Multidisciplinary Medical Team Meetings: An Analysis of Collaborative Working with Special Attention to Timing and Teleconferencing (original) (raw)
Related papers
An Analysis of the Dynamics of Multi-Disciplinary Medical Team Meetings and the Use of Communication Technology. Bridget Kane, Department of Computer Science, Trinity College Dublin. This analysis of multi-disciplinary medical team meetings (MDTMs) identifies elements, or mechanics, of collaboration among team members and proposes measures to enhance the proceedings and make the MDTM more effective. MDTMs are collaborative fora where healthcare specialists come together to discuss patient cases. The principle purpose of the MDTM is to establish a definitive diagnosis and determine the best treatment strategy for the patient. Here, the work of MDTMs is analysed both in its overall context of patient care and at the level of person-to-person interaction during a patient case discussion. This longitudinal study followed the development of a multidisciplinary medical team through a series of changes that incorporated the use of teleconferencing technology and a picture archive and communication system (PACS) into the proceedings. Analysis, based on qualitative and quantitative data, identifies the MDTM as a system that adds dependability to overall service delivery processes. Detailed analysis of screen displays and speech interactions, combined with observation data, are used to elucidate structures and analyse the dynamics of the MDTM. System boundaries are defined that extend beyond the actual duration of the meeting. Stable work routines, timing and rhythms, are shown to be critical for MDTM success. Changes in organisation structures associated with MDTMs, both positive and negative, are demonstrated as a result of the adoption of teleconferencing. Although the discussion structure is relatively stable in teleconference, the dynamics of speech interactions are affected and patient case discussions take more time as a result. Cases discussed in teleconference are less satisfactory from the users' perspective. However, there is a perceptible improvement in the quality of information exchanged at teleconferencing sessions. Case controlled study reveals a ‘doubling effect’ observed for participants who describe features in artefacts and for those who describe their professional approach (surgeons and radiation oncologist) in teleconference. Discussion around objects (artefacts) is most affected in teleconference. Examination of the use of video reveals an important requirement for the visual display of remote participants, that is not articulated in user surveys. The importance of increasing visual support for participants especially when the discussion involves image assessment and the exchange of professional opinion is highlighted. Visual needs are identified for both sides of the teleconference interface at MDTMs. Providing more control over audio, video and PACS would enhance teleconferences and image review. More control through personal devices is proposed to support interaction and increase participation. Furthermore, results suggest that having separate channels for tasks (pathology and radiology images) and person-to-person communication, by providing multiple displays, would make communication easier and save time. The display of radiological images is given special attention. With increasing complexity of imaging modalities, facilitating multiple views simultaneously is needed for satisfactory assessment. The internal temporal structure identified in PCDs prompts the investigation of novel technologies for the development of an MDTM record. These results have implications for the design of future systems and the implementation of new channels of communication within the health service.
Multidisciplinary medical team meetings
Proceedings of the 20th Australasian Conference on Computer-Human Interaction Designing for Habitus and Habitat - OZCHI '08, 2008
We present an observational study that was conducted to guide the design of an enhanced collaboration platform to support distributed multidisciplinary team meetings between two hospitals. Our goal was to find out how the breast cancer multidisciplinary team collaborates in their face-to-face meetings and in their discussions using an existing videoconferencing system and to identify obstacles and issues to their primary tasks. We identified a set of concerns around the way visibility and audibility affect the social cohesion of the group and impede communication and situation awareness between the distributed team. We also identified a parallel set of concerns around the difficulty of preparing and interacting around the medical images used in the meetings. These issues exposed a complex matrix of technical, social, procedural and organisational factors that affect the collaboration. We suggest potential directions for technical interventions in this setting.
Multidisciplinary medical team meetings: a field study of collaboration in health care
2008
Abstract We present an observational study that was conducted to guide the design of an enhanced collaboration platform to support distributed multidisciplinary team meetings between two hospitals. Our goal was to find out how the breast cancer multidisciplinary team collaborates in their face-to-face meetings and in their discussions using an existing video-conferencing system and to identify obstacles and issues to their primary tasks.
