Title: The Global Care Ecosystems of 3D Printed Assistive Devices
The popularity of 3D printed assistive technology has led to the emergence of new ecosystems of care, where multiple stakeholders (makers, clinicians, and recipients with disabilities) work toward creating new upper limb prosthetic devices. However, despite the increasing growth, we currently know little about the differences between these care ecosystems. Medical regulations and the prevailing culture have greatly impacted how ecosystems are structured and stakeholders work together, including whether clinicians and makers collaborate. To better understand these care ecosystems, we interviewed a range of stakeholders from multiple countries, including Brazil, Chile, Costa Rica, France, India, Mexico, and the U.S. Our broad analysis allowed us to uncover different working examples of how multiple stakeholders collaborate within these care ecosystems and the main challenges they face. Through our study, we were able to uncover that the ecosystems with multi-stakeholder collaborations exist (something prior work had not seen), and these ecosystems showed increased success and impact. We also identified some of the key follow-up practices to reduce device abandonment. Of particular importance are to have ecosystems put in place follow up practices that integrate formal agreements and compensations for participation (which do not need to be just monetary). We identified that these features helped to ensure multi-stakeholder involvement and ecosystem sustainability. We finished the paper with socio-technical recommendations to create vibrant care ecosystems that include multiple stakeholders in the production of 3D printed assistive devices. more »« less
Coulentianos, Marianna J.; Rodriguez-Calero, Ilka; Daly, Shanna R.; Sienko, Kathleen H.
(, 2020 Design of Medical Devices Conference)
null
(Ed.)
Abstract Stakeholder engagement with prototypes during the front-end phases of medical device design can support problem identification, problem definition, and early concept generation. This study examined what prototypes were leveraged to engage specific types of stakeholders during front-end medical device design. Analysis of semi-structured interviews with 22 design practitioners in the medical device industry revealed some common associations of prototype choice for particular stakeholders. A few associations are highlighted: designers engaged users with physical three-dimensional (3D) prototypes, financial decision-makers with physical 3D and two-dimensional (2D) prototypes, government and regulatory stakeholders with 2D prototypes, and expert advisors with digital 3D prototypes. The rationale provided by practitioners revealed the intentional selection of prototype form for specific stakeholder engagements.
Stakeholder engagement is a vital, yet under-accessed and under-studied, resource for tackling wicked environmental problems. This paper examines mental models – cognitive representations of “real” systems – refined through group model building (GMB) with stakeholders concerned with environmental issues in the US state of Oklahoma. During GMB, a diverse group of high-level decision makers met with a variety of physical and social scientists to collaborate on mental models concerning three environmental focus areas in Oklahoma: encroachment of eastern red cedar, grid and infrastructure resilience, and marginal water use and re-use. We ask: how do individuals from diverse stakeholder groups describe causes and consequences of key environmental problems in Oklahoma? Results from this analysis advance efforts toward developing socially sustainable solutions for environmental problems in Oklahoma and beyond.
BackgroundAlthough family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers’ unmet needs is via the design of digital technologies that support caregivers’ complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home. ObjectiveThis study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens. MethodsWe conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context. ResultsWe recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians’ and caregivers’ perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers’ already significant burdens. ConclusionsThese findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.
Pathak, Aishwarya; Zhang, Lu; Ganapati, Nazife Emel
(, Construction Research Congress 2020)
Despite the broader acknowledgement of shared responsibilities in emergency management, one of the hidden and overlooked issues in disaster literature is the integration of multi-sector stakeholder values: the things that are of importance to the stakeholders (e.g., safety, profit, electability). Stakeholders (e.g., different levels of government, the private sector, the non-profit sector, and the communities) hold numerous values with varying degrees of importance, forming a system of value priorities. Stakeholder values and value priorities—referred to as value systems—are not static in a disaster context; they are dynamic, time-sensitive, and event-driven. A more in-depth understanding of the dynamics of stakeholder value systems is surely needed to allow policy-makers to introduce more pro-active and timely measures towards more resilient communities. To address this need, this paper focuses on identifying and understanding the stakeholder values in the context of Hurricane Michael. Semi-structured interviews (n=24 with 30 interviewees) were conducted to understand what public and private stakeholders value in different phases of Hurricane Michael. Based on the interview results, ten stakeholder values were identified: safety, resource efficiency, natural resource preservation, culture preservation, community growth, community adaptability, community cohesion, social welfare improvement, personal achievement, and business development. This study advances the knowledge in the area of disasters by empirically investigating public and private stakeholder values across different phases of the disaster. Such knowledge will help practitioners implement disaster resilience strategies in a way that accounts for diverse stakeholder needs and priorities, thus facilitating human-centered decision making towards building more resilient communities.
