Wearable sensing devices, such as Holter monitors, will play a crucial role in the future of digital health. Unsupervised learning frameworks such as Self-Supervised Learning (SSL) are essential to map these single-lead electrocardiogram (ECG) signals with their anticipated clinical outcomes. These signals are characterized by a tempo-variant component whose patterns evolve through the recording and an invariant component with patterns that remain unchanged. However, existing SSL methods only drive the model to encode the invariant attributes, leading the model to neglect tempo-variant information which reflects subject-state changes through time. In this paper, we present Parallel-Learning of Invariant and Tempo-variant Attributes (PLITA), a novel SSL method designed for capturing both invariant and tempo-variant ECG attributes. The latter are captured by mandating closer representations in space for closer inputs on time. We evaluate both the capability of the method to learn the attributes of these two distinct kinds, as well as PLITA ’s performance compared to existing SSL methods for ECG analysis. PLITA performs significantly better in the set-ups where tempo-variant attributes play a major role.

To investigate the contextual and temporal distribution of false positives (FPs) in a state-of-the-art deep learning (DL)-based atrial fibrillation (AF) detection algorithm when applied to an electrocardiogram (ECG) dataset collected under free-living ambulatory conditions. We hypothesize that under such conditions, the FPs detected by a DL model might have some correlations with the patient’s ambulatory contexts. First, a DL model is trained and evaluated on three public arrhythmia datasets from PhysioNet. It is ensured that the model has state-of-the-art performance on these public datasets. Thereafter, the same model is applied to a 215-days long contextualized single-channel ECG dataset collected under free-living ambulatory conditions. Through a manual examination of the model’s output, ground truth is obtained and the correlations between the patient’s ambulatory contexts and the true/false positive rate are analyzed. Nearly 62% of the segments marked as AF by the model were ≤50 seconds in length, and 99.9% of them were FPs. Among these non-trivial short segments of FPs, almost 78% were mainly associated with three specific contextual events; change in activity, change in body position (especially during the night), and sudden movement acceleration. Moreover, the number of FPs detected by the DL model are higher in female than in male participants. Finally, true positive (TP) AF segments are found more in the morning and late evening. These findings may have significant implications for the current use and future design of DL models for AF detection, and help understand the role of context information in reducing the FP rate in real-time AF detection under free-living conditions.

Type 2 diabetes (T2D) is a large disease burden worldwide and represents an increasing and complex challenge for all societies. For the individual, T2D is a complex, multi-dimensional, and long-term challenge to manage, and it is challenging to establish and maintain good communication between the patient and healthcare professionals. This article presents DiaFocus, which is a mobile health sensing application for long-term ambulatory management of T2D. DiaFocus supports an adaptive collection of physiological, behavioral, and contextual data in combination with ecological assessments of psycho-social factors. This data is used for improving patient-clinician communication during consultations. DiaFocus is built using a generic data collection framework for mobile and wearable sensing and is highly extensible and customizable. We deployed DiaFocus in a 6-week feasibility study involving 12 patients with T2D. The patients found the DiaFocus approach and system useful and usable for diabetes management. Most patients would use such a system, if available as part of their treatment. Analysis of the collected data shows that mobile sensing is feasible for longitudinal ambulatory assessment of T2D, and helped identify the most appropriate target users being early diagnosed and technically literate T2D patients.

Ethical deliberation has proved a consistent feature of Human-Computer Interaction (HCI) since its earliest years, spanning the respectful involvement of research participants to design choices impacting fairness, freedom and welfare. Despite growing discussions, applied knowledge and practical approaches for navigating complex moral dilemmas remain challenging to grasp. Motivated by the need for a structured overview, this paper contributes a scoping review of ethics as discussed across 129 full-length SIGCHI papers containing the search term ‘ethic*’ in their title, abstract or authors’ keywords over the last ten years. Findings show increasing prioritisation of the topic, particularly within Artificial Intelligence. Value-Sensitive and Critical Design appear as the most frequently applied orientations, and participatory approaches are more prevalent than those without end-user input. Engaging with a spectrum from personal to societal concerns, the SIGCHI literature thus echos calls for critical perspectives on user-centred processes and the need to establish more sustainable responsibility structures.