Assessing Support Requirements for Multidisciplinary Team Meetings
This paper profiles multidisciplinary team activity (MDT) in a typical teaching hospital setting and reports on a survey conducted among the teams to establish the information needs and constraints which affect their interaction. Support for pre-meeting work and post-meeting responsibilities is considered important in enabling the interaction at team meetings to be effective. Acoustics in the meeting room have higher priority over visual displays, although both ‘hearing the discussion’ and ‘seeing images and colleagues’ is important at meetings. Issues of time include scheduling and timing and are difficult to manage, particularly when individual roles belong to several MDTs and span more than one hospital. The potential is identified for automatic processing of some decisions by simple algorithm, which potentially will allow for more time at meetings to discuss complex patient cases in more detail.
Proceedings of the 2013 Chilean Conference on Human - Computer Interaction , 2013
Primary health care centers in the Chilean public system implement a family healthcare model with collaboration of several professional disciplines. This collaboration is often through multidisciplinary case analysis meetings, but it has a high cost for each treated case. In order to understand how collaboration is done and how technology supports it, we conducted a study in a healthcare center in Maipú, Chile. We found several problems regarding collaboration: a lack of awareness of the case status and the activities held by each of the professionals, and that the standard Electronic Medical Records System was not able to capture information about collaboration instances, making the awareness more difficult. To solve this, we propose a web-based system that allows the team to visualize the case status and track the cases in just one screen. We evaluated the relevance of this proposal through interviews with team leaders, who had positive opinions about it. Although our study has limitations, we conclude that the main requirements for collaboration in this context are the awareness that must exist about the activities of other team professionals and the possibility to see them at a glance. Future work will implement the proposal for an evaluation with a large number of users. Keywords Computer supported collaborative work (CSCW), collaborative systems, primary healthcare centers, multidisciplinary healthcare teams.
Assimilating information and offering a medical opinion in remote and co-located meetings
… -Based Medical Systems, 2009. CBMS 2009. …, 2009
Discussion on patient data, among hospital staff, plays an increasingly important role in inter-specialist communication. Effectiveness of a discussion depends, among other factors, on how well its participants perceive, assimilate and interpret information exchanged during a discussion. This paper reports a field study conducted to assess information assimilation among medical observer participants during PCDs in a hospital. Medically trained observer participants undertook a questionnaire at multi-disciplinary medical team meetings (MDTMs) in teleconference and colocated settings. Results show that participants are more likely to offer opinions in teleconference while their expectations on the long-term effects of treatment are more realistic in co-located PCDs than in teleconference PCDs. Surprisingly, the presentation of clinical findings, radiology and pathology is perceived to be clearer in teleconference, and respondents believe that they follow the discussion, know the patient management plan and understand the basis for decisions, better in teleconference than in colocated PCDs. While a higher educational value is attributed to teleconference PCDs, evidence suggests a trend to have more errors in teleconference, less critical evaluation and no expression of disagreement with patient management decisions made in teleconference.
How to Prevent Technical Issues in Large Multiparty Medical Videoconferencing
Journal of the International Society for Telemedicine and eHealth, 2013
Introduction: Videoconferencing (VC) is useful for physicians who need to learn about many cases without moving from one institution to another. However, this advantage can be hampered by technical issues. This study aims to analyse the factors relating technical support that cause technical issues in regular multiparty medical VC to provide high-quality VC to meet participants’ demands. Methods: The study includes large multiparty VC between the Kyushu University Hospital Department of Paediatric Surgery and different institutions within Japan that were held from September 2014 to January 2017. Technical tests, a “previous-week test” and a “last-hour test,” were conducted for checking conditions prior to the VC. The chi-square test was used for factors: participation for previous-week and last-hour test, and attendance by an engineer VCs in each participating institution. A questionnaire survey was distributed among the participants to collect feedback on the quality of VC, ease of...
Taking Lessons from Teleconference to improve same time same place interaction
Performance on an information gathering task is shown to be superior in teleconference. Analysis of errors in an exercise revealed the data sources used in co-located and teleconference scenarios. The use of a visual display for text data, in addition to the audio source, is demonstrated in both co-located and teleconference discussions. Audio was used as a source of information more frequently in teleconference which resulted in an overall improvement in task performance. The lesson learned from the higher performance in tele conference, can be applied to improve performance at co- located meetings. Providing appropriate visual data together within audio enhanced spaces can be expected to improve the communication event and reduce medical errors. Results support proposals for the incorporation of physical spaces to improve communication in everyday work in co-operative workplaces, such as hospitals.