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Designing Collaborative Workspaces for Particular Complex Work Settings Yingjing(Jane) Li A thesis submitted for the degree of Doctor of Philosophy in Computing Sciences Faculty of Engineering and Information Technology University of Technology, Sydney February 2016

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Page 1: Designing Collaborative Workspaces for Particular Complex ... · Designing Collaborative Workspaces for Particular Complex Work Settings Yingjing(Jane) Li A thesis submitted for the

Designing Collaborative Workspaces for Particular Complex Work Settings

Yingjing(Jane) Li A thesis submitted for the degree of Doctor of Philosophy in Computing Sciences Faculty of Engineering and Information Technology University of Technology, Sydney February 2016

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Certificate of Authorship/Originality

I certify that the work in this thesis has not previously been submitted for a degree nor has it been submitted as part of requirements for a degree except as fully acknowledged within the text.

I also certify that the thesis has been written by me. Any help that I have received in my research work and the preparation of the thesis itself has been acknowledged. In addition, I certify that all information sources and literature used are indicated in the thesis.

Signature of Candidate:

Date:

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Acknowledgements This research work has been a long journey. The completion of this work would not

have been possible without the support of many people whom I would like to thank

sincerely.

To Professor Toni Robertson, my supervisor, thank you for your guidance, inspiration,

input and encouragement. I appreciate your constructive advices which helped me to

establish the overall direction of this research and your suggestions which inspired and

challenged me to explore my research in depth. You constantly helped me by pointing

out the weaknesses in my work and by guiding me to clarify my ideas. I have been

fortunate to have worked with you since my early years of research at CSIRO and

throughout the journey of my PhD. Your guidance and encouragement have helped me

grow, both personally and professionally.

To Adjunct Associate Professor Duncan Stevenson, my advisor and former CSIRO

scientist, thank you for your mentoring and continuous support. I am grateful that you

shared your extensive research knowledge and experience with me and helped me better

understand the results of my explorations. I appreciate your detailed feedback which has

greatly improved the robustness of my thesis.

To Dr Christian Mueller-Tomfeld, Dr Kenton O’Hara, Susan Hansen and Dr Alex Hyatt,

former CSIRO scientists, and to Dr Tim Mansfield, former NICTA researcher, whom I

worked closely with in the studies that are presented in this thesis, thank you for all your

invaluable contributions to the field studies, data analysis and writing of papers. Your

knowledge and insights have greatly helped shape my research.

To my CSIRO managers and colleagues, Dr Laurie Wilson, Dr Jesper Kjeldskov, Dr

Leila Alem, Dr Jill Freyne, Dr Dimitrios Georgakopoulos, Dr Sarah Dods, Dr Trevor

Bird, Dr David Hansen, Dr John Zic and Narelle Clark, thank you for giving me a

supportive environment to enable me to pursue my doctoral degree. Your understanding

and encouragement are gratefully acknowledged.

To the members and associates of the Interaction Design and Human Practice Lab at the

University of Technology, Sydney, thank you for your friendship and support. I am

grateful that I did my PhD in this wonderful academic environment. Special thanks to

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Dr Julia Prior, Dr Jeni Paay, Dr Lian Loke, Dr Tuck Leong, Dr Penny Hagen, Dean

Hargreaves, Jeannette Durick and Anita Gisch for your company during my PhD

journey.

Most of all, to my husband Kai, my two children and my parents, I would never have

gone this far without your love and support.

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Table of Contents

1 Introduction .................................................................................................................. 1 1.1 Background ............................................................................................................. 1 1.2 Research Context – Designing Collaboration Technologies .................................. 4 1.3 Challenges in Supporting Distributed Collaboration .............................................. 6 1.4 Research Questions and Objectives ........................................................................ 8 1.5 Research Approach and Three Case Studies ........................................................ 10 1.6 Summary of Findings and Contributions .............................................................. 11 1.7 Structure of the Thesis .......................................................................................... 13

2 Supporting Distributed Collaboration - Literature Review ................................... 15 2.1 Distributed Collaboration, Interaction and Design ............................................... 16

2.1.1 An Overview of Media Spaces and Related Research ............................... 17 2.1.2 Social Interaction ........................................................................................ 19 2.1.3 The Space of Media Space ......................................................................... 21 2.1.4 Communication .......................................................................................... 24 2.1.5 Asymmetries and Fractured Ecologies ....................................................... 26 2.1.6 Issues in Early Media Space ....................................................................... 28 2.1.7 Reflections and Challenges ........................................................................ 30 2.1.8 Multi-display Environment and Shared Digital Workspace for

Meetings and Information Sharing ............................................................. 32 2.2 Collaboration across Different Local Settings ...................................................... 35

2.2.1 Variations in Local Practices ...................................................................... 36 2.2.2 Common Information Spaces ..................................................................... 39 2.2.3 Flexibility and Design ................................................................................ 42 2.2.4 Configuring Technology, Practices and Resources .................................... 44

2.3 Summary ............................................................................................................... 48 3 The Research Process ................................................................................................. 50

3.1 Evolution of the Research ..................................................................................... 50 3.1.1 Original Research Interest .......................................................................... 51 3.1.2 Perspective .................................................................................................. 52 3.1.3 Getting Focused .......................................................................................... 52

3.2 Workplace Studies in a System Design Context .................................................. 55 3.2.1 Workplace Study in CSCW ........................................................................ 55

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3.2.2 Challenges in Conducting the Studies ........................................................ 58 3.3 Research Process ................................................................................................... 63 3.4 Data Collection and Data Analysis ....................................................................... 64

3.4.1 Data Collection ........................................................................................... 65 3.4.2 Data Analysis ............................................................................................. 66 3.4.3 Synthesis ..................................................................................................... 67

3.5 Summary ............................................................................................................... 68 4 Case Study: Collaboration in Multidisciplinary Medical Team

Meetings ...................................................................................................................... 69 4.1 Multidisciplinary Team Meetings ......................................................................... 69 4.2 Related Work ........................................................................................................ 71 4.3 Research Context and Motivation ......................................................................... 74 4.4 Methods ................................................................................................................ 76 4.5 Meetings Within and Between the Hospitals ........................................................ 79 4.6 Local Meetings ..................................................................................................... 81

4.6.1 Physical Settings ......................................................................................... 81 4.6.2 Preparing Information ................................................................................ 84 4.6.3 Presenting Information ............................................................................... 86 4.6.4 Context of Different Information Practices ................................................ 87 4.6.5 Conversation and Case Discussion ............................................................. 88

4.7 Distributed Meeting .............................................................................................. 88 4.7.1 Physical Settings ......................................................................................... 89 4.7.2 Presenting Information ............................................................................... 91 4.7.3 Technology-mediated Conversations ......................................................... 92 4.7.4 Synchronising Conversation and Image Sharing ....................................... 93

4.8 Exploration of the Physical Setup ......................................................................... 94 4.9 Discussion ............................................................................................................. 95

4.9.1 Designing Physical Space........................................................................... 96 4.9.2 Supporting Information Sharing ................................................................. 98 4.9.3 Challenges of Integration ......................................................................... 100

4.10 Conclusion .......................................................................................................... 101 5 Case Study: Distributed Collaboration in Emergency Response on

Animal Disease .......................................................................................................... 103 5.1 Emergency Response on Animal Disease .......................................................... 103 5.2 Related Work ...................................................................................................... 106

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5.3 Research Context and Motivation ....................................................................... 108 5.4 Methods .............................................................................................................. 110 5.5 CCEAD Meetings ............................................................................................... 111

5.5.1 Physical settings ....................................................................................... 112 5.5.2 Decision Making ...................................................................................... 115 5.5.3 Information Sharing ................................................................................. 116 5.5.4 Background Work and Multi-tasking During Meetings ........................... 119

5.6 Exploration of the Physical Setup ....................................................................... 120 5.7 Discussion ........................................................................................................... 122

5.7.1 Coordination and Working Together ....................................................... 123 5.7.2 Supporting Information Sharing ............................................................... 124 5.7.3 Different Settings and Existing Mechanisms ........................................... 125

5.8 Conclusion .......................................................................................................... 127 6 Case Study: Distributed Scientific Collaboration across

Biocontainment Barriers ......................................................................................... 128 6.1 Distributed Scientific Collaboration ................................................................... 128 6.2 Related work ....................................................................................................... 129 6.3 Research Context and Motivation ....................................................................... 131 6.4 Research Methods ............................................................................................... 133 6.5 The work of AAHL ............................................................................................. 135

6.5.1 The Physical Setting ................................................................................. 136 6.5.2 Work Groups ............................................................................................ 137

6.6 Collaboration within AAHL ............................................................................... 138 6.6.1 Collaboration within and between Groups ............................................... 138 6.6.2 Collaboration Issues ................................................................................. 141 6.6.3 Information Sharing Issues ....................................................................... 143

