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needs. The case study had the goal of support-
ing different communities of physicians, namely
radiologists and pneumologists, in the analysis
of chest radiographies and in the generation of
the diagnosis. Radiologists and pneumologists
represent two subcommunities of the physicians
community: they share patient-related data ar-
chives, some models for their interpretation, some
notations for their presentation, but they have also
to perform different tasks, documented through
different subnotations and tools. Therefore, their
notations can be considered two (visual) dialects
of the physicians' general notation. As a conse-
quence, two different application workshops have
been designed for these two communities of users.
The pneumologist and the radiologist involved
in the study of the pulmonary diseases, even if
they are working in different wards or different
hospitals, can define an agreed diagnosis using
each one her/his application workshop tailored to
her or his culture, skills, and articulatory abilities
in an asynchronous and distributed way.
We are currently applying the same approach
in a larger project in which we are involved, in
collaboration with the physicians of the neu-
rology department of the “Giovanni XXIII”
Pediatric Hospital of Bari, Italy. In this project,
different communities of physicians are involved,
namely neurologists and neuroradiologists, in the
analysis of clinical cases and in the generation
of the diagnosis. Neurologists need to exchange
consultations with other neurologists and/or
neuroradiologists in order to make a better diag-
nosis for their children patients. These groups of
physicians autonomously organized a procedure
for the exchange of information (data, images, and
text), using common network tools such as e-mail.
However, the physicians were not satisfied with
the quality and reliability of such a procedure, so
that we started a collaboration with them with the
objective of creating software environments that
might satisfy their needs.
We developed a first version of the prototypes
devoted to neurologists and neuroradiologists, on
the basis of the experience gained in the previ-
ous project with radiologists and pneumologists
(Costabile et al., 2006a). Then, usability evaluation
of these prototypes was performed by applying
different techniques, such as heuristic evalua-
tion, cognitive walkthrough, and user testing. In
parallel, we carried out an accurate field study
in the neurology department of the hospital and
we developed a second version of the prototypes.
In particular, the field study was aimed at un-
derstanding and identifying the environmental
and organization factors that influence the work
of the physicians and the flow of activities, as
well as the communities of end users involved
and their main tasks, their common languages,
and their specialized medical dialects. Various
methods have been considered to perform this
study, such as user observations, interviews,
and analysis of users' documents and languages.
From our previous experience with this particular
community of users, we decided to perform the
field study to deeply know the work practice of
the physicians.
Prototypes of SSWs have been developed on
the basis of the information collected during the
field study. As previously discussed, the resulting
interactive system is structured as a network of
SSWs, each specific for a community of users.
Being the network modular, we foresee the pos-
sibility in the future of extending it by creating
other SSWs for other stakeholders, for example,
clerks and managers dealing with management
and billing systems.
the Field study
The field study was mainly aimed at understand-
ing how the physicians collaborate in the analysis
of clinical cases. In accordance with the basic
principles of our methodology, we also wanted
to look at (a) the notations adopted in the specific
domain, (b) the documents the various users ex-
change, and (c) the tools they usually use.
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