Working in the HTO group for a week

My name is Edvin Cajander and I am 15 years old and come from 8th grade in Heby skola. I have been doing a work experience programme with the HTO group for one week.

I have updated the Project DOME page, including updating the pictures, some dates and information about the researchers. After that I updated the activities with some conference, presentations and meetings. I also worked on putting in some Journal papers and conference contributions and sorted them all out from the new at the top and the old ones at the bottom. When I was done with the Journal papers and the conference contributions I upgraded the Project DOME WordPress site to a subscription for 30 Skr a month, which gave me the ability to change the theme on the site and sorting everything out again.

Working as a Researcher was a tough ride with a lot of thinking trying to learn so much new thinks, at the start I felt like it would take years to do everything i was supposed to do but when I got into the instructions I ended up finishing all the things in a couple off hours. My Mother, Åsa Cajander, believed I would not finish everything in the length of my whole week, so she did not really believe me in that case. Then I got the other task to change the theme of the the project DOME site and I also finished that so now I am here got a new thing to do and write a blog about what I have done the last week.It felt like a very long week because I did so many new things and that was very exiting. It felt good doing something new this week and being around new people. I actually got stuck at my “missions” from mom and it actually was very fun working as a researcher.

 

 

Uppsala SciFest 2019

This is the second time visiting the Uppsala SciFest 2019, and it was an intense first day. School class after school class visited the booth in which I demonstrated the use of EEG-equipment as a simple Brain-Computer interface. The challenge is to focus your attention on one of two small circles on the screen in such a way that it starts to move. This is difficult since we are not used to using our brains in this way.

Full concentration, focusing on moving things on the screen, just by thinking hard.

However, after training for a couple of minutes, many of the visitors actually managed to make the desired circle move more than the circle not focused on. The problem is that it is not possible to describe how you do this since the learning is made in the brain, rather than as a conscious activity. This was a continuous source of slightly embarrassed comments: “I don’t know how I do it, but it just happens…!“. And that is a very good observation. This skill is actually very much like keeping the balance on a bicycle, you know when you get it right, but no one can tell you how to do it.

All in all, the first day at SciFest was a success, so I will just keep my fingers crossed that the rest of the SciFest will continue just as well, including on Saturday, when it is open to the public.

What could a digitalized primary healthcare look like in 2030? IT in Society Class of 2018 presenting at Vitalis

This years’ IT in Society Class got the task from Region Uppsala to look into primary care. Students in this class come from Uppsala University and the highly prestigious Rose-Hulman Institute of Technology. Anne Peters, Mats Daniels and Åsa Cajander are teachers in Uppsala, and Cary Laxer is the teacher in Indiana.

By the end of the semester they submitted an abstract to the peer-reviewed industry conference VITALIS – and they were accepted! The Vitalis conference is the leading eHealth conferences in the Nordic countries with more than 5000 participants who now have the opportunity to meet our students. See you at Vitalis!

Below is the abstract: 

What could a digitalized primary healthcare look like in 2030? This was the question addressed by a group of around 25 computer science students from Uppsala University and Rose-Hulman Institute of Technology in the US. To examine this question, they collaborated with healthcare professionals in Region Uppsala. In their semester long project, they researched the current primary healthcare system in order to find digitally related improvements that can impact how healthcare could look like in 2030. The research conducted is human-centered and seeks to define modernization methods that would improve the working situation for the medical professionals, as well as the patients’ experience. To grasp the current workflow in Region Uppsala we conducted a holistic overview from two perspectives: the patient perspective and the healthcare professional’s perspective. We found that the current primary care system has areas of improvement in the fields of User experience and Graphical User interfaces for computer systems that patients and staff members use. We also found that digitized self-assessment and triage is an area that can reduce the workload of the staff and enhance the patient experience.

Our research has also highlighted the need to find new digital tools and adapt the existing digital solutions to provide a better working environment for workers in primary care. This would imply moving away from “pen and papper” analog systems towards a more digitally integrated, cohesive system.

