CoOperation Support Through Transparency

The objective of the COSTT project was to achieve 'just in time' coordination in the dynamic environment of clinical work by creating a shared work space that gives all the actors involved in the collaboration real-time insight into the work process, e.g its progress and possible deviations from the expected course. As we have shown in the research output of COSTT, this insight can be constructed from events that are 'caught' in reality by either sensor devices (e.g. IPS technology) or information systems in use (e.g. operation planning system or anesthesiology information system). Examples of such events are: the patient has arrived in the operation theater, the operation has started, the operation has ended and the patient has arrived at the recovery wa rd. We evaluated different ways of presenting events both from the perspective of usefullness and from the perspective of privacy protection. Tapping into the stream of events produced in the execution of care in order to reconstruct the progress of the p atient trajectory as well as to predict what will happen next, has proven to be both feasible and useful.

Collaboration in health care is best characterized as collaborative problem solving. ICT support could be highly beneficial. However, work flow oriented systems are ill suited for this purpose, because they assume that the course of events in a work proce ss can be pre-determined to a large extend. The course of clinical work is highly dependent upon the decisions taken by clinicians based on a growing insight into the health problem of the patient. Electronic patient records facilitate sharing this insigh t and as a consequence have a role in supporting collaboration, but the information they contain does not represent clinical reality per se. The basic assumption underlying our project is that deciding on a course of events in clinical problem solving is cognitive problem, to be dealt with by the clinicians, each from their own professional perspective and based on the information they have about the status of the collaborative effort. They need to be informed about the actions taken and results obtained by the others. Proper access to this information will be referred to as transparency. We aim to optimize the delivery of advanced, multi-actor healthcare services by providing technologies that will enable coordination through transparency. We will tap data from networked multimodal and sensoring digital devices within the healthcare unit and establish a seamless infrastructure consisting of a stream of log data which in principle may be utilized by many services. We will develop technologies for inferr ing and identifying intentional healthcare acts and patient trajectories from logs and other torrents of activity data. We will supplement the digital environments of the actors by computer-generated visualizations of actors- and patient trajectories and explore their value in a communication-intensive healthcare domain.