This article presents the design, technical implementation, and feasibility evaluation of mCardia —a context-aware, mobile electrocardiogram (ECG) collection system for longitudinal arrhythmia screening under free-living conditions. Along with ECG, mCardia also records active and passive contextual data, including patient-reported symptoms and physical activity. This contextual data can provide a more accurate understanding of what happens before, during, and after an arrhythmia event, thereby providing additional information in the diagnosis of arrhythmia. By using a plugin-based architecture for ECG and contextual sensing, mCardia is device-agnostic and can integrate with various wireless ECG devices and supports cross-platform deployment. We deployed the mCardia system in a feasibility study involving 24 patients who used the system over a two-week period. During the study, we observed high patient acceptance and compliance with a satisfactory yield of collected ECG and contextual data. The results demonstrate the high usability and feasibility of mCardia for longitudinal ambulatory monitoring under free-living conditions. The article also reports from two clinical cases, which demonstrate how a cardiologist can utilize the collected contextual data to improve the accuracy of arrhythmia analysis. Finally, the article discusses the lessons learned and the challenges found in the mCardia design and the feasibility study.

The growing commercial success of smart speaker devices following recent advancements in speech recognition technology has surfaced new opportunities for collecting self-reported health and well-being data. Speech-enabled conversational agents (CAs) in particular, deployed in home environments using just such systems, may offer increasingly intuitive and engaging means of self-report. To date, however, few real-world studies have examined users’ experiences of engaging in the self-report of mental health using such devices or the challenges of deploying these systems in the home context. With these aims in mind, this article recounts findings from a 4-week “in-the-wild” study during which 20 individuals with depression or bipolar disorder used a speech-enabled CA named “Sofia” to maintain a daily diary log, responding also to the World Health Organization–Five Well-Being Index WHO-5 scale every 2 weeks. Thematic analysis of post-study interviews highlights actions taken by participants to overcome CAs’ limitations, diverse personifications of a speech-enabled agent, and unique forms of valuing of this system among users’ personal and social circles. These findings serve as initial evidence for the potential of CAs to support the self-report of mental health and well-being, while highlighting the need to address outstanding technical limitations in addition to design challenges of conversational pattern matching, filling unmet interpersonal gaps, and the use of self-report CAs in the at-home social context. Based on these insights, we discuss implications for the future design of CAs to support the self-report of mental health and well-being.

With the widespread use of smartphones and wearable health sensors, a plethora of mobile health (mHealth) applications to track well-being, run human behavioral studies, and clinical trials have emerged in recent years. However, the design, development, and deployment of mHealth applications is challenging in many ways. To address these challenges, several generic mobile sensing frameworks have been researched in the past decade. Such frameworks assist developers and researchers in reducing the complexity, time, and cost required to build and deploy health-sensing applications. The main goal of this article is to provide the reader with an overview of the state-of-the-art of health-focused generic mobile and wearable sensing frameworks. This review gives a detailed analysis of functional and non-functional features of existing frameworks, the health studies they were used in, and the stakeholders they support. Additionally, we also analyze the historical evolution, uptake, and maintenance after the initial release. Based on this analysis, we suggest new features and opportunities for future generic mHealth sensing frameworks.

Behavioral Activation (BA)therapy has shown to be effective in treating depression. Recommending healthy activities is a core principle in Behavioral Activation (BA), which is typically done by the therapist. However, most BA smartphone applications do not recommend specific activities. This article reports quantitative results from an 8-week feasibility study of a previously presented smartphone-based BA recommender system. The system supports the planning and enacting of pleasurable activities and promotes activation of diverse activity types. Enrollment included 43 clinically depressed patients who installed the system on their phone and initiated activity scheduling. Twenty-nine patients used the system daily for more than a week.These patients presented a significant reduction in depressive symptoms during the study period. They displayed a more personalized usage approach and created recurring health goals comprising of their own customized activities. Furthermore, they took inspiration within various types of activities, thereby displaying more activity diversity. This study suggests that enacting a diverse mixture of activities that promote good sleep, personal hygiene, exercise, social contact, and leisure time can be essential in managing depressive symptoms. A smartphone-based activity recommender system can help patients achieve this.