The suggestions that we provide in this presentation are based on sound scientific studies previously conducted and on extensive field interviews with more than 20 involved specialists and data gathering on the current system. We have also conducted two surveys in order to understand how patients feel in regards to the current primary care system and participated in observations to see how primary care professionals operate on a daily basis.

Some of the solutions we propose are:

– the smart, easy to use design of graphical interfaces that also adapt and learn the user’s behaviour to provide ease of access

– adding more real time alternatives to get in touch with medical professionals such as live chat messaging

– using wearable devices to monitor frequent patients’ clinical measurements

– modernizing the analog areas of the current system with the help of new technologies.

Looking forward into the future, we have ideas of how a future system could look like in 2030. The areas of improvement are relying on the continuous development of artificial intelligence and machine learning, all integrated to reiterate our objective: an efficient, human-centered primary care. We hope that these improvements would lead to a better medical system and change society for the better.

Three Key Note Speakers at the Next SuniWeb Conference

Join the HTO research group at the next SuniWeb Conference in Uppsala the 29 and 30th of April 2019! Three people from our research group will be keynote speakers.

All three researchers will be presenting on the 29th of April. First Diane Golay and Åsa Cajander will be talking in the morning about the latest research in the area of digitalisation and the work environment. This includes really interesting results from Diane Golay’s licentiate thesis related to invisible work and IT (from the DISA project). They will also touch upon fragmentation of time, changes in work tasks and the problems related to always being online.

Lars Oestreicher will be talking as the final keynote of the conference. His topic will be “How do you create communication systems for people with severe disabilities?”. In his talk, he will talk about web applications and non-excluding design.  In this way of doing design you focus on how to isolate the excluding factors already in the design process. He will also talk about his exciting research on young people with disabilities and music as a concrete example of to focus on abilities instead of disabilities.

Welcome to an International Summer School in User Centred Design and Health & Wellbeing in Finland

Welcome to an international course on interaction design!

This Nordplus funded class brings together practitioners, students, and teachers from Iceland, Finland, Estonia, Denmark, and Sweden to gain a higher level of digital literacy. The course provides the basic skills in user-centred, hands-on interaction design during two intensive weeks, including Google Design Sprint.

Experimental Interaction Design
29 July – 9 August, 2019
Aalto University, Finland (www.aalto.fi)

Applications deadline: 31 March
Acceptance notifications: 19 April
More information: https://blogs.aalto.fi/ixd19/

For questions, please contact:
Ilja Šmorgun, Lecturer of Interaction Design, Tallinn University ilja.smorgun@tlu.ee

Welcome!

How to separate the trees from the forest – The workplace as a Swiss army knife

Continuing on the “forests and trees” metaphor from a previous post we will now see what happens when you try to separate the trees from each other. So, let us start with one single tree (or task). One tree does not make a forest, but it can very easily be distinguished as a tree of a certain kind. A Pine tree has long needles; A fir tree has short needles. And a tree without needles is a leafy tree (unless it is a Gingko tree, but that is another story).  However, once there are more trees in a lump, the categorisation becomes more difficult. 

Transferred to the issue of work and tasks: As long as we are only doing one single task or having one single role, it is also quite simple to see and study it, and also (at least to some extent) to understand how it works, and what the consequences are. This is not to say that this kind of work is simple or uncomplicated, a heart transplant is a complicated task, even though it is a single task and well specified at that. We may also still make design mistakes on this single task design, but these kinds of mistakes are mostly confined to the task environment we work in at the moment. 

In a way, as long as we have many instances of the same type of single tasks that we can handle more or less sequentially, we are still proceeding through something, which in the forest metaphor is like a well-managed orchard with the same kind of trees planted spaciously and in neat rows. We can still handle the situation with the same kind of specialised tools, and the tools may also have an easier way to communicate with each other, e.g., using the same terminology, the same data formats etc. since they are designed for the same task.

