Cyber-physical systems have been deployed with considerable success in many industries. However, the implementation of cyber-physical systems in hospitals has been limited. By nature, in clinical operations, patient safety and consideration for health outcomes are of the utmost importance, thus possibly slowing the implementation of innovative solutions with limited history. Revenues from operating room (OR) time and surgery account for about 50% of the income of major hospitals (Erdogan et al. 2011; Cuschieri 2006), but the efficiency of OR utilization is often reported to be relatively low. Therefore, improving OR management with a cyber-physical system should be a priority. In this article, we will report on our experience implementing a cyber-physical system at Houston Methodist Hospital and discuss some of the difficulties and potential drivers for success. Our pilot study was done in the context of the management of a large suite of ORs. It uses the agile codevelopment of a cyber-physical system through an intense collaboration of clinicians and computational scientists. While technology remains the foundation of a cyber-physical system, this experience reinforced that the human factor is an important driving force behind the design that promotes user acceptance.

Collaboration is key to safety and efficiency in Air Traffic Control. Legacy paper-based systems enable seamless and non-verbal collaboration, but trends in new software and hardware for ATC tend to separate controllers more and more, which hinders collaboration. This paper presents a new interactive system designed to support collaboration in ATC. We ran a series of interviews and workshops to identify collaborative situations in ATC. From this analysis, we derived a set of requirements to support collaboration: support mutual awareness, communication and coordination, dynamic task allocation and simultaneous use with more than two people. We designed a set of new interactive tools to fulfill the requirements, by using a multiuser tabletop surface, appropriate feedthrough, and reified and partially-accomplishable actions. Preliminary evaluation shows that feedthrough is important, users benefit from a number of tools to communicate and coordinate their actions, and the tabletop is actually usable by three people both in tightly coupled tasks and parallel, individual activities. At a higher level, we also found that co-location is not enough to generate mutual awareness if users are not engaged in realistic tasks.

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Requirements Engineering plays a crucial role in coordinating the different stakeholders needed for safe aeronautics systems engineering. We conducted a qualitative study, using interviews and mockups, with fifteen industrial practitioners from four aeronautics companies, to investigate what tasks are actually performed by requirements engineers and how current tools support these tasks. We found that RE-specific tools constrain engineers to a rigid workflow, which is conflicting with the adaptive exploration of the problem. Engineers often start by using general-purpose tools to foster exploration and collaborative work with suppliers, at the expense of traceability. When engineers shift to requirements refinement and verification, they must use RE-specific tools to grant traceability. Then, the lack of tool usability yields significant time loss and dissatisfaction. Based on scenarios of observed RE practices and walkthrough, we formulate usability insights for RE-specific tools to conciliate flexibility and traceability throughout the RE process.

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