Le Pubblicazioni

In this paper, we discuss the architecture of WOAD, a design-oriented framework that we proposed to enact a bottom-up and document-centered approach to the development of Electronic Patient Records. We provide the essential elements of WOAD: the concept of Active Document, Didget, Template and Mechanism. Then we summarize the observational studies that inspired its development and that gave the preliminary user feedback for its validation by means of the deployment of ProDoc, aWOAD-compliant patient record. We then illustrate the core implementation details of the WOAD architecture, as it has been deployed in ProDoc.

In this paper, we present WOAD, a framework that was inspired and partly validated within a two-year observational case study at a major teaching hospital. We present the WOAD framework by stating its main and motivating rationales, outlining its high-level architecture and then introducing its denotational language, LWOAD. We propose LWOAD to support users of an electronic document system in declaratively expressing, specifying and implementing content- and event-based mechanisms that fulfil coordinative requirements and make users aware of relevant conditions. Our focus addresses (a) the user-friendly and yet formal expression of local coordinative practices based on the work con­text; (b) the promotion of awareness of both these conventions and the context to enable actors to quickly respond; (c) the full deployment of coordination-oriented and context-aware functionalities into legacy electronic document systems. We give examples of LWOAD mechanisms taken from the case study and discuss their impact from the EUD perspective.

In this paper, we present an observational case study at a major teaching hospital, which both inspired and gave us valuable feedback
on the design and development of LWOAD. LWOAD is a denotational language we propose to support users of an electronic document system
in declaratively expressing, specifying and implementing computational mechanisms that fulfill coordinative requirements. Our focus addresses
(a) the user-friendly and formal expression of local coordinative practices; (b) the agile mocking-up of corresponding functionalities; (c) the
full deployment of coordination-oriented and context-aware behaviors into legacy electronic document systems. We give examples of LWOAD
mechanisms taken from the case study and discuss their impact for the EUD of coordinative functionalities.

The paper presents PRODOC, an Electronic Document System that allows users to navigate documental artifacts according to predefined process maps. In fact in PRODOC,
process models are to be considered as maps that users willingly take as guide for their decisions and actions, rather than scripts prescribed from above. The main tenet of this research is that, by integrating documents and processes, documental practices and related work practices could better align to intended models of action. The underlying concept is
the result of a long empirical research in the healthcare domain, where we have deployed PRODOC as an innovative and process-oriented Electronic Patient Record. The user participation in the phase of document definition and clinical processes modeling is central in our
approach and it is illustrated in three scenarios of the software informal validation that we present in this paper.

[ bib ]

The aim of the paper is twofold: i) understanding how to provide additional information that is reflective of current
organizational context in knowledge production and use; ii) proposing an architectural solution that can be applied to this need. To this aim, we introduce the concept of Active Knowledge Artifact (KA), i.e., an electronically augmented (i.e., active) artifact that puts together the archival
functions of artifacts belonging to organizational ISs with context- and content-aware functionalities to promote collaboration awareness and support knowledge management.
Through a case study in the hospital domain, we illustrate an approach where documents are augmented with information intended to support context interpretation and evoke
the knowledge that actors need to coordinate their actions in that context. The autonomous provision of Awareness Promoting Information (API) and Knowledge Evoking Information (KEI) by means of modular and reactive mechanisms embedded in each KA is what makes KAs active
computationally.

The paper discusses the conventions used by medical practitioners to improve their collaboration mediated by Clinical Records. The case study focuses on the coordinative
conventions identified in two wards of an Italian hospital and highlights their role and importance in the definition of the requirements of any system supportive of collaborative work practices.
These requirements are expressed in terms of the provision of artifact-mediated information that promotes collaboration awareness. The study identified several kinds of Awareness Promoting
Information (API): the paper discusses how they can be conveyed both in the web of documental artifacts constituting a Clinical Record and in its computer-based counterpart, the Electronic Patient
Record (EPR). The paper ends with the implications for the design of EPRs and for their integration with Hospital Information Systems in light of the findings.

The paper shows how the CASMAS modeling language, and its associated pervasive computing architecture, can be
used to facilitate continuity of care by providing members of patient-centered communities of care with a support to cooperation and
knowledge sharing through the usage of electronic documents and digital devices. We consider a scenario of clearly fragmented care to
show how proper mechanisms can be defined to facilitate a better integration of practices and information across heterogeneous care
networks. The scenario is declined in terms of architectural components and cooperation-oriented mechanisms that make the support
reactive to the evolution of the context where these communities operate.

[ bib ]

This paper discusses how Clinical Pathways (CPs) are defined, used and maintained in two hospital settings. A literature review and observational study are combined to illustrate the composite nature of CPs and the different roles they play in different phases of their life-cycle, with respect to the theme of bridging medical knowledge with the related practices by which physicians deal with a specific care problem. We take the case of the CP as a paradigmatic case to stress the urgent need for an integrated approach with the computer-based support of information and knowledge management in rapidly evolving cooperative work settings.

The paper shows how redundancy can be put at work to play a positive role in facilitating the cognitive and coordinative
tasks of clinicians in a ward setting. The main requirement to accomplish this positive function is to allow and support clinicians in annotating the clinical record and
making correlations between redundant data explicit. We report of an observational study we undertook in the design of coordination mechanisms based on a minimal set of
meaningful correlations.

The paper shows how a pervasive computing architecture, CASMAS, and its associated modeling language can be used to support cooperation
among the members of a patient-centered community of care and their digital devices, and how CASMAS can be augmented by theWOAD framework, which
was developed independently to model and express awareness mechanisms in document-mediated communities. Parts of these mechanisms can be modeled
on the basis of integrated care pathways taken from the medical specialist literature. We take the distributed hypertension monitoring case as an exemplifying
and sufficiently complex scenario to show the feasibility and advantages of the our semantically informed modular approach. The scenario is then declined in
terms of architectural components and cooperation-oriented mechanisms that are shared between the devices and entities of the designed community of care.

