Group work is an essential part of modern health care. Although there have been advances in the technology of communication, these have not necessarily led to efficient and effective communication among collaborating health-care professionals. Instead, barriers such as varied organizational cultures, different training backgrounds, and varied time schedules can overwhelm technological solutions and impede efficient communication. We focus on one particular sort of collaboration, that of group work around a clinical trial protocol, where the collaboration is asynchronous and the participants are geographically distributed. In this work setting, we have applied a computer-supported cooperative work (CSCW) approach in two distinct ways. First, we used observational methods to uncover and understand a complex set of communication behaviors and needs. Second, we used participatory design and iterative prototyping to design a system that aims to improve communication and work flow among these collaborators. We found that these methods work well in tandem - our observational study helped better inform our design, and our prototyping cycles provided additional insight into the work. More specifically, we were able to identify a set of communication problems in the work that led us to specify a set of design desiderata for systems that support asynchronous collaboration around an evolving medical document. © 2005 Elsevier Ireland Ltd. All rights reserved.
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