A Shared Scheduling and Meeting Application for the iPhone - Case Study Example

A SHARED SCHEDULING AND MEETING APPLICATION FOR THE IPHONE The Target Group: The group chosen for designing the shared scheduling and meeting iPhone application is a team of hospital staff including a) The Duty Doctor in the Emergency/Casualty Ward, b) The Surgeon, c) The Administrator, d) Attendant Nurses and e) The resident supplier for medical supplies. Hospitals across the globe are increasingly resorting to technology as a means of expediting and aligning medical treatment for patients. Time is the most critical friend and enemy of the doctor at the same time. Technology has stepped in to save several lives and helped avoid permanent disabilities with timely treatment and surgery. Hence, I have chosen a small group of key hospital staff to design the iPhone scheduling application. Constant, real-time interaction amongst key hospital staff members is critical to the provisioning of effective medical treatment. The group detailed above, is a typical group that needs to interact effectively within itself. General issues/challenges encountered with shared calendars: a) Online or shared calendars depending heavily on the back-end server for availability of information. Consequently, an outage at the back-end can result in loss of critical scheduling information. Most online service providers today have robust and redundant back-end infrastructure, hence the possibility of data loss is remote. (Garret, “Sharing Calendar Issues”) Many calendar users are accustomed to set their phones to logon automatically with their logon credentials – they wouldn’t want to remember yet another password! This poses the inherent risk of accidental or inadvertent modification of scheduling details when the online calendar website or service is accessed. b) The alerting mechanism to a group of invitees is yet to evolve in terms of features and functionality. For instance, cancellation notices go into the invitee group as a message or email on which the end user is expected to take action. There are no clearly audible or visible alerts available within traditional calendar systems for status change intimation. c) Online calendars are just evolving in terms of visual appeal – Most of them follow the traditional iCal or Microsoft Outlook designs – which are sound in terms of basic features, but inadequate in terms of greater visual appeal. Visual and audio alerts need to evolve significantly! d) Most users use disparate calendar systems and a meeting organizer would need to push the ‘same’ event on to multiple calendar systems – this essentially means there has to be a ‘quick and dirty’ way of accomplishing multi-application invites (Kahn, UCBCN, 2008) e) Further, there are ‘pull based’ meeting/appointment invites wherein users subscribe to a set of desired events and would like to be alerted of new and changed schedules – Here again, the meeting or event organizer has to ensure the back-end update of schedules is accurate and timely so as to enable quick communication to all interested groups/individuals. (reference same as point e) f) Almost all users of online calendars would like to save an ‘offline’ copy of their scheduled appointments and meetings. This brings up the need for effective ‘synchronization’ between the online and offline versions. A constant refrain one hears is “I forgot to synchronize and hence didn’t get to know of the schedule change!” g) Groupware Calendar Systems (GCSs) are emerging as strong requirements for a tech-savvy world. GCSs help users create/retain multiple scheduling requirements such as booking shared equipment/resources, booking conference rooms, and scheduling traditional meetings amongst various other uses. This would mean the right levels of access privileges and restrictions are affixed to different tiers of users such as general users, power users and calendar administrators (Palen, “Situated Evolutionary Use of Calendar Systems”, n.d) Potential downsides of shared calendars for the target group a) We live today in a world of uncertainties and unknown risks. Every online user knows and worries about the risk of his/her private information being inadvertently or purposefully exposed on the public network. Online or shared calendars are no different and hence a key concern would be the need for greater application and user-data security. Thus, in this specific scenario of a group of hospital staff, leakage of any attached patient information within calendar invites could seriously impact the security of the patients. b) Regulatory requirements in the health industry are very rigorous (eg: HIPAA provisions) and every hospital has to exercise utmost caution in dealing with and protecting patient information. Shared calendars are inherently less secure than calendars on isolated computing systems. Hence, sharing a patient’s health information within shared schedules may not be a good idea unless the technological and administrative controls are sound and proven. c) Hospitals are ‘real time’ organizations – meaning, decisions need to be made at split-second speeds – thus for instance, a surgeon may not have the time to organize and plan for an emergency surgery – He would just need to rush a patient into the operation theater and complete the surgery. In these circumstances, a more real-time application such as exchange of text messages or real-time chat applications may be helpful. Scheduling applications may not be of much help here! Speech or gesture-based interactions Most applications with graphical user interfaces have evolved into becoming increasingly intuitive for users to handle/use them easily and unobtrusively. Thus, calendars or scheduling applications with speech-recognition abilities are no doubt useful, but come with their own set of disadvantages for a group such as the cited group of hospital staff. A medical room where procedures are executed quickly involves constant and rapid speech or verbal interaction amongst various hospital staff members such as the surgeon, the attendant nurses, the medical supplies person and the attendant responsible for arranging medical equipment/instruments. A shared scheduling tool on a surgeon’s iPhone is still important because his time is constantly booked for several appointments on a given day – and the surgeon may still need to access his scheduled