Another Excellent Teacher in the HTO group!!

Now the HTO group has two excellent teachers as Åsa Cajander was awarded the title last week joining Lars Oestreicher who was awarded the title several years ago.

Uppsala University has a formal process for awarding skilled teachers the title “Excellent teacher”, and the title is connected to a salary raise. There is a board that appoints excellent teachers at each faculty, and the faculty of science and technology has one Board for Appointment of Excellent Teachers that meet every semester.

The curious reader find the guidelines for admittance of excellent teachers online in this pdf document. 

The trees that hide in the forest

Sometimes when we make studies on a work environment, e.g., as a preparation for software development, there seems to be a tendency to overlook the smaller things; things that actually have a greater effect on the work situation than we might think at a first glance. There is, of course, never any doubt that big software systems will play a big role in a person’s work over the day. When there are problems with these, this often causes large breaks in the workflow and are (hopefully) sorted out fairly quickly. But there are also many small things; those annoying nuances that might not be causing disasters, but merely make a person frustrated in the long run. These smaller inconveniences are often not detected or considered in the cognitive workspace design.

The idea of a cognitive, ergonomic work context was widely discussed in the 1980’s. (c.f., Hagert, Hansson and Oestreicher, 1987, Wærn 1988) . However, the overall combination of software systems as a work environment seems today to be stressed mostly as an issue of incompatibility, e.g. causing unnecessary copying and processing of data and similar issues. Even if we manage to make the systems compatible and exchanging the data between themselves there are many other environmental factors that will still be affecting the cognitive work context negatively. These factors are sometimes well hidden in the work procedures and may be difficult to assess for software designers, and sometimes they are actually not even software issues but rather involving advanced hardware solutions.

During our previous study visits at a hospital, there were many small things happening that were hardly noticeable, but which at the same time constituted important factors in the work situation. In some cases, these small things were not directly concerned with the software systems used (although it is possible to see some of them as relevant to the overall software systems design), but proper workspace design might actually include these parts in the larger software network.

Just after Easter, in 2018, I was hospitalised for a week with an evil strand of pneumonia. Apart from being sick it also meant an interesting and close view of the nurses’ work context and the tools that they used. Since I was actually a real patient (albeit of an observing kind) I think that the nurses were more relaxed than during the earlier study visit. So, I started to observe several things that happened all around me and in this and some following articles I will go through some of the ideas that fell well into the work context situation.

One thing that was quite apparent, both in the study visits and during my week-long stay at a clinic, was the fragmented workflow for the nurses. Among the ordinary work tasks, there were many local interruptions, from alarms for a certain patients medical condition (mostly false ones, but more about this later), to calls for non-urgent requests from patients for water, tending or other less acute matters. Also, there were incoming medical transports and phone calls which, although part of the work, often tended to interrupt the nurses in their work. This kind of phenomenon is very difficult to catch in a work design study since it more or less requires a longer period of observation in order to properly judge its significance for the work. In this way, we tend to see the forest (of tasks) as a single unit, whereas the nurses instead are working on all the small trees and shrubs (of smaller activities) that actually constitute it.

Another factor that has appeared is that while the design of the main computer systems often is very thoroughly prepared, both in terms of requirements on the software and the hardware, much less effort seems to be spent on the personal software and hardware(!). This means that even if we get very advanced software systems on the ward, the personal equipment often seems to be pretty much left out of the equation. Essentially, this is also very similar to working hard on defining the forest, but lacking the ability to see all the trees making it up.

In my following blogs, I will try to disseminate these issues into a few more concrete examples of this and even make some suggestions for how to proceed and also enhance the situation at a hospital ward with these observations as a base.

Lars Oestreicher,
DISA

(this blogpost is also published on my personal blogpage: moomindad.wordpress.com)

Digitaliseringen och arbetsmiljön – en nyutgiven bok av Bengt Sandblad mfl.

Boken som Bengt Sandblad från HTO-gruppen har varit med och skrivit finns nu att köpa! Du kan besälla boken tex här. 

 

Vad är en god digital arbetsmiljö? Hur går man till väga för att skapa en sådan? Trots att det i dag finns mycket kunskap om detta, ser vi fortfarande it-projekt som havererar och missnöjda användare. Det är uppenbarligen svårt att lyckas i praktiken. Teorier måste omsättas i praktisk handling.