Now, when we consider the work situation for nurses at a hospital ward explicitly, their situation is completely different. Their work more or less constitutes the very definition of “fragmented work tasks”. First, there is planned fragmentation, where the person has to change tasks or responsibilities according to a schedule. Second, there are interrupting tasks in terms of alarms, visiting relatives, telephone calls and other randomly occurring events that also cause a fragmented work situation. There is a related blog post by Åsa Cajander “On Digitalisation and Fragmentation of Time” about this phenomenon.  

The interruptions that occur over a work day can have at least two major effects on the nurse. He or she has to switch context for the work, which in itself is a stressing action for the brain. In the case of sudden intruding tasks, there is also the problem of mentally going back to the interrupted task and continue from where it was discontinued, sometimes after many hours. This situation becomes almost, again in the forest analogy, like looking at a primeval forest or a rainforest. There are trees everywhere and of every kind, and they are all interconnected in some ways. You need both stamina and focus in order to find your way through the forest/work. 

This becomes even more problematic when we look at the computer support for work tasks in any workplace. The general computer system is in many cases designed in the same way as a Swiss Army knife. We use the same technical framework for all the tasks that should be performed, using a keyboard, a mouse (or a mousepad) and a screen for the stationary tasks, and mobile apps, in the best case redesigned for the smaller screens of mobile devices, for the tasks that are done on the run. Journal entries, medication dosage calculations, and many planning tasks are therefore performed in the same limited cognitive space, and there is no real support for the switching between those tasks, nor for the fragmentation of the ongoing work. 

In some cases, like writing down the notes for the daily ward round, the information is even taken down as hand-written jots on a paper form and has to be transferred manually into the journal later. 

A Swiss army knife is not really perfect in any of its functions (even the knife blade leaves a lot to be desired), it still works, and someone who is not a carpenter, mechanic or plumber might even think it is a good and practical tool. But for any professional, if asked, they would definitely prefer to use a specialized tool. Apart from being more efficient, specialized tools also pose a lower risk of accidents and slips. In the same way, non-specialized computer tools may, even though they can perform the desired tasks, still not be the best choice in a complex work situation.

When we design new computer systems for organizations like hospital wards, schools, etc. they are often positioned around one task at a time. We study one tree at a time in the forest. Even though we are much better off than at the beginning of the PC era, when we could only run one program at a time, we are still running several parallel processes that interconnect badly, if at all. 

During the study visit at Akademiska in Uppsala last year (the university hospital in Uppsala), I found ten different systems used in one of the wards, all running on the “same computer”. This amounts to having ten tools on the Swiss army knife. Of course, the individual programs are in some way specialized. We don’t use spreadsheets for everything. Each separate task has applications or programs that are explicitly designed for its purpose but not for the whole entangled web of work tasks. Furthermore, the interaction design is often completely different in the different systems, which means that the user has to switch from interaction style to interaction style, and from command structure to command structure.

One example to indicate what I mean: the notes that are made for each patient during the ward rounds are almost always written by hand at the ward where  I visited. However, after the ward round they have to be entered manually into the system, which has the double effect that it might be a slow process, taking valuable time from the nurses, and that there is also a high risk of misreading numbers and hastily jotted down notes.

The paper notes are not integrated into the computer system. While we note this, we might realize that we could need a more automated solution (which may still need proof-reading and checking). In this new solution, it would be possible for the doctor on duty to write, still by hand, on a tablet that may offer character recognition. This would reduce the tiring process of transcribing the text, making it much easier and also leave more time for other, more important tasks. 

Now, this is, in my opinion, where one of the problems with the systems in the hospital resides. We are so focused on the design of the single system, that we forget all the small details that could make the whole work situation simpler and more manageable.  Add to that that we also forget to look at the small details that should incorporate such things as:

  • specially designed portable devices, that are designed for a single task, such as taking notes for the information rounds. 
  • the development of distinct, but consistent interfaces to all the subsystems.
  • ncorporating support for the interruptions that occur during a day. Why not a “what did I do last”- kind of function? 