6.7 Informing the Design .......................................................................................... 145 6.7.1 Scenario One: General Group Discussion ................................................ 146 6.7.2 Scenario Two: Real-time Scientific Data Discussion .............................. 149 6.7.3 Scenario Three: Collaborative PC4 Work ................................................ 150

6.8 Post-deployment User Study .............................................................................. 151 6.9 Discussion ........................................................................................................... 153

6.9.1 Supporting Coordinative Practices ........................................................... 154 6.9.2 Linking People with People, Information and Facilities .......................... 155 6.9.3 Designing for Different Local Requirements ........................................... 156

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6.10 Conclusion .......................................................................................................... 157 7 Issues and Design Guidelines................................................................................... 158

7.1 Understanding Distributed Collaboration in Context ......................................... 158 7.1.1 Summary of Findings ............................................................................... 159 7.1.2 Common Issues ........................................................................................ 160

7.2 Guidelines for Designing Collaborative Workspace .......................................... 163 7.2.1 Guideline 1: Focusing on Supporting Information Sharing ..................... 165 7.2.2 Guideline 2: Constructing Physical Space to Support Social

and Communicative Interactions .............................................................. 167 7.2.3 Guideline 3: Configuring Physical Space and Information

Space to Support Integrated Communication and Information Sharing ...................................................................................................... 169

7.2.4 Guideline 4: Configuring Collaborative Workspaces to Enable Local Practices ......................................................................................... 171

7.2.5 Guideline 5: Configuring Collaborative Workspace in the Broader Organizational and Procedural Arenas ....................................... 174

7.3 Summary ............................................................................................................. 175 8 Contributions and Conclusion ................................................................................ 176

8.1 Contributions ...................................................................................................... 176 8.2 Future Work ........................................................................................................ 179 8.3 In Conclusion ...................................................................................................... 181

Appendix A: Publications ............................................................................................. 183 References ...................................................................................................................... 185

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List of Figures

Figure 1.1. A research prototype - Blended Interaction Space installation ...................... 3 Figure 2.1. The components of the literature review in this thesis ................................. 16 Figure 3.1. Getting focused ............................................................................................. 54 Figure 3.2. An overview of the research process ............................................................ 63 Figure 4.1. Site plan of the local meeting at hospital A .................................................. 83 Figure 4.2. Site plan of the local meeting at hospital B .................................................. 83 Figure 4.3. Preparation of patient histories ..................................................................... 84 Figure 4.4. Preparation of radiology images ................................................................... 85 Figure 4.5. Preparation of pathology images .................................................................. 86 Figure 4.6. Site plan of the room for distributed meeting at hospital A in

distributed meeting ....................................................................................... 90 Figure 4.7. Site plan of the room for distributed meeting at hospital B .......................... 91 Figure 4.8. Examples of clinicians’ design sketching ..................................................... 95 Figure 5.1. Membership of CCEAD ............................................................................. 105 Figure 5.2. A large meeting room ................................................................................. 112 Figure 5.3. The office used for the meeting .................................................................. 114 Figure 5.4. Information access and distribution ............................................................ 117 Figure 5.5. Room arrangement 1................................................................................... 121 Figure 5.6. Room arrangement 2................................................................................... 122 Figure 6.1. The physical layout of the work areas at AAHL ........................................ 136 Figure 6.4. Overview of the work groups and interactions between them ................... 139 Figure 6.5. Diagnostics collaboration between related work groups ............................ 139 Figure 6.6. Communication and information sharing between work groups ................ 142 Figure 6.7. Three design scenarios to drive the design of the collaboration

platform ...................................................................................................... 145 Figure 6.8. Shared workspace at the general office area in AAHL .............................. 147 Figure 6.9. Side view of the physical setting of the shared workspace ........................ 148 Figure 6.10. Collaboration between scientists in PC4 and scientists in the control

room in PC3 ............................................................................................... 151 Figure 7.1. Complex and interrelated issues in distributed collaboration across two

different local settings ................................................................................ 161 Figure 7.2. Mapping the five guidelines to the factors that shape distributed

collaboration in particular local settings .................................................... 165

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Figure 7.3. Integrating physical space and information space in a large meeting room environment ...................................................................................... 170

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List of Tables

Table 4.1. Participants interviewed ................................................................................. 77 Table 4.2. Participants at hospital A ............................................................................... 81 Table 4.3. Participants at hospital B................................................................................ 82

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List of Abbreviations

AAHL Australian Animal Health Laboratory

BISi Blended Interaction Space installation

CCEAD Consultative Committee for Emergency Animal Disease

CSCW Computer Supported Cooperative Work

CSIRO Commonwealth Scientific and Industrial Research Organisation

CVO Chief Veterinary Officer

DAFF Department of Agriculture, Fishery and Forestry

DSTO Defence Science and Technology Organisation

EPR Electronic Patient Record

HCI Human Computer Interaction

HD High Definition

JCSCW Journal of Computer Supported Cooperative Work

LCD Liquid Crystal Display

LIMS Lab Information Management System

MDTM Multidisciplinary Medical Team Meeting

NICTA National ICT Australia

PACS Picture Archive and Communication Systems

PC3 Physical Containment Level 3

PC4 Physical Containment Level 4

ViCCU Virtual Critical Care Unit

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Abstract

This research explores how new collaboration technology can be designed to enhance

distributed collaboration in particular complex work settings. Collaboration in work

environments increasingly involves complex interactions between individuals and teams

working across geographical, institutional and professional boundaries. This research

addresses the challenges of supporting real-time communication and information

sharing between different teams and across variable local settings. These issues are

explored within the context of developing collaborative workspaces which integrate

sophisticated video conferencing and information sharing technologies in multi-display

environments. This research aims to understand the characteristics of interactions that a

collaborative workspace needs to support and how to design a collaborative workspace

for collaboration across different local settings without compromising the integrity of

local work practices.

The research issues were explored through three case studies in three work domains:

multidisciplinary medical team meetings in two hospitals, collaboration in a national

committee responsible for the emergency response to animal disease, and scientific

collaboration across containment barriers in a biosecurity laboratory. Workplace studies

were conducted in each of the studies. The case studies were research components of

design-oriented projects carried out by the Commonwealth Scientific and Industrial

Research Organisation (CSIRO) with aims to inform the design of a collaborative

workspace within each domain. The case studies are the empirical contributions of this

thesis.

This research has shown that a set of socio-technical factors relating variations in local

physical settings, information sharing practices and organizational contexts can

influence the dynamics of collaboration across different local settings. The results

highlight different kinds and levels of configuration work required in designing

collaborative workspaces. These include the careful integration of physical settings with

information sharing practices, the appropriate configuration of collaborative workspaces

to enable diversity of local practices and the configuration of collaborative workspaces

at an organizational level and in the context of coordinative practices. The results of the

study have contributed to the development and deployment of an integrated

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collaboration platform in a scientific laboratory and have demonstrated that a generic

collaborative workspace can be extended by components developed in response to the

specific requirements of the work of the local setting. A set of design guidelines has

been developed that can be used to guide the design and development of collaborative

workspaces which provide coherent collaboration environments across different already

existing local settings while respecting the variations within local practices.

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1 Introduction

The research presented in this thesis explores collaborations between individuals

working at different locations and in complex work settings. It focuses on how to design

new collaboration technology to support these collaborations that can fit well with

particular work practices and organizational context. This focus is explored within the

research fields of computer supported cooperative work (CSCW) and human computer

interaction (HCI). Three case studies of distributed collaborations in three different

work settings form the empirical contributions of the research and theoretical

contributions are derived from the results of the three case studies.

This chapter introduces the thesis and describes its contributions to the fields of CSCW

and HCI. It includes a discussion of the background of the research, an overview of its

context and challenges, the research questions addressed in it, an introduction to the

three case studies and a summary of its findings and contributions.

1.1 Background

As a researcher working in a laboratory of the CSIRO (Commonwealth Scientific and

Industrial Research Organization), I have been involved in a number of projects in the

design and development of new technologies to enhance distributed collaboration. One

of the research foci of these projects has been the design of technologies to be deployed

in real-world work environments to support collaborative activities such as diagnosis,

planning, analysis and decision making. An example of early work that I was involved

in was the development of the Virtual Critical Care Unit (ViCCU) which was a

broadband telehealth system allowing a medical specialist to remotely supervise a

clinical team in an emergency department managing critically ill patients (Li et al. 2006,

Wilson et al. 2010). My initial role in this project was visiting hospitals and talking with

clinicians in order to understand their requirements. These understandings were then

used to generate technical specifications for technical design. After an iterative design

process the ViCCU system was successfully deployed and provided a link between the

emergency departments of a large public hospital and a small rural hospital. I

participated in the evaluation of the system in the emergency departments where I

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observed how the system was used. The design team was not familiar with CSCW and

HCI research and evaluation methods but was motivated to work closely with the

clinical users. The evaluation results showed that the factors contributing to the

effectiveness of the system were not just the high quality audio-video channels enabled

by a broadband network. Our understandings of the dynamic interaction patterns in the

clinical practices and the tailored design that benefited from field visits before and

during the design process had contributed to the successful integration of the system

into the work practices of the emergency department. These findings made it clear to the

technology designers that our design approach needed to shift from the traditional

emphasis on laboratory experiments to the real-world context in order to overcome both

technical and non-technical issues in designing and implementing new technologies.