Depression is a leading cause of disability worldwide, which has inspired the design of mobile health (mHealth) applications for disease monitoring, prediction, and diagnosis. Less mHealth research has, however, focused on the treatment of depressive disorders. Clinical evidence shows that depressive symptoms can be reduced through a behavior change method known as Behavioral Activation (BA). This paper presents MUBS; a smartphone-based system for BA, which specifically contributes a personalized content-based activity recommendation model using a unique list of validated activities. An 8-week feasibility study with 17 depressive patients provided detailed insight into how MUBS provided inspiration and motivation for planning and engaging in more pleasant activities, thereby facilitating the core components of BA. Based on this study, the paper discusses how recommender technology can be used in the design of mHealth technology for BA.

This article proposes the concept of Collaborative Affordances to describe physical and digital properties (i.e., affordances) of an artifact, which affords coordination and collaboration in work. Collaborative Affordances build directly on Gibson (1977)’s affordance concept and extends the work by Sellen and Harper ( 2003 ) on the affordances of physical paper. Sellen and Harper describe how the physical properties of paper affords easy reading, navigation, mark-up, and writing, but focuses, we argue, mainly on individual use of paper and digital technology. As an extension to this, Collaborative Affordances focusses on the properties of physical and digital artifacts that affords collaborative activities. We apply the concept of Collaborative Affordances to the study of paper-based and electronic patient records in hospitals and detail how they afford collaboration through four types of Collaborative Affordances; being portable across patient wards and the entire hospital, by providing collocated access , by providing a shared overview of medical data, and by giving clinicians ways to maintain mutual awareness . We then discuss how the concept of Collaborative Affordances can be used in the design of new technology by providing a design study of a ‘Hybrid Patient Record’ (HyPR), which is designed to seamlessly blend and integrate paper-based with electronic patient records.

The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the HyPR in a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work.

Assessing the presence and availability of a remote colleague is key in coordination in global software development but is not easily done using existing computer-mediated channels. Previous research has shown that automated estimation of interruptibility is feasible and can achieve a precision closer to, or even better than, human judgment. However, existing approaches to assess interruptibility have been designed to rely on external sensors. In this paper, we present Approximator, a system that estimates the interruptibility of a user based exclusively on the sensing ability of commodity laptops. Experimental results show that the information aggregated from several activity monitors (i.e., Key-logger, mouse-logger, and face-detection) provide useful data, which, once combined with machine learning techniques, can automatically estimate the interruptibility of users with a 78% accuracy. These early but promising results represent a starting point for designing tools with support for interruptibility capable of improving distributed awareness and cooperation to be used in global software development.

Companies are increasingly organizing work in globally distributed teams. A core challenge to these distributed teams is, however, to maintain social relationships due to limited opportunities and tools for social engagement. In this paper we present SideBar: a videoconferencing system that enhance

Prior studies show that knowledge work is characterized by highly interlinked practices, including task, file and window management. However, existing personal information management tools primarily focus on a limited subset of knowledge work, forcing users to perform additional manual configuration work to integrate the different tools they use. In order to understand tool usage, we review literature on how users' activities are created and evolve over time as part of knowledge worker practices. From this we derive the activity life cycle, a conceptual framework describing the different states and transitions of an activity. The life cycle is used to inform the design of Laevo, a temporal activity-centric desktop interface for personal knowledge work. Laevo allows users to structure work within dedicated workspaces, managed on a timeline. Through a centralized notification system which doubles as a to-do list, incoming interruptions can be handled. Our field study indicates how highlighting the temporal nature of activities results in lightweight scalable activity management, while making users more aware about their ongoing and planned work.

An increasing number of pervasive healthcare systems are being designed, that allow people to monitor and get feedback on their health and wellness. To address the challenges of self-management of mental illnesses, we have developed the MONARCA system - a personal monitoring system for bipolar patients. We conducted a 14 week field trial in which 12 patients used the system, and we report findings focusing on their experiences. The results were positive; compared to using paper-based forms, the adherence to self-assessment improved; the system was considered very easy to use; and the perceived usefulness of the system was high. Based on this study, the paper discusses three HCI questions related to the design of personal health technologies; how to design for disease awareness and self-treatment, how to ensure adherence to personal health technologies, and the roles of different types of technology platforms.