meetings/appointments – here, keystrokes would be the preferred mode of operation as against speech or verbal instructions. Likewise, gesture-based applications may not be helpful as hospital staff would not have their hands free – they would be usually carrying equipment, notes, instruments or other aids – they would need to free their hands and then keystroke commands into their iPhones instead of attempting multi-tasking with gestures. Requirements Gathering A set of hospital staff was chosen to address to them, a questionnaire and seek their inputs – the questionnaire aimed to seek role-specific inputs from each of the respondents. The questionnaire was designed to check key elements such as use preferences, specific functional requirements, work-related challenges that need to be addressed by a scheduling application, audio and visual aid needs, change management, security and privacy requirements, work/schedule prioritization facilities, specific interface requirements between private, public and shared calendars (Park, “Requirements for Groupware Calendar Systems”), etc. The detailed questionnaire can be found in Appendix A at the end of this document. Rationale for and execution of the Questionnaire The questions were designed with the following requirements in mind: a) The questions have to be simple and direct, requiring responses in the form of phrases of simple sentences. b) Ease of comprehension –> As the respondents were from a non-computing background, the questions had to be worded in simple terms to enable easy and quick understanding. c) Speed of response –> The respondents are people who are typically tied up throughout any given working day and they would not be able to invest more than 15 to 20 minutes at the maximum for this survey. d) The questions had to help discover real-world or practical problems that challenge the target group on a day to day basis. In other words, domain-specific insights had to emerge with regard to use of the application by hospital staff. Results of Survey The survey was administered to two groups of hospital staff. In each group, the target staff included the staff members mentioned at the beginning of this paper viz. a) The Duty Doctor in the Emergency/Casualty Ward, b) The Surgeon, c) The Administrator, d) Attendant Nurses and e) The resident supplier for medical supplies. The responses helped crystallize the requirements for designing a user-friendly scheduling/calendar application. The results are presented in a tabular form below: Questionnaire item Key Responses Preferences 1) Interface has to be intuitive 2) Simple usability features 3) Quick application response (2 to 4 seconds) 4) Keystrokes should be minimal (no more than 5 characters for a given command) 5) Convenient operation through stylus or finger Specific functional requirements 1) One click to trigger a schedule/invite 2) Ability to store pre-determined schedules/meets (a meeting template store) 3) Easy-to-use meeting rescheduling and cancellation facilities 4) Easy detection of schedule clashes – with visible audio-visual alerts Domain-specific requirements 1) Emergency alerts from casualty or emergency ward. 2) Link-up to medical supplies inventory in the resident pharmacy. 3) Quick lookup of important calendars such as surgeon and casualty/emergency duty doctor calendars. 4) Easy booking of medical equipment for scheduled medical procedures (X-Ray, MRI, Scanning equipment, etc). 5) Visual distinction of different classes of schedules (eg: normal medical procedures, operations, urgent procedures, supply requirements meet, etc). Audio and visual aid needs 1) Hands-free operation needed with easy audio and visual alerts (beeps, flashes, etc). 2) Feature-rich audio-visual alerts needed to detect emergency requests. 3) Speech recognition facilities 4) Gesture-based facilities Security and Privacy requirements 1) Strong hack-proofing for all calendar entries. 2) Easy-to-use password reset facilities – but, with adequate security features. 3) Protection against inadvertent disclosure of private records of patients or leakage of patient database. 4) Anti-theft locking of the phone and calendar application to prevent malicious activities. Work prioritization facilities 1) Automatic over-ride had to be available for critical schedules such as emergency operations or medical procedures. 2) Corresponding cancellation or reassignment alert to go in for cancelled or over-ridden appointments. Interface between private, public and shared calendars 1) A quick sign-on interface needed for viewing private and shared/public calendars. 2) Visual alerts needed for check for emergency schedules and corresponding cancellations within private calendar. 3) Adequate protection and segregation of private and public or shared calendar entries. Analysis of the results Based on the responses collated in the table above, the following aspects of shared calendar were clarified in line with the specific requirements of this group: a) User Interface should be simple and intuitive – richness of interface was seen as a secondary requirement and not a primary requirement (probably, a student group would have sought interface richness). b) Emergency alerts and other schedule over-ride alerts had to be clearly visible and audible – the iPhone is built with good audio support, so this should not pose a significant challenge. c) Excellent hands-free features needed for the calendar application – this would include both speech-recognition aids as well as gesture aids. At the same time, the response time on gesture aids had to be low as accidental or inadvertent gestures were easily possible during medical procedures. d) Data security and privacy was critical to this user group both from the perspective of patient safety as well as from the perspective of regulatory requirements – This mandates some form of data encryption within calendar or scheduling data. This encryption has to be built into the application. e) Exchange of information has to be possible with quick and easy keystrokes or other command interfaces – speed is of the essence, hence the number of steps (clicks, voice commands, etc) had to be no more than two to a maximum of three in closing a given activity such as scheduling, rescheduling or cancellation. Design ideas The survey provided valuable insights into designing a domain-specific shared calendar and scheduling