The experiences from this project directed my attention to CSCW and HCI fields which

are design-oriented research fields that inform technology design by empirically derived

understandings of how people work within groups and organizations and the impacts of

technology on those processes.

I participated in the “Braccetto” project within the HxI Initiative, a research

collaboration between Australia’s leading publicly funded research organisations –

CSIRO, DSTO (Defence Science and Technology Organization) and NICTA (National

ICT Australia) from 2007 to 2009. One of the research outcomes of this project was the

demonstration of a collaborative workspace, a research prototype called Blended

Interaction Space installation (BISi) (Broughton et al. 2009, Paay et al. 2011, O’Hara et

al. 2011) (Figure 1.1). It was designed to facilitate collaboration within a small group of

distributed participants and as a walk-up-and-use system where the user does not have

to deal with camera and audio setups. It enabled distributed participants to share a range

of digital content on large displays, including four large displays and a tabletop display,

with simultaneous multi-user interactions. The configuration of the furniture and

displays provided a “blending” of the local physical workspace with the video

conferencing images of the other side so the two sites appeared as one workspace. It

enabled more complex collaborative activities than the normal interactions in a board-

meeting-room type of video conferencing. By creating a shared physical and digital

workspace, it aimed to support complex hands-on collaborative activities and facilitate a

being-together user experience in distributed collaborations.

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Figure 1.1. A research prototype - Blended Interaction Space installation

The work of HxI also included conducting field studies in different work domains in

order to provide high level design insights for the design of BISi. After the completion

of the HxI Initiative, the CSIRO research team decided to extend the design of this

generic prototype and deploy the technology to real-world environments. Studies of

distributed collaboration were carried out in a number of work domains in order to

inform specific designs. Based on the conversation with the managers of related

organizations and initial understandings of the collaboration requirements, some of the

work domains were identified as potentially suitable sites to proceed with field studies

and extension design of BISi.

Since the ViCCU project, I have participated in a range of field studies of distributed

collaboration in real-world work environments. These studies include:

Collaboration in the multidisciplinary medical team meetings in two hospitals in

Sydney. This study was done by the HxI team. I was one of the key members of

the team.

Distributed collaboration between members of a large-scale committee working

in managing the responses to emergency animal disease. This study was done by

CSIRO researchers. I was one of the key members of the study.

Distributed scientific collaborations within a national animal health laboratory

which has high bio-containment facilities. This was conducted by the CSIRO

researchers and I led the study.

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My involvement in these design-oriented investigations led to the research in this thesis.

The aim of the research is to address the challenges of particular complex work settings

and the design of technologies to support distributed collaboration within and across

these complex settings.

I had approvals from the University of Technology, Sydney and CSIRO ICT Centre to

be enrolled as a part-time PhD student and I had permission from CSIRO to use the

intellectual property from my work at CSIRO towards my degree.

1.2 Research Context – Designing Collaboration Technologies

There has been an interest for more than three decades, within the research fields of

CSCW and HCI, in developing systems that use audio-video communication

technologies to support real-time collaborations between people based in different

locations. A central and on-going focus of this stream of research has been the design

and development of systems to provide support for activities and interactions in real-

world settings. This research focuses on understanding people’s work practices and

experiences in order to design technologies that support the way people communicate

and interact in their everyday and working lives (Bannon & Schmidt 1991, Blomberg

1993, Schmidt 1998, Rogers et al. 2011, Kuutti & Bannon 2014). Studies in these

research fields, particularly CSCW, provide rich insights into how work is

collaboratively achieved as well as guidelines for designing technologies that support

that work (Blomberg & Karasti 2013, Fitzpatrick & Elingsen 2013, Bjorn et al. 2014).

Research in distributed collaboration explores technical design challenges (e.g. Tang &

Minneman 1990, Gaver 1992, Childers et al. 2000), recognizes issues of computer-

mediated communication (e.g. Bly et al. 1993, Heath et al. 1995, Olson & Olson 2000)

and, importantly, addresses the complex socio-technical issues that shape the

collaboration (Harrison 2009 and most of the studies referred to in this thesis). It is

widely accepted that a collaborative system has “the technological components which

determine how the system will behave and the social components which determine the

acceptable use and behavior” (Dourish 1993, p.125). Interaction in a technology-

enabled environment is, by its nature, a social activity and the collaborative systems

used to manage the connectivity of the work environments are always embedded within

social and organizational contexts (ibid). Researchers need to go beyond traditional

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cognitive and usability-based models to understand the relationship between people,

technology and practice.

The interrelations between work practice and the design of collaboration technology

have been widely explored in a wide range of work domains, such as healthcare

delivery (Heath & Luff 1996, Reddy et al. 2001, Kane & Groth 2013, Fitzpatrick &

Ellingsen 2013) and collaborative scientific work settings (Finholt & Olson 1997, Olson,

Zimmerman et al. 2008), that relate to the case studies in this thesis. Research in the

healthcare domain has highlighted the needs for a “contextual” understanding of the

actual work practice and a socio-technical approach in the design process (Zuiderent et

al. 2003, Kane et al. 2011). Similarly, research in scientific collaboration has called for

a shift from a focus on technical design and development to consider how technologies

and infrastructure can be embedded into the everyday working lives of scientists

(Jirotka et al. 2013). One key challenge for technology designers has been to understand

the practices that new technologies will support and the context in which they need to

be integrated (Kuutti & Bannon 2014).

There has been a range of collaboration technologies developed to support work-

focused interactions since the early 1990s when audio-video communications were used

to connect office environments (e.g. Dourish & Bly 1992, Gaver 1992, Bly et al. 1993).

These technologies include Access Grid which is an ensemble of resources such as large

displays and conferencing facilities for group-to-group collaboration (e.g. Childers et al.

2000, Corrie & Zimmerman 2009), high-definition and high fidelity telepresence video

conferencing system (e.g. Gorzynski et al. 2009) and the recent developments

integrating telepresence video conferencing with shared digital workspaces (e.g. Wigdor

et al. 2009, Stevenson 2011, Yamashita et al. 2011, Luff et al. 2013, and BISi described

in Section 1.1). The technology investigated in this thesis relates to this recent

technology development which supports high quality audio-video communication and

advanced information sharing and interaction in a multi-display environment. The term

“collaborative workspace” will be used to refer to this technology development.

Researchers have found that despite the increasing use of collaboration technologies and

the creation of prototypes, people are still not successfully embedding these systems

into everyday work life (e.g. Baecker et al. 2008, Luff et al. 2009, Tang 2009, Jirotka et

al. 2013). As Luff et al. (2009) commented, it has been a “highly intractable” problem

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to put a successful and usable collaborative system into an organizational setting (p.27).

Social, behavioural and cultural issues are still relevant (Baecker et al. 2008, Harrison

2009, Olson & Olson 2013, Bjorn et al. 2014). Interaction issues are still evident (e.g.

Harrsion 2009, Luff et al. 2013). Technology improvements are still being explored by

researchers, such as shared interaction with information by remote pointing and

annotation (e.g. Stevenson et al. 2010, Norris et al. 2013) and configuration of the

physical setup to create coherent collaboration environments (e.g. Ciolfi et al. 2008,

Buxton 2009, Paay et al. 2011). While introducing collaboration technology has been

considered as a way to improve work efficiency, getting it right has been considered an

ongoing challenge (e.g. Fitzpatrick & Ellingsen 2013, Olson & Olson 2013, Schmidt &

Bannon 2013).

1.3 Challenges in Supporting Distributed Collaboration

The research in this thesis addresses the challenges in designing collaborative

workspaces to support collaborations in complex real-world work settings. There are

two main aspects of these challenges: understanding the socio-technical issues of

collaboration in a particular setting and designing technology to support the

collaboration within that particular setting.

The first aspect relates to understanding the complexity of collaborative work and its

settings. The complexity here is also discussed from the perspective of different local

settings for collaboration. It relates to the organizational and procedural contexts, the

particular work practices and collaboration activities and the relationships and

interactions among individuals and teams, as described below.

