Supporting Wards with Interactive Resources and Logic-based Systems

In this position paper we outline the visions of the SWIRLS project, focusing on the aspects more closely related to ubiquitous computing. In order to support practitioners in coordinating care-giving in hospital wards without disrupting the practices they have established within their work, we present a solution that augments the natural interaction with pre-printed paper-based forms through context-adaptivity of situated whiteboards. Information flows coming from these heterogeneous artifacts are elaborated by a rule-based layer in order to provide practitioners with awareness information on the status of work. 1 Visions in Ubiquitous Hospital Ward Support Our research is based on literature regarding observations of real practices that workers have established in order to deal with the complexity of coordination [1] [2] [3] [4] [5]. The majority of these practices involve at various degrees the use of artifacts that for historical reasons and for convenience of means are paper-based. Information Technology has till now tried to provide support to these practices by substituting the paper artifacts with digital counterparts. These endeavors seem to underestimate the pivotal role and often implicit value of paper affordances. On the contrary, we consider a benefit not to change the way users interact with traditional artifacts. This opinion relies also on studies that reveal how critical is the hospital domain about the introduction of technologies that could disrupt work practices consolidated in years: people tend to react either not using the digital counterparts or limiting their use so that their actual utility can be questioned [6] [7]. We are focusing on technologies that enable the design of systems that can involve traditional artifacts almost unchanged but augmented by computation. In fact we also think that digital enhancement is a feasible way to support coordination, either by improving performances of tools that deal directly with it or by enabling reliable communication among actors. In particular, in domains characterized by mobility and spread of involved actors, like hospital healthcare is, computation can provide artifacts with context-adaptivity and can also make information spanning across heterogeneous and distributed actors possible. Computation can thus enable a support that can fast align to actors needs and follow them to be ready-at-hand wherever and whenever they need it: in other words computation can enable ubiquitous support. From the Weiser seminal definition [8], we stress the vision of an ubiquitous computing where the information is depending on context, available throughout the physical environment and where computation on this information is effectively invisible to the user. Ubiquity can be achieved not necessarily by scattering digital devices in the environment but rather by strengthening relationships among the heterogeneous artifacts spread in the work-setting and by linking and correlating the various information they objectify. Ubiquity can then be seen as an emerging property of the overall system regarding high level functionalities. Therefore we conceive a system that is ubiquitous in the sense that it facilitates the sharing throughout the work-setting of information regarding work status and planned activities and makes computation invisible. Such a system thus aims at facilitating an information flow that promotes awareness about the status of work in a coherent way. Involved artifacts can also be seen as a “web of artifacts” [9]; by which we mean to stress that any node of this net may influence all other nodes at some extent while carrying within itself the twofold and primary goal it has been designed for: accumulating inscriptions and coordinating activities [10]. This paper presents an application of ubiquitous computing aiming to support practitioners in caregiving process within hospital wards. Our web of artifacts encompasses some of the most common resources practitioners use in their ward practices: pre-printed paper forms where data are annotated by actors during their everyday work, and wall-mounted whiteboards where information about planned activities and status of the work is displayed and hence shared by all practitioners. The formers represent a highly flexible, convenient and mobile support to assigning and reporting activities; the latter ones provide actors with a highly interactive and timely support. This application will be illustrated in the following by describing the current work concerning the SWIRLS (Supporting Wards with Interactive Resources and Logic-Based Systems) project.