När användningen och betydelsen av de digitala stödsystemen i arbets­­livet ökar handlar det i allt större utsträckning om en digital arbetsmiljö. Om alla ska kunna utföra sina arbetsuppgifter på ett effektivt och säkert ?sätt, med hög kvalitet och utan onödiga belastningar, måste man ställa höga krav på de digitala systemens utformning och införande. Erfarenheterna i dag är tudelade: dels bidrar it-systemen till förnyelse ?och verksamhetsnytta, dels uppvisar de alltför ofta stora brister vilket medför påtagliga arbetsmiljöproblem. Många användare är frustrerade över att deras it-verktyg inte stödjer dem eller fungerar som de borde.?

Den här boken ger en grundläggande beskrivning av kunskapsläget om digitalisering och digitala arbetsmiljöproblem, samt en omfattande vägledning i hur man kan utnyttja digitaliseringens möjligheter och samtidigt försäkra sig om en god och hållbar digital arbetsmiljö.

Presentation on “Individualizing Without Excluding”

Anna Normark and Rebecca Oskarsson presented their interesting master thesis on filter bubbles today. In their work they answer several research questions through the use of an experiment with bots on a social media platform, and a qualitative literature study on filter bubbles.

In their presentation they concluded that filter bubbles can be a threat to society, and that our awareness of filter bubbles need to be raised. However, interestingly enough they did not find clear evidence of filter bubbles in the experiment that they did on one of the existing social media platform. Though this does not mean that they do not exist elsewhere.

Anna Normark and Rebecca has previously presented their work twice in the blog, and you can read these blog posts here and here. I also hope that they will do one last blog post presenting some highlights from their resuls. 🙂

I was one of the supervisors of this master thesis work and I am very impressed. These students combine technical skills with an interest in society and ethics which is needed in our digital society. And today they also proved that they have  excellent presentation skills!

Presentation by Åsa Cajander and Jonas Moll at Medical Informatics Europe

During the first day of the Medical Informatics Europe (MIE) Conference Åsa Cajander and I presented the paper that was introduced in this blog post. Actually, this was the first presentation held by representatives from the HTO group during this year’s combined MIE/Vitalis event, but certainly not the last – we were active on stage, or as workshop leaders, during each and every day!

This particular presentation was based on a study that was conducted within the scope of a master’s thesis project at Uppsala University by Sara Englund and Anastasia Hansman. The project focused on the Swedish patient accessible electronic health record system Journalen (and hence was tightly connected to the DOME consortium) and more specifically on how nurses see that Journalen has affected their work environment and their communication with patients.

The result of the semi-structured interviews conducted with the nurses at a primary care center in Region Uppsala, first of all showed similar as our earlier interviews with physicians – Journalen has changed the interaction with patients, created an increased workload and created uncertainty regarding when to inform patients of results now that the patients can read even unsigned notes. Even though most of the results were in line with results from our earlier research in DOME, one new theme arose from the interview analysis – the need for new knowledge. Several nurses indicated that education was needed, focusing on how Journalen should be used both by patients and in the clinician-patient relationship. This is an important result, which should be taken very seriously.

All conference papers are published open access, so you can find all research presented at MIE here. You can find the paper that Åsa and I presented here.

Stay tuned for more posts about the HTO activities at MIE/Vitalis 2018! 🙂

Cognition in the Wild – Halfway PhD Seminar by Rebecca Andreasson

Rebecca Andreasson from the Department of Information Technology, Uppsala University, held her halfway seminar this week. She did an excellent presentation and many from the HTO group were there and listened to the presentation and discussion with Professor Henrik Artman from KTH. Rebecca started off her presentation with a description of what her papers included in her thesis have in common. The questions that she is addressing in her work are:

  • How do humans accomplish daily work activities in complex work environments?
    • How do we use tools and artefacts in practice?
    • How do we coordinate internal (memory, attention etc.) and external structures (tools, computers etc.) to accomplish a task?
  • How can workers be supported in their execution of tasks? 

Rebecca’s work is based on the theoretical framework of Distributed Cognition (DCog), introduced by Ed Hutchins, which emphasizes that thinking/cognition does not take place in isolation, but is the result of the interactions between the human, and his/her social, physical and cultural environment. All elements of the cognitive system are considered equally important.

