Mapping the conceptual design activity of interdisciplinary teams

The conceptual design phase of any project is, by its very nature, a vibrant, creative and dynamic period. It can also be disorganized with much backtracking accompanying the exchange of information between design team members. The transfer of information, ideas and opinion is critical to the development of concepts and as such, rather than being recognized as merely a component of conceptual design activity, it needs to be understood and, ultimately, managed. This paper describes an experimental workshop involving fifteen design professionals in which conceptual design activity was tracked, and subsequently mapped, in order to test and validate a tentative design framework (phase and activity model). The nature of the design progression of the various teams is captured and analyzed, allowing a number of conclusions to be drawn regarding both the iterative nature of this phase of design and how teams of professionals actually design together.

Unity in diversity: electronic patient record use in multidisciplinary practice

In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this perspective is illustrated through the analysis of a year-long, longitudinal case study of a multidisciplinary team of surgeons, oncologists, pathologists, radiologists, and nurse specialists adopting a new EPR. Each group adapted their use of the EPR to their diverse specialist practices, but they nonetheless orientated their use of the EPR to each others' practices sufficiently to support unity in multidisciplinary teamwork. Multidisciplinary practice elements were also reconfigured in an episode of explicit negotiations, resulting in significant changes in EPR use within team meetings. Our study contributes to the growing literature that questions the feasibility and necessity of achieving high levels of standardized, uniform health information technology use in healthcare.