The conclusion of this observation is that we need to look at a work situation from a holistic and a reductionistic perspective simultaneously when we are planning and designing the digitised work place, resulting in a well planned and easily manageable rain forest of work tasks.

A social event in celebration of our new financial system

At Uppsala University, the administrative system Raindance has been updated to a new version. The HTO-group is doing collaborative work in relation to this project (the EASY project). Last Thursday afternoon, the project celebrated that the implementation phase in now complete, by inviting the users to a network meeting. Approximately 100 users came to the meeting. From the HTO-group, Gunilla and Thomas went.

The afternoon started with information regarding the process as a whole: from the procurement phase until today. Edrun Eriksson (Head of the Ledger Office unit at the Financial Administration and Procurement Division) reminded the users of what expectations and hopes they had forwarded themselves, early on in the process. She gave us some illustrative examples. Furthermore, she had made a printout of the complete list, which was put up on the wall, so that all participants could read them later on during the afternoon. She also presented a summary of all sub groups and sub projects that have been active in the process. They were quite many! For meetings, she had just marked the amount with a question mark – being a bit over conscious regarding the great number of hours put into the project!

Edrun also took the opportunity to express a big “Thank you!” to all the people that have contributed with energy, experience, and time! It is nice for everyone to be reminded about the great effort that has been put into the project, and to hear of everything that is already achieved. Furthermore, the audience was asked a couple of questions with the aid of Menti.com and participants’ cell phones. The first question was “In what area are you presently in biggest need of support?” By choosing from given alternatives, the answers showed up in a pie chart. The other question was regarding ideas for future improvements, which was a free text question; so that the participants could write whatever answers they wanted.

The presentation then continued with a section where we (Gunilla and Thomas) got the chance to present ourselves to the audience. We, of course, have not met so many of all the users previously. We talked in general about IT artifacts, and of how people in an organization often experience them at times of changes. IT artifacts holds not only the technological dimension, but also a social dimension. It is OK to feel lost sometimes, and one needs to hear someone tell you this. 🙂 We ended our section by talking more specifically about the survey we are preparing to distribute to the users. The purpose of the survey is to evaluate some issues that can – hopefully! – be described as successes, and to point out some specific areas where users would like to see further improvements.

After us, we all got some information regarding the closing of the year 2018, presented by Hanna Mörtberg (newly appointed University Director of Finance at the University Management and Management Council). She showed us some comparative numbers from the years 2010 until today. The university is growing at an amazing speed and has now reached over a 7 billion turnaround!

Spirits were quite high when the presentations were over and we started on some nice snacks with a glass of bubbling refreshments. Anyone had the opportunity to write down whatever ideas they wanted to share about the project, on a writing wall that was positioned at the back of the room. Still, I believe people mostly wanted to chat with friends, have some good food, and just relax after a great job done! Overall, the afternoon was a well-spent time to mark the end of the implementation phase. Now, the system will continue to change over time, as any IT system would. It is a never-ending story.

Digitaliseringen och arbetsmiljön

Idag var det officiellt boksläpp för Digitaliseringen och arbetsmiljön, en bok som professor emeritus Bengt Sandblad författat tillsammans med sina kollegor. Medförfattare är Jan Gulliksen, Ann Lantz, Åke Walldius och Carl Åborg – alla kända namn inom just digitalisering och arbetsmiljö.

Bokens redaktör Jens Fredholm passade på att ställa lite frågor till författarna. Bengt Sandblad slog fast att de flesta problem är onödiga idag, kunskap finns om hur de ska lösas. Åke Walldius fyllde i med att verktygen ska stödja, inte störa men att samverkan mellan alla parter är viktigt. Ann Lantz pekade på ständiga förbättringar som en viktig strategi. Carl Åborg underströk att vi måste sträva mot ett hållbart arbetsliv, det är inte hållbart om en ökande mental belastning ska göra att människor blir sjukskrivna. Jan Guliksen avrundade med att peka på att läget ändå är annorlunda idag, ledningen brukar vilja ta ett ansvar och det finns många fantastiska digitala verktyg vi använder utan problem.