[ bib ]

In this paper, we present an ubiquitous and pervasive computing architecture, CASMAS, aimed at supporting cooperation among the members of a community and their devices. We also show how CASMAS can be
augmented by theWOAD framework, which was developed independently to model and express coordination mechanisms in document-mediated communities. We take the distributed hypertension monitoring case as
an exemplifying and sufficiently complex scenario to show the feasibility and advantages of the our semantically informed modular approach. The scenario is then declined in terms of architectural components and
cooperation-oriented mechanisms that are shared between the devices and entities of the designed community of care.

In this paper we consider the role of standards as a means for enabling interoperability among members of different communities. A
critical issue raises when local customizations of standards are used as standards. If this occurs, standards are no more able to guarantee the
needed support to interoperability. To overcome this problem we propose a solution aiming at making members of different facilities aware of the
changes occurred locally in a standard. We claim that this awareness is able to facilitate different people in the process of aligning the local
standards with the standards. An example from the healthcare domain is given, when two communities of practitioners are involved in the care of the same patient.

A wide literature illustrates how collaborative awareness improves process coordination in distributed work settings. The paper discusses
this theme in the light of distributed care when supported by Integrated Care Pathways. The latter can be used as relevant source of information to propagate this kind of awareness information. The paper
shows on a reference scenario how the CASMAS model can support the design of collaborative applications by focusing on awareness promotion:
this can be fostered and modulated to reduce information overflow by using specific features of the model.

[ bib ]

[ bib ]

Clinical Pathways (CPs) are artifacts that clinicians are increasingly introducing in their practices in order to deal with health problems in the most effective, efficient and agreed
way. As a result of an observational study at a Neonatology Intensive Care Unit, we found that most CPs are still paper-based. Although perceived useful even on paper, the physicians advocated a system integrating CPs with the clinical
record. Based on their requirements, we present a proposal on how to conceive a computational system that can promote awareness in order to achieve better coordination and
committed inclusion of pathways in daily clinical practice.

This paper focuses on clinical pathways, a tool that physicians are introducing to support the management of patients’ illness trajectories. We undertook a six
months long observational study in an intensive care unit of an important Italian teaching hospital and we acknowledged with physicians the importance of relying on
well-agreed and properly defined clinical pathways in daily care practice. As a result of this study, we propose a roadmap on how to participatorily design a computer-based
system supporting practitioners’ decisions on the basis of the integration between clinical data and the indications reported in clinical pathways.

In this paper, we concentrate on how conventions among practitioners are put at work for the sake of cooperation in those work settings where coordination is mediated
at a large extent by complex webs of documental artifacts. Our case study focuses on coordinative conventions exhibited in the hospital domain and mediated by compound
patient records. We conceive of the provision of document-mediated awareness information as a ''learning device'' by which these conventions can be made explicit in all
those situations where practitioners need support in coping with and solving cooperative problems in the articulation of their activities. To enable such a context-dependent and
user-centered provision of awareness, we also present and outline the WOAD framework that provides users and designers with a conceptual model and language aimed at
facilitating the construction of a convention- and collaboration-aware layer on top of traditional architectures of electronic documental systems. To this aim, we take the case
of the Electronic Patient Record (EPR) as paradigmatic.

[ bib ]

[ bib ]

[ bib ]

The paper proposes quality standards in domains such as healtcare as a common theme between Computer Supported Cooperative Work (CSCW) and the Information Systems (IS) researchers. Their
complementary objectives and research approaches could provide a comprehensive solution to the apparently incompatible requirements. The paper proposes quality standards in domains such as
healtcare as a common theme between Computer Supported Cooperative Work (CSCW) and the Information Systems (IS) researchers. Their complementary objectives and research approaches could
provide a comprehensive solution to the apparently incompatible requirements. The paper proposes quality standards in domains such as healtcare as a common theme between Computer Supported
Cooperative Work (CSCW) and the Information Systems (IS) researchers. Their complementary objectives and research approaches could provide a comprehensive solution to the apparently
incompatible requirements. The paper proposes quality standards in domains such as healtcare as a common theme between Computer Supported Cooperative Work (CSCW) and the Information Systems
(IS) researchers. Their complementary objectives and research approaches could provide a comprehensive solution to the apparently incompatible requirements. The paper proposes quality
standards in domains such as healtcare as a common theme between Computer Supported Cooperative Work (CSCW) and the Information Systems (IS) researchers. Their complementary
objectives and research approaches could provide a comprehensive solution to the apparently incompatible requirements.

In this paper we present Torres, a conceptual framework that supports people belonging to different groups to articulate their activities. Our work is
based on observations of how healthcare practitioners manage the interactions occurring when the patients’ care crosses the borders of a healthcare facility. On
the basis of previous works on reconciliation and of our observations, we aim to provide a framework to understand these interactions and to computationally
support them so to convey the local knowledge needed both to guarantee the continuity of care and to promote the articulation of the related activities.

[ bib |
http ]

The paper discusses the role of redundancy in hospital ward work on the basis of a field study that focuses on the use of paper artifacts supporting healthcare and its coordination. On the basis of literature and direct observations, we identified different kinds of redundancy, i.e. redundancy of effort, functions and data. Hence, we analyzed how these different forms of redundancy may affect each other and the coordination inside hospital wards. Redundancy plays a positive or negative role depending on various circumstances. This twofold nature defines different requirements for a technology to support healthcare and ward work by preserving practices linked to paper-based artifacts and by unobtrusively augmenting them with computational capabilities.

[]

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.