LAB-IN-A-BOX: semi-automatic tracking of activity in the medical office

Abstract

Patient-centered healthcare and increased efficiency are major goals of modern medicine, and physicianpatient interaction and communication are a cornerstone of clinical encounters. The introduction of the electronic health record (EHR) has been a key component in shaping not only organization, clinical workflow and ultimately physicians' clinical decision making, but also patientphysician communication in the medical office. In order to inform the design of future EHR interfaces and assess their impact on patient-centered healthcare, designers and researchers must understand the multimodal nature of the complex physician-patient-EHR system interaction. However, characterizing multimodal activity is difficult and expensive, often requiring manual coding of hours of video data. We present our Lab-in-a-Box solution that enables the capture of multimodal activity in real-world settings. We focus here on the medical office where our Lab-in-a-Box system exploits a range of sensors to track computer-based activity, speech interaction, visual attention and body movements, and automatically synchronize and segment this data. The fusion of multiple sensors allows us to derive initial activity segmentation and to visualize it for further interactive analysis. By empowering researchers with cutting-edge data collection tools and accelerating analysis of multimodal activity in the medical office, our Lab-in-a-Box has the potential to uncover important insights and inform the next generation of Health IT systems.

Eyes on the Clinic: Accelerating Meaningful Interface Analysis through Unobtrusive Eye Tracking

“…Lastly, by exploiting sensor data fusion, as enabled by our infrastructure [10], eye activity data could be aligned alongside other streams. To aid in our endeavor to better understand EMR system use and interface design through eye tracking, we therefore merged the eye movement data with the context of the activity performed on the computer and connected eye movements with patient care activities.…”

“…RESEARCH ENVIRONMENT To track visual attention and eye activity in the clinic, and specifically to be able to investigate how eye tracking is associated with the usage of EMRs, we leverage a remote eye tracking device, the SMI RED-m, 2 and we integrate it within an extensive infrastructure for multi-modal data collection [10]. The small device is configured to collect data at a rate of 120 Hz, and is mounted unobtrusively beneath the primary monitor of the physician's desktop computer as shown in Fig.…”

“…It aims to build quantifiable profiles of EMR use within clinical settings through the application of easily deployable sensor technologies in real-world settings [10]. By combining these data with clinical context, we aim to better understand the consequences of how EMR use affects the communication and work flow of physicians.…”

TeMoCo: A Visualization Tool for Temporal Analysis of Multi-party Dialogues in Clinical Settings

“…The Lab-in-a-box system [9] uses sensors (3D camera, eye tracking, computer activity) to track the clinician's workflow during a medical consultation. The collected data are presented as events along a timeline representing the consultation.…”

Using telephony data to facilitate discovery of clinical workflows

“…This challenge becomes evident when hospitals embark on "Six Sigma" or "Lean" re-engineering efforts and struggle to discover their current processes by asking their employees to manually identify workflow inefficiencies [26,27]. Instrumented workflow discovery tools such as RFID tagging and saccadic eye-movement tracking have had limited success here [28][29][30].…”