Collaboration involves complex interactions between people (e.g. Schmidt & Bannon

1992). Both the particular work practice itself (such as delivering healthcare services)

and the physical work environment of that practice (such as a scientific laboratory

which has expensive instruments and access restrictions), can be extremely complex.

There are complexities of coordinating activities and information sharing practices

among individuals and teams (e.g. Schmidt & Simone 1996, Abraham & Reddy 2013).

In addition, technology advances have enabled sharing high definition images and

videos (e.g. Ackerman et al. 2013) and integrating various local information systems

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(e,g. Kane & Luz 2013). Collaborations in work practices increasingly involve richer

and more complex interactions (e.g. Jirotka et al. 2013, Kuutti & Bannon 2014).

Distributed collaboration involves individuals or teams working in different local

settings across geographical, institutional and professional boundaries. A typical

example can be found in healthcare where work practices have been widely considered

as “complex, diverse and locally situated”, involve multiple groups of professionals in

private or public funding environments and depend on a highly collaborative approach

(Fitzpatrick & Ellingsen 2013, p. 609). The major focus of collaboration technology is

to support individuals and teams from diverse disciplines and backgrounds to coordinate

their work and information sharing across institutional and professional boundaries

(Olsen, Hofer et al. 2008). Local variations in different work settings present a

challenge that needs to be explicitly addressed by designers during their design of new

collaborative technologies (Schmidt et al. 2007). Balka et al. (2008) argue that

identifying essential sources of variations and configuring technology to support local

practices remain open issues in CSCW. The key question is how to address socio-

technical issues to enable the technologies to fit with the particular contexts and

practices and to support smooth collaboration across different settings.

With technology advances there has been a trend of expanding the context of work

practices, such as involving distributed care teams in healthcare, cross-institutional

collaboration in scientific work, large scale national initiatives for health related issues

and crisis management and emergency response (Fitzpatrick & Ellingsen 2013, Jirotka

et al. 2013, Pipek et al. 2014). Collaborative work has become more distributed and

involves an increasing number of people from different disciplines. These changes have

broadened the scope of collaboration settings and introduced more complexities in

distributed collaborations. They have also created challenges in studying large-scale and

multi-site collaborations (Randell et al. 2011, Blomberg & Karasti 2013).

The second aspect of the challenges in supporting distributed collaboration relates to

designing technologies and solutions that can fit well with particular local settings.

Fitzpatrick et al. (1998) in a study of distributed collaboration in a healthcare

environment remark that solutions relying only on the introduction of collaboration

technologies will always need to work within local constraints and will not in

themselves change the problems which cause the constraints in the first place.

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Technologies involved in distributed collaboration, particularly displays and new

interaction technologies, have changed rapidly over the last ten years. Advanced

networks offer higher bandwidth and higher quality for audio-video communications.

However, one of the issues with the recent development of multi-display environments

and shared digital workspaces is that these technologies have been mostly studied only

at a research prototype level and for generic collaborations (Baecker et al. 2008, O’Hara

et al. 2011). It is acknowledged that there are gaps in understanding the design solutions

when transition is made from the laboratory to the implementation in local and

organizational contexts (Stevenson 2011, O'Hara et al. 2011). Significant effort is still

required to deploy innovative collaboration technologies and experimental prototypes in

real work environments and to address the challenges of everyday work and interaction

(Baecker et al. 2008, Luff et al. 2014). Designing a collaborative workspace within a

complex work setting, that includes the physical environment, people's behaviours and

interactions, and their information sharing practices, still needs to be more completely

understood. A deeper and detailed analysis of the development of collaborative

workspaces in real-world settings is still needed and will contribute to the

understandings of whether and how previous socio-technical issues identified in CSCW

and HCI in distributed collaboration come into play in the development and how to

address these issues (Schmidt & Bannon 2013, Olson & Olson 2013, Bjorn et al. 2014,

Kuutti & Bannon 2014).

1.4 Research Questions and Objectives

Common to distributed collaboration in the work domains investigated in this thesis are

the complexity of information sharing requirements and the coordination work required

for diverse disciplines, teams and organizational contexts. These include distributed

medical team meetings between two hospitals which have different meeting practices;

multi-site, multi-state collaboration on emergency response which involve individuals

and teams from different organizations; and distributed collaborations within a

biosecurity laboratory where different groups of scientists collaborate across physical

containment barriers. A particular complexity with distributed collaboration in these

settings is the variation in work practices between local settings in which the distributed

collaboration is embedded. There is a complex set of asymmetries between local

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settings that need to be considered in any technology intervention to support

collaboration between them.

The research questions in this thesis are organized in two groups. One concerns people’s

cooperative work and interactions. The second concerns how to design technology to

support the cooperative work and interactions. These two related groups of questions

are addressed by investigating the design of collaborative workspaces to support

distributed collaborations across different local settings and in complex work

environments. The two groups of research questions are:

What special characteristics of interaction do collaborative workspaces need to

support in complex work settings? What are the socio-technical factors that

shape the dynamics of the distributed collaborations across different local

settings?

What principles and guidelines might support the design of collaborative

workspaces for complex work settings? How can collaborative workspaces be

configured to support distributed collaborations across different local settings?

Results from this research will be discussed with reference to these research questions

in Chapter 7.

The central aim of this research is to understand not only what perceptual or technical

functionalities a collaborative workspace needs to provide, but also how appropriate

these functionalities are to support the complexity of interaction in work practices.

Particularly, there is an opportunity for this research to contribute to the research trend

in developing collaboration technologies that can be used across highly variable local

settings (Schmidt et al. 2007, Balka et al. 2008). The research goals are to:

acquire a thorough understanding of issues in collaboration spanning different

contexts and boundaries

understand the implications and design efforts that are required for appropriate

solutions to enhance distributed collaborations

provide guidelines on configuring collaborative workspace technology for

different contexts and environments in distributed collaborations

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1.5 Research Approach and Three Case Studies

The workplace studies were designed to understand collaborations in each of the three

specific work domains and generate insights to inform technology design. Mixed

methods, including participant interviews and observation conducted within the

workplace, were chosen for the qualitative inquiry in each study. The research draws on

ethnographic methods to explore the nature of cooperative work. Particular foci of

investigations include coordination - how people align and adjust their activities in

relation to the action of others; material resources for action - the ways artefacts (such

as paper documents, computer displays) enable people to work together; how people

share and interpret information resources collaboratively to enable collaboration; and

the physical environment in which the work is done.

The research process was not a linear sequence of one case study following another.

Instead it was an iterative and reflective process between and across the three studies.

The results of each study provided design implications for the particular setting. They

also informed and helped to refine the research design of the next study. A cross-case

analysis brought together socio-technical issues identified in the field work and led to a

set of guidelines that can be applied to other similar research efforts in designing

collaborative workspaces to support collaboration across different local settings.

The particular collaborations that the three case studies investigated are briefly

introduced below.

MDTM study. The study of multidisciplinary team meetings (MDTMs) was conducted

with two multidisciplinary breast cancer teams at two hospitals in Sydney. The goal was

to find out how the teams collaborated in their local face-to-face meetings and in their

discussions across the two hospitals using a standard video-conferencing system.

Investigation focused on the organizational contexts, existing collaboration technology

facilities, the physical setups of the meeting rooms, the preparations of medical

information before the meetings and the sharing of medical information during the

meetings.

CCEAD study. The study of distributed meetings for emergency response on animal

disease explored work practices of the Australian Consultative Committee for

Emergency Animal Disease (CCEAD), a geographically distributed committee

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established to recommend action plans during an animal disease outbreak. The study

focused on the structures of the local teams in this large-scale committee, their local

environments and constraints, the ways in which the CCEAD members share and

analyse information together in the teleconferencing mediated meetings which support

audio connections only between members in different states.

AAHL study. The third case study was conducted at the Australian Animal Health

Laboratory (AAHL). AAHL has a sophisticated containment environment which allows

scientists to conduct research requiring high level biosecurity. Scientists of this

laboratory work in the same building but are often separated by the containment barriers

that particular procedures are required to cross. The goal of the study was to understand

how different groups of scientists working on different sides of the containment barriers,

share information and collaborate in its analysis.

In writing this thesis, “MDTM study”, “CCEAD study” and “AAHL study” will be used

to refer to each of the studies. Details of these studies will be described in Chapters 4, 5

and 6.

These workplace studies were conducted by a team of researchers, including the

supervisor of this PhD thesis in the first study. Different researchers had different levels

of involvement in designing the studies, conducting the studies and analysing the data.

Details of these researchers and their roles will be described in each case study Chapter.

I designed the studies with the guidance from senior researchers involved, coordinated

the field study activities and took a leadership role in analysing interview and

observation data and informing the results to the design team.

