UNRUH AND PRATT

Question 1

Although we see the results of patients’ work (e.g., medication taken, arrived at appointment) we do not see the work itself.

-due to fragmented and pooly coordinated care
-include interpreting various medical info, advice, logistcis of care (scheudling an medication), not recorded, not supported

Answer 1

invisible/background work

Question 2

To be informed participants in distributed care contexts, patients require information about their evolving health status vis-à-vis their specific cancer care trajectory. In our study, patients struggled to obtain information about their current health situation, a concept we call ______
-deficit of this cause patients experienced knowledge deficits that inhibited their ability to understand their health situation. Patients responded in ways that drained staff resources and created institutional inefficiencies at the treatment center.

Answer 2

state awareness

Question 3

bridging inter-institutional care

Answer 3

A key task for patients who receive care at multiple treatment centers
-This work is particularly important for patients who live away from large urban centers and thus lack access to cancer centers with cutting edge research and clinical care. Such patients regularly receive some care at cancer centers with follow-up at local institutions. However, these patients must work to maintain continuity of care between different institutions.
3 barriers: (1) variation in operation procedures (2) patient lack rodecural information to manage these variations in care(3) inefficient communication (ex: Nancy drain stays in chest)

Question 4

CIS

Answer 4

common information spaces
-How can we support cooperation through design? Researchers in the field of CSCW note that cooperation of actors distributed in time and space requires: (1) “the active construction by the participants of a common information space where the meanings of the shared objects are debated and resolved (Schmidt and Bannon 1992:27)” and (2) [that] both the producer and the receiver [of information] consciously make an effort to understand each other’s context - of production and use, so that even though the efforts may be distributed over time and space, there is a form of communication, of ‘putting in common’, going on in [cooperative] activity
-shared platform where all info about patients care is available to both patients and all their healthcare providers

Question 5

Explicit Representations/Interactions

Answer 5

In these examples, the CIS provides two critical services that remain poorly supported in the current cancer-care environment. First, the CIS facilitates cooperation through explicit representations constructed by either the patient or their clinician. In the current cancer-care environment, patients and clinicians rely on heavily on oral communication to communicate their respective views on the patients’ evolving health situation. Second, the CIS facilitates cooperation through interaction by allowing both the patients and their clinicians to develop shared understandings of each others’ needs and perspectives through iterative refinement of these representations.

Question 6

Clinical Recommendations and (Invisible) Justifications (Donna)

Answer 6

Patients like Donna illustrate how patients lack resources to resolve inconsistent recommendations. First, patients lack explicit justifications for clinical recommendations. Without evidence to contextualize the recommendation (e.g., research studies, institutional protocols, and diagnostic results), patients cannot evaluate individual recommendations. In this example, Donna appeared to receive only partial justification for the respective decisions and these justifications came predominately in oral form. For example, without explicit access to her pathology report or the specific study cited during the consultation, Donna could not understand the specific details the local radiation oncologist used to justify her recommendation