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Design as Bootstrapping

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Telemedicine is expected to enable huge improvments of health care services ... in a trial set-up of a broadband network between the Interventional Canter ... – PowerPoint PPT presentation

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Title: Design as Bootstrapping


1
  • Design as Bootstrapping
  • On the evelution of ICT networks in health care

2
Introduction
  • Keywords
  • - Network growth
  • - Critical mass
  • - Bootstrapping
  • - Telemedicine

3
Introduction
  • Telemedicine is expected to enable huge
    improvments of health care services through
    radically new and improved ways of collaboratin
    and organizing within health care sector
  • Lots of prototypes have been made and demostrated

4
Introduction
  • Has been proved to be hard to bring the
    prototyped into regular use
  • Dont seem to take-off

5
The logic of networks
  • A crucial aspect of various large scale and
    networked technologies is that their value
    increases with the number of users
  • As the number of users grow, the technology tends
    to get momentum and starts growing through a
    self-reinforcing prosess

6
Critical mass
  • The challange is to get strarting building
    networks like this because no user wants to be
    the first one
  • This lead to the consept critical mass

7
Critical mass
  • To get the critical mass its commen to use a
    strategy which identify and subsidize a number
    of users willing to adapt the technology
  • This is not always as easy as it seems

8
Critical mass
  • The critical mas model is simple
  • Makes all elements equal
  • But individual preferences vary
  • Not static and given
  • Dependent upon other peoples actions

9
Critical mass
  • So in small cases small changes in distribution
    of preferences can have tremendous effect on the
    outcome
  • Implication of this model is the rather bying
    users until critical mass is reached, one have
    to identify the users being willing to adopt the
    technology first, then these willing to adpot the
    second etc.

10
Bootstrapping
  • Definition to proote or develop by initiative
    and effort with no or little assistace
  • Also described as the prosess of making a tool by
    the tool itself
  • A design prosess taking its starting point the
    challange of enrolling the first users and then
    drawing upon the existing base of users and
    technology as a resource to extend the network

11
Broadband networks in minimal invasive surgery
  • A Intervential Centre was established in 1996 to
    do research and development on interventional
    radiology, image guided and minimal invasive
    procedures
  • The hospital sat up an ISDN based
    vidioconferencing studio

12
Broadband networks in minimal invasive surgery
  • A starting point for the research was to focus
    on the feasibiliyt of the available ISDN
    technology for transmission of the procedures
    preformed locally.
  • The quality was inadequate
  • Other technological alternatives were explored.

13
Broadband networks in minimal invasive surgery
  • That resulted in a trial set-up of a broadband
    network between the Interventional Canter and
    Ullevål hospital for 14 days, where equipment and
    network access was provided by Telia
  • The test were promising and the cooperation was
    continued and truned into a formal project

14
Broadband networks in minimal invasive surgery
  • Started with less complex and critical areas
  • Then they expanded
  • Avoid expensive solutions by expanding existing
    ones
  • Experiment with the tecnology in areas where one
    can avoid interfering with exsisting practices
  • Learn from simpler areas before moving into more
    comples ones
  • Identify areas which are considerd important for
    users

15
EDI infrastructures
  • A private laboratory develop a simple
    technological solution enabling electronic
    transmission of reposrt from the lab to General
    Practitioners
  • The solution was highly appreciated by the
    existing costomers, and it attracted lots of new
    ones

16
EDI infrastructures
  • Wanted to expand this to a wide range of areas
    inside health care.
  • Would require a shared and open infrastructure
    for the hole health care sector
  • Was decided that the messages should be exchanged
    using an underlying infrastricture based on X.400

17
EDI infrastructures
  • In practical terms no X.400 infrastructur was
    available
  • Needed to build one
  • No one would use the new system, everybody was
    waiting to see whether others really bougt X.400

18
Telemedicine in ambulances
  • In 1998 there was a process of rationalization
    and centralization the hospital into one
    organizartion
  • Care units were reduced
  • The time from door-to-needle-time became longer

19
Telemedicine in ambulances
  • Criticall in the care of myocardiak infraction
  • Have to vertify the diagnosis before treatment
  • MobiMed, a telemedicine system that facilitated
    transmission of text and ECGs from ambulances to
    a reciver(hospital)

20
Telemedicine in ambulances
  • Managed to get a try out of the system
  • With a nurse available for emergency trips
  • Was a big sucsess and the door-to-needle-time
    was reduces with 25-30 minutes
  • The ambulace personnel was thougt how to use the
    equipment

21
Telemedicine in ambulances
  • The health authorities decided to support the
    purchase of the equipment to other ambulanses in
    other towns

22
Summary
  • Highly motivated users have to be identified
  • Less motivated users may be enrolled as
  • The network grows and the use values increases
  • The technology is imporved
  • The sceptics become convinced about the positive
    contribution

23
Summary
  • The cost of adpoting a technology depend on the
    adoptersknowlede about it. The more konwledge
    about the technology, the easier it is to adopt,
    since the user have some idea of what it may be
    used for

24
Summary
  • Whether a user wants to adpot a technology or not
    also depends on
  • Availability
  • Simplicity
  • Costs
  • Flexibiliyt
  • Future oriented
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