Modern knowledge work consists of both individual and highly collaborative activities that are typically composed of a number of configuration, coordination and articulation processes. The desktop interface today, however, provides very little support for these processes and rather forces knowledge workers to adapt to the technology. We introduce co-Activity Manager, an activity-centric desktop system that (i) provides tools for ad hoc dynamic configuration of a desktop working context, (ii) supports both explicit and implicit articulation of ongoing work through a built-in collaboration manager and (iii) provides the means to coordinate and share working context with other users and devices. In this paper, we discuss the activity theory informed design of co-Activity Manager and report on a 14 day field deployment in a multi-disciplinary software development team. The study showed that the activity-centric workspace supports different individual and collaborative work configuration practices and that activity-centric collaboration is a two-phase process consisting of an activity sharing and per-activity coordination phase.

There is a growing interest in personal health technologies that sample behavioral data from a patient and visualize this data back to the patient for increased health awareness. However, a core challenge for patients is often to understand the connection between specific behaviors and health, i.e. to go beyond health awareness to disease insight. This paper presents MONARCA 2.0, which records subjective and objective data from patients suffering from bipolar disorder, processes this, and informs both the patient and clinicians on the importance of the different data items according to the patient's mood. The goal is to provide patients with a increased insight into the parameters influencing the nature of their disease. The paper describes the user-centered design and the technical implementation of the system, as well as findings from an initial field deployment.

Distributed interaction is a computing paradigm in which the interaction with a computer system is distributed over multiple devices, users and locations. Designing and developing distributed interaction systems is intrinsically difficult as it requires the engineering of a stable infrastructure to support the actual system and user interface. As an approach to this re-engineering problem, we introduce NooSphere, an activity-centric infrastructure and programming framework that provides a set of fundamental distributed services that enables quick development and deployment of distributed interactive systems. In this paper, we describe the requirements, design and implementation of NooSphere and validate the infrastructure by implementing three canonical real deployable applications constructed on top of the NooSphere infrastructure.

Smart spaces research focuses on technology for multiple displays and devices for collocated participants. In most approaches, however, users have to cope with heterogeneous interfaces and information organization, as well as a lack of support for collaboration with mobile and remote users outside the smart space. In this paper, we present ReticularSpaces; a multi-display smart space system built on the principles of activity-based computing. The focus of ReticularSpaces is to support: (i) unified interaction with applications and documents through ReticularUI, a novel distributed user interfaces design; (ii) management of the complexity of tasks between users and displays; (iii) mobile users in a local, remote or 'nomadic' settings; and (iv) collaboration among local and remote users. We describe the motivation, design, and architecture of ReticularSpaces, and report from a preliminary feasibility study. The study shows that participants found ReticularSpaces useful and effective, but at the same time reveals new areas for research on smart environments.

In this paper we present a field trial of the eLabBench, a digital tabletop-based laboratory bench designed to support the exploratory practices of molecular biologists in the laboratory. The eLabBench supports the organization of personal information, capture of experimental work for later access, and the use of a variety of computational resources directly at the lab bench. We deployed the eLabBench in a biology laboratory for 16 weeks, and invited seven molecular biologists to run experiments on it. We report on how they used the bench and how it fitted within their larger experimental process. The main impact of the eLabBench lies in the changes it sparked off in preparing, running, and documenting lab experiments. By supporting computation at the bench and management of physical objects in the office, the eLabBench blurred the separation between office and laboratory work. Based on our observations, we discuss how interactive systems for laboratories such as the eLabBench can support a more exploratory or design-oriented way of 'doing' science.

This paper presents a recommender system for teams of medical professionals working collaboratively in hospital operating rooms. The system recommends relevant virtual actions, such as retrieval of information resources and initiation of communication with professionals outside the operating rooms. Recommendations are based on the current state of the ongoing operation as recognised from sensor data using machine learning techniques. The selection and non-selection of virtual actions during operations are interpreted as implicit feedback and used to update the weight matrices that guide recommendations. A pilot user study involving medical professionals indicates that the adaptation mechanism is effective and that the system provides adequate recommendations.