application for the hospital environment. The key design aspects being treated here include: a) Basic Functionality b) Information Availability c) Usability d) Domain-specific Features and Information Protection e) Response and Processing speeds (of the application) f) System administration and maintenance requirements (for the associated infrastructure) a) Basic Functionality The proposed calendar is a shareable online calendar with a front-end calendar/scheduling application that is graphical and resides on the iPhone while the back-end is a blade server hosting an Oracle database for enabling the sharing. The server infrastructure and the database are designed to handle a transaction capacity of 1000 calendar transactions per day, assuming the hospital is a small, 50-bed facility. The number ‘1000’ is an approximation based on subjective judgment and will be clarified at the time of building the actual application. The basic functionalities that will be built into the calendar include: i. Creating meeting/appointment schedules and sending out the appropriate alerts. ii. Viewing of group and individual appointments (daily, weekly and monthly) iii. Triggering reschedules and changes against existing appointments iv. Deleting meeting/appointment schedules and sending out the appropriate cancellation alerts. b) Information Availability The Server is designed with redundant power supply and UPS to handle 24X7 operations. The front-end application on the iPhone is provided with a ‘backup’ or ‘archive’ to store local or cached copies of meetings and appointments. Automatic synchronization facility is provided to seek and obtain data refresh from the server at periodic intervals. c) Usability The calendar application will be intuitive and support commands that are brief and simple. The following usability features will be embedded into the application: i. Each command is no more than 4 to 5 keystrokes/characters. ii. The application can be opened and closed with a single click or keystroke. iii. The entire application window can be viewed easily without clutter on the iPhone. iv. Cancellations to be done with a ‘confirmation’ pop-up. v. Different categories of appointments/schedules are shown in different hues/colors within all views viz. daily, weekly and monthly views. vi. The application supports voice and gesture commands. The gesture commands are to be set with customizable response time so as to enable each user to set the speed for his or her own speed of affirmative gesture in enabling/triggering a command. d) Domain-specific features and Information Protection The following features are to be built into the application considering the unique requirements of the hospital work environment: i. Audio-visual alerts to cater to emergencies – to enable this, the application will have a facility for building a set of customizable emergency or high-priority alerts – and when these alerts are triggered, a unique and different audio-visual alert has to be enabled on the user’s iPhone – again, each type of alert should have a different audio-visual signal or alert to ensure easy differentiation and identification of the alert. ii. Automatic over-ride of existing normal-priority appointments with high-priority or emergency schedules should be possible. Again, there should be an administrator facility available to configure the emergency alerts and trigger the right and appropriate levels of over-ride. iii. Automatic cascading of appointments in a tiered hierarchy will be made possible – for instance, a priority engagement introduced by the surgeon will automatically block the calendar of assisting staff such as attendant nurses and assistant doctors. iv. Shared viewing of critical calendars such as surgeon calendars would be made possible. v. 128-bit DES encryption will be built into the application to ensure strict privacy and confidentiality of data. e) Response and processing speeds The response times for keystrokes has to be very sensitive to the urgency levels while the processing speed has to be significantly high for critical operations such as triggering of emergency appointments and automatic over-rides. With this in mind, the application will be tested with sufficient iterations of user acceptance testing until acceptable levels of speed are achieved. f) System administration and maintenance requirements The back-end calendar database will be affixed with a weekly full backup and daily incremental backup schedule. Administrator logins will be built with higher levels of security such as longer and more complex password requirements. The Oracle database will be affixed with a periodic tuning schedule and responsibilities will be assigned to the Database Administrator to tune periodically. Synchronization facility between front-end (on the iPhone) and back-end application will be monitored through an appropriate daemon process, aided by an auto-recovery facility. If the auto-recovery of the synchronization facility fails, then the system administrator will be alerted through a system alert. References: Jeffery Kahn, “Application for 2008 University of California Larry L. Sautter Award for Innovation in Information Technology”, 20 Mar 2009, Laysea Palen, “Situated Evolutionary Use of Groupware Calendar Systems”, 19 Mar 2009, Sungmin Park, et al, “Requirements for Groupware Calendar Systems”, 20 Mar 2009, John Garett, “Sharing Calendar issues”, 19 Mar 2009 Appendix A – Questionnaire # Question Your Response 1. What are you basic preferences for a shared calendar utility? 2. Can you specify any functionality that is important to you? (eg: creating a calendar invite, reschedule, etc) 3. Can you specify features that are important to you within the hospital industry and within the context of your daily work? (eg: emergency rescheduling, shared viewing of calendar, etc). 4. What kind of audio-visual needs and alerts do you prefer? 5. What kind of usability features do you need? (speech recognition, gesture recognition, etc) 6. What are your information security and privacy requirements? What is the sensitivity of data stored for you and for the hospital? 7. What types of prioritization and reprioritization features are required? (eg: over-riding priority to surgeon requests, etc) 8. What kind of interfacing needs do you have between your private calendar and your work calendar? ========+++++======== Read More