Lawrence, Katharine; Singh, Nina; Jonassen, Zoe; Groom, Lisa L; Alfaro Arias, Veronica; Mandal, Soumik; Schoenthaler, Antoinette; Mann, Devin; Nov, Oded; Dove, Graham
(, JMIR Human Factors)
Background Remote patient monitoring (RPM) technologies can support patients living with chronic conditions through self-monitoring of physiological measures and enhance clinicians’ diagnostic and treatment decisions. However, to date, large-scale pragmatic RPM implementation within health systems has been limited, and understanding of the impacts of RPM technologies on clinical workflows and care experience is lacking. Objective In this study, we evaluate the early implementation of operational RPM initiatives for chronic disease management within the ambulatory network of an academic medical center in New York City, focusing on the experiences of “early adopter” clinicians and patients. Methods Using a multimethod qualitative approach, we conducted (1) interviews with 13 clinicians across 9 specialties considered as early adopters and supporters of RPM and (2) speculative design sessions exploring the future of RPM in clinical care with 21 patients and patient representatives, to better understand experiences, preferences, and expectations of pragmatic RPM use for health care delivery. Results We identified themes relevant to RPM implementation within the following areas: (1) data collection and practices, including impacts of taking real-world measures and issues of data sharing, security, and privacy; (2) proactive and preventive care, including proactive and preventive monitoring, and proactive interventions and support; and (3) health disparities and equity, including tailored and flexible care and implicit bias. We also identified evidence for mitigation and support to address challenges in each of these areas. Conclusions This study highlights the unique contexts, perceptions, and challenges regarding the deployment of RPM in clinical practice, including its potential implications for clinical workflows and work experiences. Based on these findings, we offer implementation and design recommendations for health systems interested in deploying RPM-enabled health care.
Savage, Saiph, Flores-Saviaga, Claudia, Rodney, Rachel, Savage, Liliana, Schull, Jon, and Mankoff, Jennifer. The Global Care Ecosystems of 3D Printed Assistive Devices. Retrieved from https://par.nsf.gov/biblio/10344061. ACM Transactions on Accessible Computing . Web. doi:10.1145/3537676.
Savage, Saiph, Flores-Saviaga, Claudia, Rodney, Rachel, Savage, Liliana, Schull, Jon, & Mankoff, Jennifer. The Global Care Ecosystems of 3D Printed Assistive Devices. ACM Transactions on Accessible Computing, (). Retrieved from https://par.nsf.gov/biblio/10344061. https://doi.org/10.1145/3537676
Savage, Saiph, Flores-Saviaga, Claudia, Rodney, Rachel, Savage, Liliana, Schull, Jon, and Mankoff, Jennifer.
"The Global Care Ecosystems of 3D Printed Assistive Devices". ACM Transactions on Accessible Computing (). Country unknown/Code not available. https://doi.org/10.1145/3537676.https://par.nsf.gov/biblio/10344061.
@article{osti_10344061,
place = {Country unknown/Code not available},
title = {The Global Care Ecosystems of 3D Printed Assistive Devices},
url = {https://par.nsf.gov/biblio/10344061},
DOI = {10.1145/3537676},
abstractNote = {The popularity of 3D printed assistive technology has led to the emergence of new ecosystems of care, where multiple stakeholders (makers, clinicians, and recipients with disabilities) work toward creating new upper limb prosthetic devices. However, despite the increasing growth, we currently know little about the differences between these care ecosystems. Medical regulations and the prevailing culture have greatly impacted how ecosystems are structured and stakeholders work together, including whether clinicians and makers collaborate. To better understand these care ecosystems, we interviewed a range of stakeholders from multiple countries, including Brazil, Chile, Costa Rica, France, India, Mexico, and the U.S. Our broad analysis allowed us to uncover different working examples of how multiple stakeholders collaborate within these care ecosystems and the main challenges they face. Through our study, we were able to uncover that the ecosystems with multi-stakeholder collaborations exist (something prior work had not seen), and these ecosystems showed increased success and impact. We also identified some of the key follow-up practices to reduce device abandonment. Of particular importance are to have ecosystems put in place follow up practices that integrate formal agreements and compensations for participation (which do not need to be just monetary). We identified that these features helped to ensure multi-stakeholder involvement and ecosystem sustainability. We finished the paper with socio-technical recommendations to create vibrant care ecosystems that include multiple stakeholders in the production of 3D printed assistive devices.},
journal = {ACM Transactions on Accessible Computing},
author = {Savage, Saiph and Flores-Saviaga, Claudia and Rodney, Rachel and Savage, Liliana and Schull, Jon and Mankoff, Jennifer},
}
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