1.6 Summary of Findings and Contributions

Results from this research contribute to the expanded understanding, knowledge and

practices in the fields of CSCW and HCI. The results also contribute to related research

in specific work domains where they were situated, namely MDTM, emergency

response for animal diseases and scientific collaboration.

Firstly, the three case studies provide an understanding of distributed collaboration in

complex work settings, including the novel collaboration settings of studies that have

not been reported in the literature. They draw on the fundamental idea of

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conceptualizing distributed collaboration as a flexible assemblage of people, technology

and practices to explore socio-technical issues.

MDTM study. The MDTM study shows that factors such as arrangement of physical

setup, medical information sharing practices and asymmetries between these factors

across different sites clearly influenced the dynamics of collaboration and the

experience of participants in distributed MDTMs. Of more significance in presenting

the findings is the consideration of how these arrangements and practices arise and

implications this has for understanding practices and technology intervention. The study

identifies key design issues in spatial configuration and supporting different medical

information sharing practices when designing a collaborative workspace and integrating

it into particular local practices. It extends prior research in MDTMs (Kane & Luz 2006,

2011, 2013, Groth et al. 2008, Kane et al. 2013, Kane & Groth 2014) to explore

variations in local settings and aligns with the growing research attention to the

distributed care teams in CSCW and HCI fields (Fitzpatrick & Ellingsen 2013).

CCEAD study. The CCEAD study highlights factors relating to the emergency features

of the task, loosely coupled group structure, multiple sites with different local physical

settings and how these influence the group’s information sharing and communication

practices in an emergency response. It contributes to our understanding of large-scale,

across-organizational collaboration as well as our understanding of collaborations in

national emergency response for infectious animal diseases. This context does not

appear to have been explored previously in the literature.

AAHL study. The AAHL study shows how collaboration issues relate not just to the

challenges caused by the biocontainment barriers but also to the need for collaboration

support between the scientists and their work groups. Results of this study have

contributed to the design and development of a collaboration platform that has been

integrated into the work of AAHL to address three specific collaboration requirements

of local practices. This research extends prior work in prototypes of collaborative

workspace (Wigdor et al. 2009, O'Hara et al. 2011, Luff et al. 2013) to the design and

actual deployment of the technologies in a complex real-world environment. The

novelty of the specific collaboration context and the challenging scientific work

environment provides a unique opportunity to contribute to the growing CSCW

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literature on distributed scientific collaborations (Olson, Zimmerman et al. 2008, Jirotka

et al. 2013).

Most importantly, the insights from this research contribute to the development of

design approaches and design guidelines for designing collaborative workspaces across

different local settings. Firstly, this research addresses the issue of variability in local

practices in distributed collaboration. It highlights that local practices cannot be simply

treated as isolated practices and that distributed collaboration is shaped by various

dependencies associated with the practices of local settings. This research develops an

in-depth understanding of a range of socio-technical factors that need to be considered

to support collaboration across different local settings. Secondly, as shown in the AAHL

study, this research demonstrates the important design and configuration approaches to

support flexibility of use and deployment of generic technologies that can be combined

and re-combined in different settings (Schmidt et al. 2007, Balka et al. 2008). Thirdly,

this research provides design implications and design guidelines which aim to help in

developing collaborative workspaces. It extends related design guidelines in the

research literature to a broader perspective on configurative work.

Drawing on the specific implications generated in each of the case studies and synthesis

across these studies, this research highlights a set of design guidelines to address the

challenges of designing collaborative workspaces for particular complex work settings.

These guidelines include: focusing on supporting information sharing; appropriate

construction of physical space; configuration of physical space to enable and integrate

information sharing; configuration of the collaborative workspace to enable local

practices; and configuration at organizational level to enable information sharing and

coordinative practices across different local settings.

Key findings and contributions of this research have been published in two peer-

reviewed journal papers and seven peer-reviewed conference papers. These are listed in

Appendix A. These publications have been drawn on to write each of the studies in

Chapters 4, 5 and 6.

1.7 Structure of the Thesis

Chapter 1 presents an overview of this research and a brief summary of the findings.

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Chapter 2 presents literature reviews of related issues and concepts that have been

explored in CSCW and HCI fields.

Chapter 3 addresses the research process and methodology.

Chapters 4, 5 and 6 describe details of the three case studies and their results.

Chapter 7 brings findings from the three case studies together and presents synthesized

insights.

Chapter 8 summarizes contributions of this research.

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2 Supporting Distributed Collaboration - Literature Review

There has been a long-standing interest in CSCW and HCI research in developing

systems to support synchronous collaboration among individuals and teams based in

different locations. This chapter reviews the literature within CSCW and HCI concerned

with understanding interaction in distributed collaboration, the socio-technical issues

and design principles that are relevant to the design of collaboration technologies. I will

focus on the work that provides the foundations and inspiration for this thesis.

In section 2.1, I will draw on the literature of “media space” to show how various

aspects of interaction in distributed collaboration and related design issues have been

explored. The concept of and research about “media space”, using real-time audio-video

communication to connect separately located groups of people, has had significant

impact on the design and development of collaborative systems in CSCW and HCI

since it was introduced from the mid 1980’s into the early 1990’s. There is no doubt that

technologies and systems since then have become more sophisticated than the original

media spaces. However, the media space research paradigm with its concerns for

collaborative system design and how people manage to cooperate within these systems

is still important in distributed collaboration research.

Section 2.2 specifically focuses on designing collaboration technologies for complex

work settings. The attention here is directed to how the complexity around variations in

local settings has been analysed and designed for, in CSCW and HCI research.

There is a wide range of research that addresses the particular collaboration challenges

in each of the three work domains studied in this research. I will introduce research

specifically related to each domain in Chapters 4, 5 and 6 where the details of each case

study are described. The literature on research methods used in studies of work practice

is presented in Chapter 3.

The structure of all the components of literature review in this thesis, including those

that are not covered in this chapter, is shown in Figure 2.1 below.

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Figure 2.1. The components of the literature review in this thesis

2.1 Distributed Collaboration, Interaction and Design

The term “media space” is generally applied to “computer-controllable networks of

audio and video equipment used to support synchronous collaboration” (Gaver 1992,

p.17). The term emerged from a concern for both the social and technical practices of

collaborative work and from an effort to support those practices (Bly et al. 1993). Work

beginning in the mid 1980’s demonstrated that by offering rich environments for

communication and collaboration, media spaces could enable social connection, foster

close collaboration, and create a sense of being-together for distributed individuals or

teams (e.g. Stults 1986, Buxton & Moran 1990, Mantei et al. 1991, Gaver 1992, Fish et

al. 1992, Heath & Luff 1992a, Bly et al. 1993, Dourish 1993, Tang et al. 1994).

Participants in CSCW and HCI conferences have reflected on the research focus of

media space and discussed its impact on the long-term research of collaborative

technologies and collaborative experience. One significant output of these reflections is

the book “Media Space 20+ Years of Mediated Life” (Harrison 2009) which came out

of a workshop in the CSCW’06 conference. It includes chapters written by researchers

who were involved in the early media spaces and other researchers who explored

collaborative technologies. In the introductory chapter of this book, Harrison (2009)

points out that there are three different but interconnected approaches to media space

research: social, spatial and communicative. Each approach implies a different

exploration of the connectivity that constitutes a media space.

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It is beyond the scope of this literature review to pursue all research about media space.

In section 2.1 I will focus on those issues that have informed the research in this thesis.

This section is organized as follows:

Section 2.1.1 gives a brief introduction to media space.

Sections 2.1.2, 2.1.3 and 2.1.4 follow Harrison’s approaches to review the social,

spatial and communicative aspects in media space research.

Sections 2.1.5, 2.1.6 and 2.1.7 review the design issues that have been explored

since early media spaces were introduced and design challenges identified in the

recent reflections of media space research.

Section 2.1.8 describes technologies and challenges that are relevant to the

design of collaborative workspaces.

2.1.1 An Overview of Media Spaces and Related Research

According to the well-cited paper about media spaces (Bly et al. 1993) and other early

work (Gaver 1992, Heath & Luff 1992a), media spaces, particularly those from mid

1980’s to early 1990’s, can be characterized as a system that: connects fixed locations

such as offices; uses continuous audio and video media; enables both awareness and

communication by means of always-open channels; and enables an understanding of

spatial/social context for individuals or small groups at different locations. A media

space aims to give distributed individuals and teams a strong sense that they are

connected and ‘share’ the same physical spaces.

The first media space was created by researchers at Xerox PARC (Stults 1986). It used

always-on video and audio channels to connect the offices of the Palo Alto and Portland

sites. The nodes connected were usually common areas or individual workspaces.

