Multidisciplinary Medical Team Meetings: An Analysis of Collaborative Working with Special Attention to Timing and Teleconferencing

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.

[1]  Susan Leigh Star,et al.  Institutional Ecology, `Translations' and Boundary Objects: Amateurs and Professionals in Berkeley's Museum of Vertebrate Zoology, 1907-39 , 1989 .

[2]  Kjeld Schmidt,et al.  Taking CSCW seriously , 1992, Computer Supported Cooperative Work (CSCW).

[3]  Judith S. Olson,et al.  Face-to-face group work compared to remote group work with and without video. , 1997 .

[4]  David Chow,et al.  Development of an ATM-based radiology consultation workstation for radiotherapy treatment planning , 1997, Medical Imaging.

[5]  N. Israeli,et al.  The social psychology of time. , 1932 .

[6]  Sang Joon Kim,et al.  A Mathematical Theory of Communication , 2006 .

[7]  Rob Procter,et al.  Making a Case in Medical Work: Implications for the Electronic Medical Record , 2003, Computer Supported Cooperative Work (CSCW).

[8]  John Øvretveit,et al.  System negligence is at the root of medical error , 2000 .

[9]  Madhu C. Reddy,et al.  A finger on the pulse: temporal rhythms and information seeking in medical work , 2002, CSCW '02.

[10]  Carl E. Landwehr,et al.  Basic concepts and taxonomy of dependable and secure computing , 2004, IEEE Transactions on Dependable and Secure Computing.

[11]  Carl Gutwin,et al.  Task analysis for groupware usability evaluation: Modeling shared-workspace tasks with the mechanics of collaboration , 2003, TCHI.

[12]  S. Feldstein,et al.  Rhythms of dialogue , 1970 .

[13]  GutwinCarl,et al.  Task analysis for groupware usability evaluation , 2003 .

[14]  Sara Bly Talking About Talking About Things , 2003, Hum. Comput. Interact..

[15]  Claus Bossen,et al.  The parameters of common information spaces:: the heterogeneity of cooperative work at a hospital ward , 2002, CSCW '02.

[16]  Judith S. Olson,et al.  Distance Matters , 2000, Hum. Comput. Interact..

[17]  B. Asher The Professional Vision , 1994 .

[18]  Austin Henderson,et al.  Interaction Analysis: Foundations and Practice , 1995 .

[19]  Ian Alexander Designing Collaborative Systems. A Practical Guide to Ethnography , 2003, Eur. J. Inf. Syst..

[20]  Kjeld Schmidt,et al.  Taking CSCW Seriously: Supporting Articulation Work * , 1992 .

[21]  Steve Whittaker,et al.  Things to Talk About When Talking About Things , 2003, Hum. Comput. Interact..

[22]  Steve Whittaker,et al.  Conversations Over Video Conferences: An Evaluation of the Spoken Aspects of Video-Mediated Communication , 1993, Hum. Comput. Interact..

[23]  G. Bepler,et al.  Lung cancer. Practice organization. , 2003, Chest.

[24]  R Droste-Ehrhardt [Practice organization]. , 1978, Quintessenz Journal.

[25]  Gerrit C. van der Veer,et al.  GTA: Groupware task analysis — Modeling complexity , 1996 .

[26]  Saturnino Luz,et al.  Enabling change in healthcare structures through teleconferencing , 2005, 18th IEEE Symposium on Computer-Based Medical Systems (CBMS'05).

[27]  T. Thrall Work redesign. , 2003, Hospitals & health networks.

[28]  Liam J. Bannon,et al.  Constructing Common Information Spaces , 1997, ECSCW.

[29]  William Housley,et al.  Category work and knowledgeability within multidisciplinary team meetings , 2000 .

[30]  R GEISSENDORFER,et al.  [Diagnosis and treatment of lung cancer]. , 1951, Strahlentherapie.

[31]  Gillian Symon,et al.  The coordination of work activities: Cooperation and conflict in a hospital context , 1996, Computer Supported Cooperative Work (CSCW).

[32]  E. Schegloff,et al.  A simplest systematics for the organization of turn-taking for conversation , 1974 .

[33]  Rob Procter,et al.  Supporting informality: team working and integrated care records , 2004, CSCW.

[34]  M. Whitehouse,et al.  A policy framework for commissioning cancer services , 1995, BMJ.

[35]  Marisa E. Campbell,et al.  Conference preview: HCI 2000: usability or else! , 2000, INTR.

[36]  Richard Harper,et al.  The Organisation in Ethnography –A Discussion of Ethnographic Fieldwork Programs in CSCW , 2000, Computer Supported Cooperative Work (CSCW).

[37]  M. D. Dunnette Handbook of Industrial and Organizational Psychology , 2005 .

[38]  Saturnino Luz,et al.  Probing the Use and Value of Video for Multi-Disciplinary Medical Teams in Teleconference , 2006, 19th IEEE Symposium on Computer-Based Medical Systems (CBMS'06).

[39]  Paul Dourish,et al.  What we talk about when we talk about context , 2004, Personal and Ubiquitous Computing.

[40]  Masood Masoodian,et al.  Video Support for Shared Work-Space Interaction: An Empirical Study , 1995, Interact. Comput..

[41]  Abigail Sellen,et al.  Speech patterns in video-mediated conversations , 1992, CHI.

[42]  J J McAleer,et al.  Broadcast quality teleconferencing for oncology. , 2001, The oncologist.

[43]  J. M. Dabbs,et al.  Dimensions of Group Process: Amount and Structure of Vocal Interaction , 1987 .