Rebecca identifies four of her (numerous) publications as the foundation for her continuing work towards a PhD. :

  1. A study on interruption handling at an assembly line in a manufacturing company:
    Andreasson, R., Lindblom, J., & Thorvald, P. (2017). Interruptions in the wild: Portraying the handling of interruptions in manufacturing from a distributed cognition lens. Cognition, Technology & Work, 19(1), 85-108.
  2. A study on collaboration and tool use in dock assembly:
    Andreasson, R., Lindblom, J., & Thorvald, P. (2017). Tool use and collaborative work of dock assembly in practice. Special Issue in Production and Manufacturing Research, 5(1), 164-190.
  3. A study on the need for a system perspective in railway HF:
    Andreasson, R., Jansson, A. A., & Lindblom, J. (accepted for publication). Past and future challenges for railway research and the role of a systems perspective. To be published in Proceedings of the 20th Congress of the International Ergonomics Association. August 26-30, Florence, Italy.
  4. A study on coordinating activities in operational railway traffic:
    Andreasson, R., Jansson, A. A., & Lindblom, J. (under review). The coordination between train traffic controllers and train drivers: a distributed cognition perspective on railway. Cognition, Technology & Work.

Rebecca’s overall aim, in her own words, is to: enhance the understanding of the distributed work practices of cognitive cooperative work and to explore the interaction between human beings, tools, and technology in complex work settings where the theoretical framework of DCog has previously not been applied in depth.

Her contribution to the field, thus far, is the ethnographically founded descriptions of real work practices in real work situations and the application of DCog to new domains of complex work. This includes creating new concepts as well as complementing on existing concepts. She introduces DCog to the theoretical “toolbox” of Human Factors and Ergonomics (HF&E) research.

Her ideas for the future are:

  • To investigate how the results of a DCog analysis could be used to (re)design a socio-technical system through workshops and/or vision seminars with examples from real situations (based on the DCog analysis made).
  • To provide a structured “how-to” method for DCog users through analysis of comparison of current DCog methods (e.g. by analysing the same empirical material with the use of multiple DCog methods) and iteratively developing and validating a new (or modified) method. A final validation could potentially be done with students or practitioners in a HF&E domain.

With this account of her research and progress so far, Rebecca finished her presentation and the seminar continued with a critical discussion by invited guest Henrik Artman from KTH. Overall, Henrik was quite impressed and opened the discussion by relating that in his experience Rebecca is already way ahead of the halfway mark for her PhD. He then guided the discussion into the details of the foundation Rebecca has laid and suggestions on  how to strengthen it in Rebecca’s final sprint towards her PhD.

With such an impressive start, we certainly look forward to seeing what Rebecca will have achieved and contributed with to the field when it is time for her dissertation a few years from now!

Physicians, Patients and the Patient-Accessible EHR

Christiane presenting her draft of her doctoral thesis on April 17, 2018

Christiane Grünloh, one of the members of our research group, will soon be defending her PhD thesis. Last week, it was time for her to present a draft of her work, which she plans to defend by the end of the year. I jump on the opportunity to write of few lines on her research, which revolves around the Patient-Accessible Electronic Health Record online.

Christiane is one of the researchers of the DOME Consortium, working on the Development of Online Medical records and E-health services. She has been focusing on investigating the perspective of, respectively, physicians and patients on the EHR online – “Journalen” in Swedish. Research about this topic is particularly important since the implementation of Journalen in Sweden has been a very controversial project. Indeed, while patient organizations predominantly were in its favour, caring professionals were, for the most part, against it.

In her research, Christiane was able to look more closely at the reasons behind physicians’ strong opposition to the idea of enabling patients to access their EHR online. She was also able to investigate what was the value of this service from the patients’ point of view. In doing so, she found that physicians and patients had very different perspectives on the topic, and reflected on ways to bridge the gap between those two groups in order to improve the quality of the patient-physician relationship.

You can find Christiane on Twitter (where she is a very active user!) and LinkedIn. If you were attending the Vitalis / MIE 2018 conference in Gothenburg, you maybe also were able to attend her workshop on “Identifying the Need of Self-reported Data and Self-measurements for Diagnosis and Treatment of Cancer”, which she is held together with Jonas Moll, Isabella Scandurra and Åsa Cajander last Thursday.

Vad kan vi lära av Ladok?

