines in GLIF: Individual and collaborative expertise. JAMIA 1998; 5: 467-83.
• 10 Shortliffe EH, Patel VL, Cimino JJ, Barnett GO, Greenes RA. A study of collaboration among medical informatics laboratories. Artif Intell Med 1998; 12: 97-123.
• 11 Ohno-Machado L, Gennari JH, Murphy SN. et al. The guideline interchange format: A model for representing guidelines. JAMIA 1998; 4: 357-72.
• 12 Patel VL, Kaufman DR. Science and practice: a case for medical informatics as a local science of design. JAMIA 1998; 6: 489-92.
• 13 Cimino JJ, Socratous SA, Grewal R. The informatics superhighway: Prototyping on the World Wide Web. In: Reed M. Garder, ed. Proceedings of the Nineteenth Annual Symposium on Computer Applications in Medical Care . New Orleans: Hanley & Belfus; 1995: 111-5.
• 14 Greenes RA. H.SE. Medical informatics. An emerging academic discipline and institutional priority. JAMA 1990; 263: 1114-20.
• 15 Patel VL, Kaufman DR. Medical informatics and the science of cognition. JAMIA 6: 493-502.
• 16 Simon HA. The Sciences of the Artificial . Cambridge, Massachusetts: MIT Press; 1981
• 17 diSessa AA. Local sciences: Viewing the design of human-computer systems as cognitive science. In: Carroll JM. ed. Designing Interaction: Psychology at the Human-Computer Interface . Cambridge: Cambridge University Press; 1993
• 18 Norman DA. Cognition in the head and in the world: An introduction to the special issue of situated action. Cog Sci 1993; 17: 1-6.
• 19 Goel V, Pirolli P. The structure of design problem spaces. Cog Sci 1992; 16: 395-429.
• 20 Okada T, Simon HA. Collaborative discovery in a scientific domain. Cog Sci 1997; 21: 109-46.
• 21 Safran C, Jones PC, Rind D. et al. Electronic communication and collaboration in a health care practice. Artif Intell Med 1998; 12: 137-51.
• 22 Patel VL, Kaufman DR, & Magder SA. The acquisition of medical expertise in complex dynamic environments. In: Ericsson KA. ed. The Road to Excellence: The Acquisition of Expert Performance in the Arts and Sciences, Sports and Games . New Jersey: Lawrence Erlbaum Associates, Inc.; 1996: 127-65.
• 23 Bradshaw JM, Gawdiak Y, Canas A. et al. Toward an intelligent aviation extranet,. In: Proceedings of the International conference on Human-Computer Interaction in Aeronautics . 1998
• 24 Olson GM, Olson JS, Carter MR, Storrøsten M. Small group design meetings: An analysis of collaboration. Human-Comp Inter 1992; 7: 347-74.
• 25 Kraut R, Galegher J, Fish R, Chalfonte B. Task requirements and media choice in collaborative writing. Human-Comp Inter 1992; 7: 375-40.
• 26 McLeod PL. An assessment of the experimental literature on electronic support of group work: Results of a meta-analysis. Human-Comp Inter 1992; 7: 257-80.
• 27 Nohria N, Eccles RG. Networks and Organizations: Structure, Form and Action . Boston, Mass.: Harvard Business School Press; 1992
• 28 Sproul L, Kiesler S. Connections: New Ways of Working in the Networked Organization . Cambridge, MA: MIT Press; 1991
• 29 Suchman L. Plans and Situated Actions: The Problem of Human/Machine Communication . Cambridge: Cambridge University Press; 1987
• 30 Kouzes RT, Myers JD, Wulf WA. Collaboratories: Doing science on the Internet. IEEE Computer 1996; 29: 40-6.
• 31 Clark HH, Brennan SD. Grounding in Communication. In: Clark HH. ed. Using Language . Cambridge, England: Cambridge University Press; 1996: 127-49.
• 32 Patel VL, Evans DA, Kaufman DR. Cognitive framework for doctor-patient interaction. In: Evans DA, Patel VL. eds. Cognitive Science in Medicine: Biomedical Modeling . Cambridge, MA: MIT Press; 1989: 253-308.
• 33 Allen VG, Patel VL. Medical decision making: Formal analysis of negotiation and conflict resolution. In: Proceedings of the Fourth Annual HealNet Conference. 1998: 36.