Another important early media space was EuroPARCs RAVE (Gaver 1992), similar to

Xerox PARC’s, but connecting multiple researchers in the same building. The first

media space used analog video and audio feeds from each of four offices, the common

area in Palo Alto and the common area in Portland. Each of these locations had a

monitor display and a remote display and all the remote displays were synchronised to

show the same thing. A video switch provided modifiable connections. The view on the

monitors was that of the four separate videos shown in different quadrants of the display.

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Later on with more installations in other offices and areas, different members of the

group regularly reconfigured the four images according to individual preferences.

In research after 1994, media spaces were most often seen as part of a system that

incorporates video and audio but also with many more channels of communication (e.g.

Buxton et al. 1997, Greenberg & Rounding 2001, Judge et al. 2011). The term has been

extended to cover more recent systems, such as traditional video conferencing which is

the most widespread media space technology; sophisticated video conferencing systems

which focus on creating a ‘telepresence’ user experience (e.g. Gorzynski et al. 2009,

Pece et al. 2013, Rea et al. 2015); the Access Grid which supports team-to-team and

multiple site audio-video communications (e.g. Childers et al. 2000, Corrie &

Zimmerman 2009); and multi-display environments and shared digital workspaces

which support telepresence video conferencing and information sharing (e.g. Stevenson

2011, O’Hara et al. 2011, Luff et al. 2013, 2015). These systems provide high quality

real-time audio and video connections that support distributed collaboration via high-

speed networking. Details of related technologies will be further described in 2.1.6.

Research issues for media spaces concern the design, the use and the technology

underlying these systems as well as “the ways in which work and technology are

mutually interwoven” (Bly et al. 1993, p.30). Following the early media space work,

during the early 1990s, a number of accounts of media space implementation and

evaluation were published (e.g. Buxton and Moran 1990, Mantei et al. 1991, Gaver

1992, Fish et al. 1992, Bly et al. 1993, Tang et al. 1994). A common focus of the papers

from that period was on supporting casual or informal communication. Most explored

aspects relating to connections, collaborations and communications, including

awareness of others’ presence through peripherally sensed movement and activity

(Dourish & Bly 1992, Gaver 1992); access control to preserve privacy, such as a glance

feature to view a selected office node (Gaver 1992) and knocking on doors (Dourish &

Bly 1992, Fish 1992, Tang 1994); and close collaboration over content, such as

Videowhiteboard and Clearboard (Tang & Minneman 1991, Issii et al. 1993). There has

been subsequent work on awareness in distributed groupware (Gutwin & Greenberg

1995, 2002), video conferencing and telepresence (e.g. Buxton et al. 1997, Gorzynski et

al. 2009, O’Hara et al. 2011), and a large body of research exploring embodied

communication, concerning issues such as how bodies orient to each other and to

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various artefacts in the environment when collaborating, the importance of deictic

reference for conversational flow and how shared understanding is negotiated (e.g.

Dourish 2001, Robertson 1997, 2000, 2002).

Bly et al. (1993) observed some practical issues in the use of early media spaces. They

found that some issues can be addressed by the development of social conventions,

some may have technological fixes and some remain open issues (p.41). Beacker et al.

in their panel at the 2008 CHI conference and Harrison (2009) in his book “Media space

20+ Years of Mediated Life” state that there have been many technology developments

since early media research but “we have yet to fully understand and exploit the power of

context, to design for space, task and working relationships instead of short-term

connection between talking heads” in media space research (Harrison 2009, p.2).

Distributed collaboration has remained as an active topic in CSCW and HCI and issues

of media space have been further explored while new technologies are being developed

in different contexts (e.g. Jirotka et al. 2013, Oslon & Olson 2013, Luff et al. 2013,

2014).

2.1.2 Social Interaction

A media space connects people. Social interaction in a media space involves people,

relationships and activities (e.g. Bly et al. 1993, Dourish et al. 1996, Harrison 2009).

Researchers have explored not only what people do with a media space, but also how it

shapes people’s behaviours and perceptions and how it is adopted and appropriated into

their practices.

Social interaction in media space has some core aspects, including sharing awareness

and context, negotiation and coordination (Aoki & Tang 2009). Bly et al. (1993) argue

that a media space can be used as a tool for sustaining relationships and coordinating

activities among distributed individuals and groups. It provides a “being there”

communication support which “extends beyond communication on the explicit content

of the work task” (Bly et al. 1993, p.42). Participants in media spaces share the

awareness and context that surrounds each others’ activities. This characteristic in turn

enables people to socially negotiate starting interactions with each other at appropriate

times and situations (Aoki & Tang 2009, p.18). Henderson (2009) presents a summary

of his involvement in media space research and notes that the value of a media space is

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that it makes possible the distributed remote social construction of meaning, particularly

agreements. He explains that, for example, you can tell who is in the room and you can

tell from body language the nature of their engagement. He suggests that a media space

“supports the undeniable understanding that ‘you’ are there and that you are part of the

‘we’ that had the discussion and made the decision” (p. 215).

Dourish et al. (1996) in their paper “Your place or mine? Learning from long-term use

of audio-video communication” argue that the baseline for the study of mediated

communication in the real-world needs to move further from just face-to-face

communicative behaviour in order to explore a wider range of communicative practices.

The authors outline a framework to understand the behaviour of individuals and groups

linked by media space technologies. Their framework is based on four perspectives –

individual, interactional, communal and societal - and is defined from a different

perspective to traditional behaviour analysis. Dourish et al. (1996) emphasize that a

media space connects not only individuals, but also “their immediate context and

environment, encompassing wider social groupings in which they are located” (p.34).

Most of the early media space research concerned just informal interaction and the most

common social unit studied is that of office workgroup(s) (Aoki & Tang 2009). This

early research includes many of the classic empirical reports of media space use in the

early 1990’s and some studies involve idealized accounts of practices. Aoki and Tang

(2009) and Henderson and Henderson (2009) echo Dourish et al. (1996)’s argument for

the importance of communicative practices and comment that the underlying models of

social interaction in complex work practices, such as the work of London underground

control rooms studied by Heath and Luff (1992b), are different to those in empirical

studies of early media space. Henderson and Henderson (2009) point out that the

coordination work required in real work practice is “much richer” and the social

interactions are not always as “sharply contrasting” as those observed in studies within

experimental settings (p.355).

The exploration of media space from a social perspective complements the spatial and

embodied communication perspectives which will be described in the next two sections

where the social interaction aspects will be revisited. Understanding the dynamics of

how people work together combined with understanding of the spatial and

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communicative aspects of collaborative work can be used to guide the design of

collaborative systems (ibid).

2.1.3 The Space of Media Space

Media space connects distance-separated locations. Early media spaces have been seen

as an alternative to physical proximity (e.g. Bly et al. 1993, Gaver 1992, Buxton 1992).

The landmark features of media space - always on, high fidelity audio-video

connections and real-time awareness - have allowed researchers to explore and identify

the important elements of spatial proximity and how these could be captured or

replicated by technology. Importantly, media spaces provide an environment that

extends physical space to include remote people, interactions and communication

spaces and concerns the ordering of the spaces and human experience in the connections

(Harrison & Dourish 1996, Harrison 2009).

The notion of “space” in CSCW has been linked to the notion of “place”. Space and

place and the relations between them, when used in reference to technology-mediated

interactions, have been investigated since the 1990s’ (e.g. Harrison & Dourish 1996,

Dourish 2006b, Ciolfi et al. 2008). Harrison and Dourish (1996) differentiate space and

place, emphasizing that places have “social meanings”, and different media have

different spatial properties (1996, p.74). In his book chapter of “the space of media

space”, Harrison (2009) explains that our bodily experience and observations, such as

our experience of front and back, up and down etc, translate into the idea that there is an

enabling “medium” and that medium is called space. Harrison explains that the

organization of physical space (such as to build shelter to be secure from threats or to

store food) creates locations in space with meaning and the events that occur at

locations (such as to own and to control locations) load locations with meaning. These

processes create “place”. Media space augments and changes the normal “medium”, the

space, with electronic properties. In distributed group meeting situations, space is the

medium that surrounds people, both physically and digitally, e.g. a meeting room, the

table and chairs in the room, displays, and images on displays. Such space becomes a

place through the utilization of the environment to facilitate social interactions among

individuals (Corris & Zimmerman 2009).