The success of a volunteer computing infrastructure depends on the contributions of its users. An example of such an infrastructure is the Mini-Grid, a local peer-to-peer system used for computational analysis of DNA. The speed of analysis increases as more users join the Mini-Grid. However, the invisible nature of such an infrastructure hinders adoption, as it is difficult for users to participate in an infrastructure they are not aware of. This paper introduces GridOrbit, a system designed to increase user awareness, fostering contributions to this infrastructure. We designed GridOrbit using a participatory design process with biologists, and subsequently deployed it for use in a biology laboratory. Our results indicate that the number of contributors to the Mini-Grid increased with the use of awareness technologies. In addition, our analysis presents their motives and behaviors. Finally, a characterization of user interaction with GridOrbit emerged, which enabled us to understand how awareness systems can be better designed. We see GridOrbit as an example of a broader class of technologies designed to create "Infrastructure Awareness" as a means to increase the contributions to technological infrastructures.

This showcase paper describes the Global Interaction Research Initiative - GIRI - recently inaugurated at the IT University of Copenhagen. It presents the motivation for this initiative, namely that the use of information technology is the core enabling factor for global collaboration and business. We argue that there is a fundamental need for understanding and providing next generation technologies for this ultra large-scale interaction paradigm. GIRI is organized around a set of research themes and projects, focusing on different application areas. Themes and projects are loosely coupled in the sense that each research project is defined in its own right with a specific set of challenges, vision, approach, partners, and funding scheme. At the time of writing, GIRI has 3 research themes and are hosting 6 projects, but these numbers are expected to increase as GIRI grows. GIRI is an open research initiative, and we invite other researchers to join.

This paper presents "Activity Analysis" as a method for conducting and analyzing field studies based on Activity Theory. Two cases of activity analysis of work in a hospital ward and inside an operating room are presented. Guidelines for moving from Activity Analysis to systems design is presented and illustrated with the design of a context-aware system for hospitals.

Interactive surfaces like diffuse illumination tabletops (DIT) identify and track objects using multiple techniques like shape and color recognition, fiducial markers, electronic components, and RFID tags. However, tracking becomes more complex when dealing with multiple small objects of similar form. We propose to use tangible mediators for integrating such objects to tabletops. This paper reports on our initial explorations of mediated tabletop interaction consisting of a mediator prototype and a design space definition. We built a mediator, the Rabbit, a device that translates thevalue of an RFID tag into a visual 2D code. The Rabbit rests on the interactive surface, holds the object, reads its passive RFID tag, and converts the read value into a 2D code that can be read by the DIT's built-in camera. When handling multiple objects, the Rabbit iterates through the generated 2D codes. Through a series of participatory activities with end users (molecular biologists), we collected initial feedback from participants and defined a design space for mediated tabletop interaction.

In Ubiquitous Computing (Ubicomp) research, substantial work has been directed towards sensor-based detection and recognition of human activity. This research has, however, mainly been focused on activities of daily living of a single person. This paper presents a sensor platform and a machine learning approach to sense and detect phases of a surgical operation. Automatic detection of the progress of work inside an operating room has several important applications, including coordination, patient safety, and context-aware information retrieval. We verify the platform during a surgical simulation. Recognition of the main phases of an operation was done with a high degree of accuracy. Through further analysis, we were able to reveal which sensors provide the most significant input. This can be used in subsequent design of systems for use during real surgeries.

Infrastructure awareness systems reveal invisible aspects of infrastructures to their existing or potential users. Designing such systems is challenging as it requires making visible the hidden activity of infrastructures while providing information of interest to the users. To address this challenge we introduce the AMC technique (for Awareness Model Cards). This technique relies conceptually on awareness model's concepts of nimbus and focus. The main objective is to match the users' interests to the information the infrastructure awareness systems can provide, through the use of card matching. This technique provides three benefits: 1) evaluate how relevant is the information displayed by infrastructure awareness systems; 2) identify which of users' interests infrastructure awareness systems do not take into account; 3) identify elements of re-design in the infrastructures themselves, so to improve their adoption.