Nya Ladok har nu införts på Lunds universitet. Med denna milstolpe avslutas projektet.  (Grattis till alla inblandade!) Arbetet tar inte slut utan övergår istället i en utvecklingsfas, som hanterar fortsatt utveckling och driftsättning. 

Vi har följt förberedelserna för det lokala införandet vid Uppsala universitet. Under våren 2018 kommer jag att vidga perspektivet för att försöka se vilka lärdomar som kan dras. Min förhoppning är att jag ska hinna intervjua både en del av dem som arbetat i projektet och en del av dem som arbetar med lokala införanden.

Det kan finnas anledning att understryka att jag inte gör någon utvärdering av projektet utan att det handlar om just att fånga upp goda och mindre goda erfarenheter. Det är onekligen ett intressant projekt, när ett så komplext system rullas ut till så många verksamheter. Det faktum att förutsättningarna varierar så mycket gör inte heller att det går att tala om rätt eller fel. Däremot är det väldigt intressant att förstå olika vägval och strategier, både i projektet och i de lokala införandena.

Att lärosätena befinner sig i olika faser ger också en ögonblicksbild av utmaningar i olika skeenden av ett införande.

Den första intervjun ägde rum idag och om allt vill sig väl följs den snart av fler. Alla kommer jag inte att hinna intervjua, inte ens alla projektledare. Därför ska jag komplettera intervjuerna med en mindre enkät eller rundfråga. Men – finns det mer att berätta om arbetet med nya Ladok än vad som ryms i enkäten får du förstås gärna kontakta mig.

Automated Bots – the Mission of Creating Filter Bubbles

Are you aware of that even the smallest actions you do and the likes you give online, can put you into a filter bubble? In our investigation of filter bubbles we use automated bots as our own test subjects. If you don’t know what a filter bubble is, read our first blog post to find out more (https://www.htogroup.org/2018/02/13/what-is-a-filter-bubble/). This Wednesday, 14th of March, we are speaking at the Women in Data Science conference in Stockholm about our work.

For the mission of creating filter bubbles we are using a large social media platform as our tool. A user of this platform has access to a flow of information. This flow is individualized for each user based on its actions and behavior on the platform. We are creating 14 unique accounts on this site, extremely similar to one another, with the exception of username, email and IP address. The purpose is to have the individualized flows exactly alike in the beginning. For each of the 14 accounts, we are creating a bot (total of 14 bots). A bot is an automated software, designed to click and use the website just like a human would. In this case, each bot is hitting a like-button for a certain type of information, a certain amount of times per day. This is simulating a real user’s actions on the site. The information that is liked by the bot, is uploaded to a storage on the cloud, that we are using to investigate the behavior, potentially leading up to a filter bubble.

In order to get the data from the individualized flow, we use a crawler. The crawler go through the individualized flow and save the important parts to a file which is then uploaded to the cloud. The data is later used to evaluate the content of the flow to establish whether the user is put in a filter bubble or not. To get a deeper understanding of filter bubbles and whether they can be harmful, we conduct a literature study as well.

Our names are Anna Normark and Rebecca Oskarsson. We are two master students in the IT engineering programme, currently working on our master thesis. Our thesis consists of investigating filter bubbles and their effects, and have the title “Individualizing Without Excluding: Ethical And Technical Challenges”. We are invited to write some blog posts here by our reviewer Åsa Cajander and this is our second part.

Åsa Cajander interviewed about our HTO hosted workshop at Uppsala Health Summit!

The HTO group is presently involved in many different activities and one of the latest additions to the list is a workshop at Uppsala Health Summit, which Åsa Cajander (main organizer), Christiane Grünloh and Jonas Moll are organizing. This workshop was introduced by Åsa in this blog post. The planning has continued since then and now we have a setup which will soon be available in the pre-conference report which will be posted on the summit web page. On this page you can also already find a short description of our workshop, “Using Data for Better Cancer Treatments”.

In February, Åsa was interviewed about our workshop! Among other things, she discusses some challenges regarding the use of data for diagnosis and treatment of cancer and how we will make use of critical incidents as points of departure in the workshop. You can read about the interview here!

The summit will be held at Uppsala Castle, June 14-15, and according to the recently published summit programme our three-hour workshop will be held during the second day. Organizing this workshop will surely be an interesting and rewarding experience for all of us and hopefully we will come up with results that will inspire further research in this important area!