Visualization and Simulation Technology in Healthcare - From a technology-centered to a human-centered perspective

Abstract: With the aid of modern computer technology the application of visualization and simulation technology has become increasingly important in today’s society. Through computer modelling it is possible to experience, understand and explore environments, systems or objects in two or three dimensions and to see, hear and sometimes tangibly feel them. It may be environments or objects that do not yet exist, that are to be changed or for some reason are not possible to interact with or evaluate in the real-life setting. Many areas of application have been found for visualization and simulation technology over the years. Examples are systems for training in various settings or for simplifying and sharing complex information. But the technology can also be used as a method in design and planning processes as a mediating tool for concretizing ideas or transforming stakeholders into active participants. Healthcare is one context in which visualization and simulation technology has been adopted for certain tasks but has the potential to contribute to many more. Healthcare is characterized by continuous changes related to work organization, facility planning, treatment routines, and use of technical equipment, in order to improve care and make it more resource efficient. This requires new ways of thinking about how resources are to be allocated when planning new healthcare organizations or changing existing ones. As part of this process I suggest that visualization and simulation technology can be used to train generic and specific skills, plan new organizations and involve staff and patients in the design and development. The first aim of the research presented in this thesis is thus to increase the knowledge about how visualization and simulation technology can be used as a method for sharing information and knowledge and to support training, planning and participation in the healthcare context. In so doing, the results can contribute to an improved work environment for the staff and safety for both patients and staff. Three empirical cases were examined, two of which relate to training applications and one to planning. Participation is touched upon in all of them but has had a more central role in the latter two. When it comes to the development of visualization or simulation systems, much of the research has had a technology-centered perspective, often focused on more advanced graphical representations and new ways of interacting. Less focus has been put on the actual use situation around these systems. In this thesis I argue that a human-centered perspective can help to ensure that the users’ needs, tasks and contexts are guiding the design and development processes. The second aim has thus been to put forward a discussion about a technology-centered versus a human-centered approach in the design and development process of visualization and simulation technology. This discussion has grown out of the different methodologies adopted in the three case studies. The research has been guided by methods and principles from human factors and human computer interaction with data gathered through observations, interviews, questionnaires and video recordings. This means that the results are based on both subjective data from the participants in which they have expressed their thoughts about the visualization and simulation that has been applied, and on objective data in which the participants’ reactions have been assessed by analyzing video or observing the participants directly in the context. The results show that visualization and simulation technology can contribute to information and knowledge sharing as well as support training, planning and participation in the healthcare context. Case 1 is a typical example of how the development of these systems is carried out today – with a technology-centered perspective. The case involves an expansion of an existing system so that it can be used for the training of a wider range of patient cases and for planning specific surgical procedures. Case 2 however shows that when adding a human-centered perspective to the development process by involving users in design and focusing on their needs, tasks and context, new applications and new ways of designing the technology may be found. Case 3 is an example of how a range of visualization and simulation technologies can be combined to involve staff in a development process to elicit their knowledge of the work organization that can contribute to the planning process. The results also show that a human-centered approach is employed to some extent in a small part of the simulation training community, while a more comprehensive implementation of this way of thinking falls short. One of the obstacles to a more frequent and easy employment of visualization and simulation technologies in general is that the method still “belongs to” the technical community and in order to use it, someone with technical expertise has to be part of the process. If human-centered perspectives becomes a natural part of the development and application of visualization and simulation technology, a better balance can be achieved between the technology-centered focus of creating high-tech and advanced solutions and the human-centered focus, where the needs, tasks and context of the users guide the development.