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ItemDesigning User-Centered Interfaces to Support Clinical Decision-Making and Patient Engagement(Georgia Institute of Technology, 2021-12-17) Evans, Hayley IreneThe delivery of most psychotherapies has been constrained by data collected from patient self-report and clinician intuition for the last century. Clinicians who use evidence-based treatments need methods, tools, and data to efficiently track, assess, and respond to mental health needs throughout the treatment process. Patients need tools that provide feedback to optimize their therapeutic exercises and increase engagement. In this dissertation, I explore how interfaces shared by clinicians and patients can be used to support this aim in the context of prolonged exposure (PE) therapy, an evidence-based treatment used in treating post-traumatic stress disorder (PTSD). I focus on the case of designing for United States (US) veterans as well as the clinicians who treat them as US Veterans are disproportionately affected by PTSD due to the nature of their work. In this dissertation, I investigate how to design shared, user-centered interfaces which seek to support clinical decision-making and patient engagement in the context of veterans with post-traumatic stress disorder (PTSD). To lay the groundwork for design, I detail the care ecologies of veterans with PTSD, identifying the human and non-human intermediaries involved in their circles of care as well as barriers to care and future design opportunities. Leveraging this information, I explore how a clinician dashboard for PTSD, sensor-captured patient generated data, and feedback gathered via text message from trusted others (e.g., friends, family) can be designed into a shared interface and support clinical decision-making and/or patient engagement.
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ItemWarm Solutions: Medical Making & Collaborative Infrastructure for Care(Georgia Institute of Technology, 2021-12-13) Tattamangalam Ananthanarayanan, Udaya LakshmiMaking, as an activity and culture, enables people to participate in technological innovation at non-traditional sites. In healthcare settings, medical makers undertake activities as a part of routine, professional care practice. Their collaborative process occurs at the intersection of centralized healthcare systems and decentralized maker technologies with reflexive opportunities for human-centered design. In my research, I propose a critical view of medical making as an opportunity to reposition the power to participate in design within traditional healthcare practice. I develop my thesis from multiple efforts in a wide ecosystem of medical makers across private and public practice, STEM institutions, academic research labs, and non-profit groups. I apply Science and Technology Studies (STS) and HCI theories to analyze stakeholder efforts in relation to long-term patient-centered care infrastructure. Embedded in practice, infrastructure becomes visible in relation to its use. In my dissertation, I develop an understanding of how stakeholders in healthcare settings and networks influence care infrastructure with maker technologies. I do this by foregrounding the norms, values, and expertise related to stakeholder participation across three sections. First, I re-locate the site where physician-led making begins from labs to the bedside – as safe, reliable, small-scale prototypes. Second, I re-frame the importance of medical making, with lessons from the COVID-19 pandemic, when grassroot- and institutional makers repaired temporary manufacturing breakdowns by creating reliable medical supplies. Third, I re-center the role of point-of-care medical makers, highlighting present-day nurse contributions as makers and contrasting their historically undocumented contributions in routine care. My research work culminates in a discussion of the human infrastructure, in addition to information systems, required to design environments for innovation based on the case study of medical making. For HCI researchers, this work first diversifies design values of novelty to include healthcare values of safety, reliability, and verifiability in collaborative systems, and second, extrapolates lessons from medical making to build fair, equitable, and sustainable infrastructure for collaboration between experts and non-experts. From these value-driven insights, I hope my work further contributes practical, methodological, and ethical implications for multiple stakeholders including policymakers and researchers.
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ItemCompute-proximal Energy Harvesting for Mobile Environments: Fundamentals, Applications, and Tools(Georgia Institute of Technology, 2021-12-13) Park, Jung WookOver the past two decades, we have witnessed remarkable achievements in computing, sensing, actuating, and communications capabilities of ubiquitous computing applications. However, due to the limitations in stable energy supply, it is difficult to make the applications ubiquitous. Batteries have been considered a promising technology for this problem, but their low energy density and sluggish innovation have constrained the utility and expansion of ubiquitous computing. Two key techniques—energy harvesting and power management—have been studied as alternatives to overcome the battery limitations. Compared to static environments such as homes or buildings, there are more energy harvesting opportunities in mobile environments since ubiquitous systems can generate various forms of energy as they move. Most of the previous studies in this regard have been focused on human movements for wearable computing, while other mobile environments (e.g., cars, motorcycles, and bikes) have received limited attention. In this thesis, I present a class of energy harvesting approaches called compute-proximal energy harvesting, which allows us to develop energy harvesting technology where computing, sensing, and actuating are needed in vehicles. Computing includes sensing phenomena, executing instructions, actuating components, storing information, and communication. Proximal considers the harvesting of energy available around the specific location where computation is needed, reducing the need for excessive wiring. A primary goal of this new approach is to mitigate the effort associated with the installation and field deployment of self-sustained computing and lower the entry barriers to developing self-sustainable systems for vehicles. In this thesis, I first select an automobile as a promising case study and discuss the opportunities, challenges, and design guidelines of compute-proximal energy harvesting with practical yet advanced examples in the automotive domain. Second, I present research in the design of small-scale wind energy harvesters and the implementation and evaluation of two advanced safety sensing systems—a blind spot monitoring system and a lane detection system—with the harvested power from wind. Finally, I conduct a study to democratize the lessons learned from the automotive case studies for makers and people with no prior experience in energy harvesting technology. In this study, I seek to understand what problems they have encountered and what possible solutions they have considered while dealing with energy harvesting technology. Based on the findings, I develop a comprehensive energy harvesting toolkit and examine its utility, usability, and creativity through a series of workshops.
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ItemDesigning collaborative mobile health experiences for adolescent patients(Georgia Institute of Technology, 2020-05-17) Hong, Matthew K.The proliferation of patient-generated data and mobile health (mHealth) technologies has provided unprecedented opportunities for patients' everyday health management and active participation in health care. Designing and introducing personally-collected mobile data into pediatric patients' everyday health management tasks, however, brings unique challenges for computing research. These patients will need to collaborate with family and clinical caregivers to successfully manage their care, yet they struggle to articulate their needs and face many barriers that affect their participation in care. My research focuses on the design of collaborative health management tools for adolescent patients (ages 10--19) in onco-hematology and rheumatology settings. It includes a series of qualitative and formative design studies involving patients, family members, and clinicians, to formulate design requirements for mHealth tools for illness documentation, communication, and management. This dissertation describes several completed studies organized under three themes. My early formative work provides an overview of the problem and design space for patient participation in complex chronic care, which informed my decision to focus on tracking illness experiences. Through two collaborative design studies, I characterized patient-defined, patient-generated health data for illness communication, by engaging with patient-parent dyads and clinical professionals. Finally, I describe a long-term probe study and design of a mHealth technology to gain an in-depth understanding of how technology can be designed to support patient-authored illness narratives based on experiential data collaboratively generated by patients and their family caregivers. This research contributes: 1) a critical understanding of the ways that human-centered design can address the primary challenges that adolescent patients face when engaging in complex chronic care management, and 2) design guidelines and artifacts that can inform new tools to support families' collaborative documentation and communication of patient-generated health data in pediatric care.