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   Interaction with Pervasive Computers
- New interfaces for the clinicians.

The motivating question

How can information technology support highly mobile and cooperating work?

Introduction

Several studies done by international and local researchers have proven that the currently used medical information systems are insufficient to support clinical work, especially at hospitals.

A conventional PC is highly refined to support office work. Office work is characterized by a user sitting in a chair, at a desktop with a lot of space for a keyboard and a mouse, the user is typically situated at the same desktop the entire day and the user is the only one who uses the computer on the desktop. The users logs in on the computer in the morning and stays logged in until s/he leaves the place in the evening. Finally the user primarily works alone.

Clinical work differs from this office work situation in almost every aspect.
1) The clinical work is ‘nomadic’, that is people move around all the time and there work is not done at a desktop.
2) Their work is not tied to one person but requires a high degree of cooperation, which leads to many interruptions and shifts between tasks.
3) The object clinicians are working on is not spreadsheets or word documents but living human beings, which also adds new requirements to the interaction with the technology.
4) Because the clinician work is nomadic, they move around and they use many different computers during a normal work day, which again requires many log in and out sessions.
5) Finally because the clinician moves between different environments (operating theatre, hospital ward, office, x-ray room and meeting place) the interaction with computers in one setting might be quite different from the interaction in another setting.

The technology currently available to this nomadic and cooperative work setting is a traditional office PC.

The aim of this project is to consider, if new technology can be used in a creative way to support this kind of setting. This is not a quest for pushing technology forward at any means, but to develop, investigate and test how new interaction forms can be used to improve the use of information technology in a clinical setting.


Two main scenarios
In this project we have chosen two main scenarios we are focusing on.

Operating Theatre
We have chosen the operating theatre as one of our cases because it is one of the clinicians work situations that differ most from office work. Some of the characteristics are:

• The work is highly cooperative; the surgeons are reliant on each other, the nurses and the anaesthetist.
• The work may require fast intervention.
• It requires the use of different types of technology e.g. X-ray machines, access to the electronic patient record, ultrasonic equipment, respirators.
• The surgeons have to remain sterile and a traditional keyboard and mouse is not an option for the surgeon.

Nomadic clinician
The second scenario we have chosen is the mobile clinician. The mobile clinician addresses the situation where clinicians or nurses move around treating the patients. It can be within a hospital but it could also be in the patients own home. Some of the characteristics of the nomadic clinician are listed below:

• The clinician is working in different environments with different needs for IT-support (the ward, the office, the outpatient department, the meeting room, the patient home).
• There is a need for cooperation between young and experienced clinician, between clinician and nurses etc. However the cooperation might be difficult due to the fact that the nurses and clinicians are nomadic and not co-located.


Technology: Pervasive Computing and Multimodal interaction
The technological area we are looking into and developing is the area of pervasive computing.

”Pervasive computing is the next generation computing environments with information & communication technology everywhere, for everyone, at all times.
Pervasive computing goes beyond the traditional user interfaces, on the one hand imploding them into small devices and appliances, and on the other hand exploding them onto large scale walls, buildings and furniture”. (www.cfpc.dk)

Within the area of pervasive computing we are focusing on multimodal interaction.

• That is interaction that does not necessarily uses the mouse and keyboard as input, but might also use input such as gestures, speech, eye gazes, context clues etc as.
• That is interaction that does not necessarily uses a traditional screen as output but might use a large wall display, a small display on a phone or a PDA, 3D-screens, speech, ambient displays etc as output.

Updated 2005-05-12: Contact information: thomasr@daimi.au.dk