In this paper, we present the idea of a composite device, which is one device made up of a composition of several separate devices working together in concert. We present the CompUTE architecture as a runtime infrastructure for device composition. This architecture is implemented in the CompUTE .net platform, which enables device composition between Windows XP devices based on an 'extended desktop' metaphor. We discuss how the CompUTE .net platform enables users to merge multiple computers into one composite device with an enlarged desktop area and several keyboards and mice. Each user is equipped with a unique cursor, which works across all connected devices and she can drag and drop any application window and files between the connected devices. User can also work collaboratively on the composite device. We reports from a usability study involving 24 participants who found the CompUTE .net platform very useful, easy to use, and easy to learn.

Most studies of plans and situated work have applied ethnographic methods and and thus fail to provide any quantitative insight into the extent of this phenomenon. We present a study of planning and executing operations in an operating suite. Quantitative analysis of log data reveals the extent to which operation schedules are carried out as planned, and qualitative studies reveal the reasons behind changes to the plan, the consequences of such changes, and the strategies used to cope with them. 67% of the plan is changed and only 56% of all operations are planned ahead. We discuss how operation schedules are subject to "continuous planning", and how this needs to be supported by technology.

Studies have revealed that people organize and think of their work in terms of activities that are carried out in pursuit of some overall objective, often in collaboration with others. Nevertheless, modern computer systems are typically single-user oriented, that is, designed to support individual tasks such as word processing while sitting at a desk. This article presents the concept of Activity-Based Computing (ABC), which seeks to create computational support for human activities. The ABC approach has been designed to address activity-based computing support for clinical work in hospitals. In a hospital, the challenges arising from the management of parallel activities and interruptions are amplified because multitasking is now combined with a high degree of mobility, collaboration, and urgency. The article presents the empirical and theoretical background for activity-based computing, its principles, the Java-based implementation of the ABC Framework, and an experimental evaluation together with a group of hospital clinicians. The article contributes to the growing research on support for human activities, mobility, collaboration, and context-aware computing. The ABC Framework presents a unifying perspective on activity-based support for human-computer interaction.

Many studies and concepts within CSCW deal with the temporal, spatial, social, and computational aspects of supporting collaborative work. In this paper we want to pay attention to another central aspect to the achievement of collaborative work, namely the competence of the people involved. In particular, we want to look at the dynamic quality of competences, and investigate how competence is mutually developed in coordinated work. We have termed this process competence articulation, a concept which tries to emphasize competence as well as social development of competence as part of cooperation. The concept has emerged out of a longitudinal participatory design process investigating telemedical treatment of diabetic foot ulcers using video phones. We analyze the transitions occurring with the introduction of synchronous telemedical consultations and detail how the online video facilitates communication options for competence articulation, which again improve collaboration and thus the quality of the treatment.

Most context-aware systems have been designed for non-safety-critical environments such as offices, museums, and university campuses. This paper argues that context-awareness can be used for safety-critical systems too. But since the consequences of errors or failures in safety-critical systems are potentially severe, we should have a high degree of confidence in these systems. We present the design, implementation, and evaluation of a context-aware patient safety and information system (CAPSIS) designed for use during surgery. Specifically, our study indicates that CAPSIS could improve patient safety in the operating room. More generally, the paper suggests that context-aware technologies offer a promising step forward in the design of safety-critical systems.

Research has shown that computers are notoriously bad at supporting the management of parallel activities and interruptions, and that mobility increases the severity of these problems. This paper presents activity-based computing (ABC) which supplements the prevalent data- and application-oriented computing paradigm with technologies for handling multiple, parallel and mobile work activities. We present the design and implementation of ABC support embedded in the Windows XP operating system. This includes replacing the Windows Taskbar with an Activity Bar, support for handling Windows applications, a zoomable user interface, and support for moving activities across different computers. We report an evaluation of this Windows XP ABC system which is based on a multi-method approach, where perceived ease-of-use and usefulness was evaluated together with rich interview material. This evaluation showed that users found the ABC XP extension easy to use and likely to be useful in their own work.