På en fråga från publiken hur man nu ska komma till rätta med alla dessa problem var svaret givet: läs boken.

Shut Up and Write!

Writing is one of our main tasks as researchers: we author papers, books or book chapters, grant applications, blog posts, newspaper articles, etc. for a broad range of different audiences. However, setting time aside for writing is rather challenging, as it is so easy to fill up our schedule with the variety of other assignments we need to accomplish: teaching, supervision, administrative work, data collection, reviewing other researchers’ publications or grants, and more. In the HTO group, we have thus implemented several strategies to help us write more and better.

Following in the footseps of some of our colleagues at Uppsala University (see article above taken from Uppsala University’s magazine, Universen), we are launching afternoon “Shut Up and Write!” sessions every last Tuesday of the month. The idea is simply to sit together and write – each person working in silence on her or his own project – for a few hours at a time. We sit in a meeting room instead of our usual offices to create a change of scenery and atmosphere. The session schedule – the length of each writing slot – is decided beforehand. For example, we might write for an hour to an hour and a half, and then take a break together, possibly with a little fika. Then we move to the next slot. Since it is very focused work, three writing slots in an afternoon can result in significant progress.

Writing retreats, consisting of one or two days of writing in a row, have also become a tradition in our research group. We then gather in Åsa Cajander’s house in the countryside, and sit together the whole day, enjoying fika toghether between writing slots. We wrap up the day with a shared dinner we prepare together, which is a really nice teambuilding activity. Such writing retreats are thus not only an opportunity to be really productive and reach our writing goals, but also to get to know each other in a different context, and to develop friendly working relationships. The discussions that arise throughout the day also give us insights into what others are working on, and can inspire and guide us in our own work. Although writing for several hours is very energy-consuming, I always come back from such writing retreats with renewed motivation and fresh ideas!

Writing sessions and writing retreats can sound over-the-top, but they have definitley been opportunities for very productive work for me. In my experience, getting into the habit of writing often, for a few hours at a time, makes it possible to improve one’s writing and to become a more efficient writer. When are you starting?

The Year 2018 in Review

In retrospect, 2018 was a great year for our research group. So, as we move on to 2019, here are some of the hilights for this year.

The year began with Thomas Lind doing one of his first –but definitely not last– presentations as a PhD, on the topic of IT implementations in health care.

Just after that, the new course on Complex IT Systems in Large Organizations started, with Diane Golay as one of the teachers. In the field of education there were of course also a number of interesting master thesis (such as this, this, this and this).

The second quarter saw Åsa Cajander earn the title excellent teacher but more importantly she also became full professor. You can still view her inauguration speech here (in Swedish). As if that was not enough Bengt Sandblad’s new book on the digital work environment was published – and our colleague Rebecca had her half time seminar.

During the summer Shweta Premanandan visited us once again and she got to experience the Swedish midsummer festivities. Minna Salminen Karlsson escaped the same festivities and instead joined the OAP workshop in the Netherlands.

Of course there were a number of other conferences and events attended by members of the HTO group (here or there). Gunilla Myreteg enjoyed a workshop arranged by Birgitta Wallgren at EPJ (the department for Electronic Patient Records). The HTO group also was responsible for a workshop at Uppsala Health Summit on the topic of Using Data for Better Cancer Treatments.

Much of the research efforts were related to the DISA project. Among many other things Ida Löscher reflected on the use of Work Domain Analysis and Lars Oestreicher shared some observations on cognitive workspace design.

We celebrated Jonas Moll as he concluded his PostDoc in Uppsala, two years and quite a few presentations and papers later. The year finally ended in high spirits when Christiane defended her thesis and became Dr Grünloh.

So, what do we have in store for 2019? More courses, more papers and more conferences of course. Perhaps we could also land a grant or two, to fill the gaps of those who have moved on to new positions. But we will no doubt continue to collaborate with our HTO alumni, in academia you can check out—but you can never leave.