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The space in media space is designed to support the construction of sociality and

interpersonal communications (Harrison & Dourish 1996). Dourish (2006b) draws out

the relevance of space and place “ten years on” in CSCW and argues that in addition to

the social and cultural production of space, concerns in the real-world must be directed

to the ways in which information technology creates new “virtual spaces” that transcend

and overlay the “real” of everyday world (p. 304). In other words, technologies create

new social places when users attribute social interactions to the new technological

features. He claims that designing collaborative systems that simply replicate features of

space and mimic the spatial organization of the real-world is too simplistic. Fitzpatrick

et al. (1996) point out that a work environment can be structured into different spatial

areas that support different tasks and each area has its social meanings which shape the

interactions in this environment. Although spatial layout helps shape interaction by

fostering informal interaction and ambient awareness of what other people are doing,

the solution to solve a social phenomenon is through the arrangement of space and

services and not just the physical layout (Fitzpatrick et al. 1998). Corris and

Zimmerman (2009) argue that the aim of designing interaction spaces for distributed

collaborations is to provide the infrastructure and mechanism to support users to

construct a meaningful place for collaboration through the use of technological tools.

A particular question here is how to construct space to facilitate social interaction

among individuals and the particular forms of communication that occur between them.

The following are two examples of how this issue has been explored in meeting

environments.

Henderson (2009) in his book chapter on “constructing space” summarizes some design

considerations that relate to physical settings. He argues that media space is a way of

making a single virtual constructed space out of a number of component spaces.

According to him, a major challenge in videoconferencing is that its facilities, the

component spaces and practices do not lend themselves to the easy creation of a single

shared space. He suggests that a well constructed space needs to: 1) provide capability

to be always on and available so the beginning of any interaction is easy; 2) ensure that

it is in place for everyone, and for both formal discussion and informal socializing; 3)

have proper camera and audio devices set up to ensure everyone feels included, gets all

the information they need and can maintain awareness of group interaction; and 4) be

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shaped by the current activity, e.g. conversation, presentation, a working session or

hands-on interaction.

As an illustration of this argument, Henderson and Henderson (2009) describe their

work in contrasting the practice between a normal video conferencing meeting and a

spatial configured video conferencing meeting. In the latter setting, the video

conferencing was setup at one end of the table in a small conference room and with the

presentation area (e.g. screen, whiteboard) at the other end of the table. The two rooms

then looked like a coupled room with one long virtual table with presentation areas at

both ends. They found that the practices in these two types of setup are based on two

different models of social interaction in distributed meetings. Participation in normal

video conferencing is focused on conveying information and on being able to hear a

presentation, while participation in a coupled room is about engagement, discussion,

negotiation and decision. They conclude that users in the coupled room feel that it is “a

single meeting taking place in a virtual space spanning two sites” (p.355).

Buxton (1992, 2009) introduces three space dimensions in a media space to address

social, spatial and communicative aspects from a design perspective. These spaces are:

Person space: this is the space where an individual reads the cues about

expression, trust, and gaze. It is where the other people’s voices come from, and

where the individual looks when speaking to someone

Task space: this is the space where the work appears. If others can see it, it is

shared. If not, it is private. Besides viewing, this is the space where an individual

does things, such as marking or creating

Reference space: this is the space within which the remote party can use body

language to reference the work, for example pointing and gesturing. It is also the

channel through which an individual can sense proximity, approach and

departure and anticipate intent (Buxton 2009, p. 229)

Buxton explores the architectural and social interactions as well the reference

interactions in workspaces and maps these interactions onto the three dimensions he

introduces. His research in the reference space dimension will be described in the next

section. By analysing some of the key properties of physical space and social

interactions in workspaces (e.g. office), Buxton (2009) maintains that media space

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technologies, introduced into a workspace, need to reflect the particular function of a

physical space and the distances between different physical spaces so that technologies

can be set up at the appropriate locations within that space (Buxton 1992, Buxton 1997

et al. 1997, Buxton 2009). He uses an example of designing a media space in a small

office room to illustrate the following basic principles:

Maintain a clear distinction between person space and task space

Respect the function-location relationships and conventions for all participants,

either physically or electronically via technology

Treat electronic and physical participants in the same way

Use the same social protocols for electronic and physical social interactions

(Buxton 2009, p. 220)

2.1.4 Communication

Another fundamental feature of the connections in media space is communication.

According to Harrison (2009) a communication-centred approach not only concerns

issues around information, content and meaning but also examines embodied

communication, such as moves, gestures and utterances, that “constitute the richness of

meaningful transmission and understanding in conversation” (p.281). The

communication aspect of a media space is interrelated to its particular social context and

physical setting.

Health, Luff and Kuzuoka have undertaken a series of social and technical research

projects related to the design and assessment of experimental systems to support real-

time distributed collaboration (Heath et al. 1992a, Heath et al. 1995, Heath et al. 2001,

Luff et al. 2003, Kuzuoka et al. 2004, Luff et al. 2009, 2013, 2014, 2015). They

particularly focus on work that relies on participants’ abilities to access a range of

tangible and digital resources. Drawing on their observations and explorations, Luff et

al. (2003) identify a number of design principles that a collaborative system needs to

provide and reiterate these principles in their later laboratory studies (e.g. Luff et al.

2009), including the recent study of interaction in a multi-display collaborative

workspace environment (Luff et al. 2013, 2015). These principles include:

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The ability for the participants to determine the location, orientation and frame

of reference of others

The ability for participants to determine where they are in relation to other

participants

Enabling the discrimination of the other participants’ actions when these actions

involve shifts in orientation and references to the space, objects and artefacts

The ability to reference objects and features in the space, e.g., pointing and

highlighting, and the ability to coordinate such actions with the real-time

conduct of others

Preserving a stable constellation of relevant objects, artefacts and scenes within

the spaces (Luff et al. 2009, p.32)

Robertson (1997, 2000, 2002) has published a series of papers addressing the need to

support the perceivability of bodily actions and artefacts in collaboration by all those

people involved in it. She maintains that for people to be aware of something in the

collaborative process, it must be publicly available to them. She states that this public

availability of actions and artefacts is not just to make them visible to others but most

importantly to convey and make available “the potential communicative function of

specific actions and artefacts in a particular situation” (Robertson 2002, p. 303). She

points out that this public availability of “collaborative organized world of artefacts and

actions” (Suchman 1987, p.50) enables the communicative potential of actions and

artefacts within a collaborative environment and it is this communicative function of

action that enables people to engage in cooperative activities (Robertson 1997, 2000).

She argues that a basic principle in the design of technology to support distributed

collaboration is that other people’s perception of individual’s actions needs to be

regarded as part of the same process as that individual’s perception of their own actions

(Robertson 1997, 2000). She emphasizes that designers of collaborative systems need to

“explicitly and deliberately” support this awareness (Robertson 2002).

As mentioned in the last section, Buxton (2009) draws attention to three distinct

dimensions in a media space, one of which is communication. He emphasizes that the

importance of reference in media space is directly related to the importance of being

able to effectively frame and reference things that we use in our everyday work. He

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supports his argument by referencing the following work: 1) his own early work in

shared task and person spaces (Buxton 1992); 2) the Videodraw and Videowhiteboard

systems which were concerned with shared personal presence and a shadow gesturing

tool (Tang & Minneman1991); 3) the Clearboard system which was an integration of

shared inter-person space and shared workspace (Ishii et al. 1992); and 4) The Hydra

system which supported four-way roundtable multiparty videoconferencing (Buxton et

al. 1997). Buxton claims that reference is a rich form of communication and the

different types of reference have different richness, with a telepointer being low on the

scale and shadows of gestures being high. He argues that “telepresence systems that do

not support it well will be impoverished as a result – no matter how good the audio and

video might otherwise be” (Buxton 2009, p. 229). In other words, people need to easily

understand what is being referred to and by whom if they want to make a meaningful

interpretation of the reference.

2.1.5 Asymmetries and Fractured Ecologies

Heath and Luff (1992a) introduced the concept of asymmetry to CSCW research. They

claim that communication asymmetry has particular characteristics in video-mediated

collaboration because some features of a media space may transform the impact of

visual and vocal impact and introduce asymmetry in interpersonal interactions. They

argue that:

“Video-mediated co-presence appears to reveal asymmetries in interpersonal

relations that, as far as we know, are found neither in face-to-face interaction nor

in other technologically mediated forms of communication such as telephone

calls… In video-mediated communication, the relative asymmetries tend to

parallel the categories of speaker and hearer and thereby are in constant flux as

conversation and different forms of activity and participation emerge.” (Heath &

Luff 1992a, p.335).

They explain that in a face-to-face situation a speaker may respond automatically to

cues arising from gaze direction or physical gestures that are perceived by peripheral

vision, whereas users communicating via video-conferencing may completely fail to

pick up these signals. The result of this is an unbalanced coordination of the interaction,

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even when explicit attempts to adjust the conversation are made by one of the parties

involved.

Gaver (1992) in his paper examining the “affordances” of media space for collaboration

explicitly argues that media space is an inherently asymmetrical technology. He

recognizes that the inherent asymmetries of video-mediated communication result from

the fact that within this kind of communication “making information available is an

independent act from obtaining it” (p. 23). For instance, seeing a colleague in a media

space does not imply that your colleague can also see you.