Several CSCW studies have shown that coordination of work in hospitals is particular challenging, and that clinicians put much effort into maintaining mutual awareness on the flow of work. Despite these apparent challenges, very little work has been done to design technology which helps people coordinate highly cooperative work in such a critical setting. In this paper we propose a novel way of supporting coordination in this hectic and time-critical environment. AwareMedia is a system which promotes social, spatial, and temporal awareness in combination with a shared messaging system. AwareMedia runs on large interactive displays situated around the hospital, and it is designed especially to support coordination at an operation ward. We present the design, implementation, and deployment of AwareMedia and based on preliminary data from our on-going deployment, we discuss how AwareMedia is working in-situ.

This paper reports from a field study of a hospital ward and discusses how people achieve coordination through the use of a wide range of interrelated non-digital artifacts, like whiteboards, work schedules, examination sheets, care records, post-it notes etc. These artifacts have multiple roles and functions which in combination facilitate location awareness, continuous coordination, cooperative planning and status overview. We described how actors achieve coordination by using different aspects of these artifacts: their material qualities, the structure they provide as templates and the signs inscribed upon them that are only meaningful to knowledgeable actors. We finally discuss the implication for the design of CSCW tools from the study.

Transformations in collaborative work due to the introduction of new technology are inevitable, but are often difficult to study. In this paper, we consider the patterns of transformation that are seen in a patient-physician relationship based on the introduction of homecare monitoring equipment. We report findings from interviews and fieldwork with patients and physicians participating in a clinical experiment of homecare monitoring. By studying both the group of patients who receive homecare-based treatment and the control group we were able to identify transformations in the collaborative activity as caused by the homecare monitoring technology. We apply activity theory as a theoretical basis for this analysis. We consider the implications of these findings for the design of pervasive health monitoring technologies.

Maintaining social awareness of the working context of fellow co-workers is crucial to successful cooperation. For mobile, non co-located workers, however, this social awareness is hard to maintain. In this paper we present the concept of Context-Mediated Social Awareness to denote how context-aware computing can be used to facilitate social awareness. We illustrate the concept in a case study of mobile collaboration in a hospital and present the `AwarePhone', which is designed to support context-mediated social awareness among hospital clinicians. Based on this conceptual and empirical basis, the paper presents the AWARE architecture, which is a generic platform for supporting context-mediated social awareness.

With the growing research into mobile and ubiquitous computing, there is a need for addressing how such infrastructures can support collaboration between nomadic users. We present the activity based computing paradigm and outline a proposal for handling collaboration in an activity-based architecture. We argue that activity-based computing establishes a natural and sound conceptual and architectural basis for session management in real-time, synchronous collaboration.

A major part of software architecture design is learning how specific architectural designs balance the concerns of stakeholders. We explore the notion of "architectural prototypes", correspondingly architectural prototyping, as a means of using executable prototypes to investigate stakeholders' concerns with respect to a system under development. An architectural prototype is primarily a learning and communication vehicle used to explore and experiment with alternative architectural styles, features, and patterns in order to balance different architectural qualities. The use of architectural prototypes in the development process is discussed, and we argue that such prototypes can play a role throughout the entire process. The use of architectural prototypes is illustrated by three distinct cases of creating software systems. We argue that architectural prototyping can provide key insights that may otherwise be difficult to obtain before a system is built. Furthermore, they define skeleton systems that serve as communication means and knowledge transfer among stakeholders.

CSCW seems to have a persistent problem of understanding the nature of “cooperative work”. This paper argues that this problem is a direct result of not looking at the dynamic aspects of work – i.e. that cooperative work is not one thing, but different things at differ-ent times and in different places. Based on Activity Theory the paper gives a conceptual frame for understanding the dynamics of collabo-rative work activities, and argues that the design of computer support should view cooperative breakdowns not as a problem but as an im-portant resource in design. These arguments are based on empirical studies of healthcare work and the design of a computer support for planning and scheduling operations and other activities within a hos-pital.

This paper addresses how studies of work can provide the basis for redesigning existing information technology (IT).The paper reports on a field study of the differences in work practices of hospitaIs using a computer system and hospitals not using the system.We shall present the variety of strategies healthcare workers have adopted to coordinate their widely distributed activities, and discuss the consequences for these strategies when using the computer system.The paper concludes that the design of groupware should recognize the multiplicity of artifacts in the workplace (both manual and computational) and the need for interconnecting groupware with Information Systems.