Relating to asymmetry issues in computer-mediated communication are the differences

in physical features in the local environment where communication and interaction are

embedded. A set of “ecology” notions have been introduced to inform the design of

coherent environments for distributed work in CSCW (e.g. Luff et al. 2003, Zuiderent et

al. 2003, Kuzouka et al. 2004, Kirk 2005, Norris et al. 2013).

In a special issue of the Human-Computer Interaction Journal focusing on computer-

mediated communication ‘about things’, Luff et al. (2003) introduced the concept of

“fractured ecologies”. They argue that when participants in computer-mediated

interaction have only limited access to the environment in which others’ actions are

produced, “their actions are fractured - fractured from the environment in which they

are produced and from the environment in which they are received” (p. 55). For

example, because of a restricted field of view of a remote environment, the relation

between actions (e.g. gestures) and the relevant ecology may be ‘fractured’, causing

interaction problems (e.g. breakdown in how we perceive interaction as it occurs).

In this special issue Zuiderent et al. (2003) recognize the importance of the invisible

work that participants do “splinting” the fractures that emerge in the ecologies in which

they interact. They argue that “the risk of communication being fractured” in

collaboration “cannot be underestimated”, and splinting the emerging fractures in an

existing ecology of practice between distributed individuals requires substantial efforts

to overcome communication problems (Zuiderent et al. 2003, p.173). Technical

solutions for fractured ecology include using remotely controllable cameras and laser

pointers (Kuzouka et al. 2004); embedding naturalistic hand gesturing video of a remote

person within the local task environment that is visible to both sites (Kirk 2005); and

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using screen based pointing tools to interact with physical resources and digital

representation of physical and virtual resources (Norris et al. 2013).

Vioda et al. (2008) propose a broad categorisation of the perceptual asymmetries in

computer-mediated communications. They unpack asymmetries to include: media

(different kinds of content to share through media space); fidelity (different amounts of

details provided in media space); participation (the varying degrees of participation in

communities surrounding media spaces); engagement (the breadth of attention and

focus one may have with media spaces); benefit (the varying degrees to which

participants benefit from media spaces) and place (the varying cultural norms

surrounding the use of media spaces in different contexts). While many research efforts

have focused on facilitating some degree of “symmetry” to provide a balance of power

between collaborators to support their access to communicative resources and

information awareness, Vioda et al. (2008) present a media space designed to support

collaboration in an office environment that embodies a range of existing asymmetries.

They highlight that these asymmetries, such as participation, engagement, benefit, place,

are closely related to collaborators’ socio-technical contexts and can be “valuable assets”

that play out in the combination of technical and social spheres (Vioda et al. 2008, p.

321). They argue that these asymmetries need to be explored alongside symmetries as

part of the design space of a collaborative system.

2.1.6 Issues in Early Media Space

Bly et al. (1993) review their experience using early media spaces and identify a range

of socio-technical issues relevant to their design. They argue that while many of these

could be “addressed by the development of social convention, there have been recurring

problems with several aspects of the media space which individual adaptation and social

convention are not equipped to fix” (p. 41). They maintain that some of these problems

may be fixed by technologies while others remain open issues. The issues that Bly et al.

(1993) identify include:

Scale: This relates to how a media space extends to larger communities and

organizations. Issues include how to support members who are less familiar with

one another and with each other’s work and how to develop media spaces in

different organizational contexts with different needs. They point out that “with

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media spaces, one size does not fit all” (p.41). They suggest that media spaces

need to reflect the changing requirements of different user communities and

accommodate different styles of work situations.

Audio: Bly et al. identify audio as the most noticeable problem in early media

space systems. Audio problems included noises, uneven levels of audio

resources from different sites and difficulties of discriminating multiple speakers.

These problems introduced difficulties with seamless turn-taking and

appropriate interruptions during conversations.

Camera Control: Bly et al. observe problems of maintaining spatial orientation

with the remote physical space. They explain that although it is technically

possible to remotely control a camera to look around a remote space, this is

disturbing to the remote participants since they may feel “watched” and have no

control of the camera. They also identify that there is a trade-off between

showing close details and showing a wide field of view when remotely

controlling cameras.

Integration of shared technologies: Bly et al. argue that “having media space

connections alone is not sufficient to support focused task activity” and support

for activities of shared drawing and awareness of colleagues need to be

integrated into the media space environment.

Heath, Luff and Sellen (1995) in their paper “Reconsidering the virtual workplace:

flexible support for collaborative activity” identify the shortcomings of early media

space implementation in supporting collaboration in real-world environments. They

found that while media spaces emphasize support for informal sociability and peripheral

awareness, there is a relative lack of concern with task-focused collaboration. The

limitation of offering a single and fixed view is apparent when considering the demands

and complexities of cooperative work in an organisational environment. They note that

“it is this static and inflexible notion of collaborative activity which has inadvertently

hindered media space research, and undermined its ability to provide a useful

environment to enable people to work, or even socialise with each other” (p.88).

Drawing on their wide range of naturalistic studies of work practices, they argue for the

importance of designing for flexible access for collaborative work. They suggest ways

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in which a system can be configured to support different forms of collaborative work

and greater access to the focus of activity “at hand”, including artefacts and objects.

They illustrate this by referring to Clearboard (Ishii et al. 1992), the Hydra system

(Buxton 1992) and their own preliminary design of the Multiple Target Video

experiment system (Heath et al. 1995). Their system uses multiple cameras and

monitors, provides multiple views simultaneously (including face-to-face view, in-

context view, document view and feedback view), and allows some flexibility of camera

and monitor placements to make it feasible to reconfigure the space to support different

kinds of collaborative arrangements.

2.1.7 Reflections and Challenges

Advanced networks offer higher bandwidth and higher resolution and allow the original

promises of media space to be considered further. Technical issues with audio and

camera control can be largely resolved by careful design. However socio-technical

problems still exist – as researchers active in the development of media space concluded

after reflecting on the significant lessons of 20 years of work in media space in a

workshop at the CSCW’06 conference (Harrison 2009) and a panel at the CHI’08

conference (Baecker et al. 2008). More recently, other researchers have revisited the

CSCW fundamentals on distributed collaboration (Olson & Olson 2013, Bjorn et al.

2014), embedded interactions in video mediated environment (Luff et al. 2013, 2014)

and CSCW research in distributed collaboration in healthcare and scientific

collaboration domains in the past three decades (Fitzpatrick & Ellingsen 2013, Jirotka et

al. 2013). These researchers highlight that distance still matters and requires further

exploration as new collaboration situations emerge due to the introductions of new

technological opportunities. The focus of these ongoing reflections on media space

related research is to understand how it can continue to contribute to the shaping of new

technologies to support collaborative work and the experience of it.

From this perspective, I summarize the challenges that are of particular relevance to my

research below. These challenges include asymmetrical access to the remote

participants, their environments and digital resources, supporting reference gesture in a

collaborative system, the spatial configuration of media space and putting media space

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into work environments to support distributed teams and cross-organizational

collaborations.

Luff, Heath and their colleagues (2009) state that “problems raised by the early media

spaces are not necessarily avoided by shifting to alternative applications or shifting to

other kinds of collaboration technology” (Luff et al. 2009, p.29). They re-emphasize the

need to support different forms of interactions in media spaces, just as they claimed in

their early work (Heath et al. 1995). They argue that even advanced telepresence

systems may not provide the expected support required for many forms of collaboration.

According to Luff et al. (2009, 2013, 2014), a number of issues have been neglected or

are still not well-supported. One of these is the asymmetries introduced by distributed

collaborative systems when two different physical environments are connected, such as

asymmetrical access to each other for the participants, to each other’s environments and

to digital resources. There is still a challenge to provide systematic support for offering

access to a workspace (e.g. objects and artefacts) and to remote colleagues in a work

setting. Another issue Luff et al. identify relates to the ability to reference in enhanced

collaborative systems – a problem that becomes increasingly complex due to the range

of materials and digital resources involved. A similar argument made by Buxton (2009)

is that a shared reference space is a requisite for a rich presence but this has been the

most neglected aspect of shared space research (Baecker et al. 2008). With technology

advances enhancements have been developed to allow mutual references and facilitate

transitions between different and multiple forms of collaborations (e.g. Luff et al. 2009,

2013, 2014, Norris et al. 2013).

The need for spatial configuration of communication space and workspace has been

paid attention to in the recent design of collaboration systems. For example, in their

introduction to the 2008 special issue of the Journal of Computer Supported

Cooperative Work (JCSCW) on “Settings for Collaboration, the Role of Place”, Ciolfi

et al. emphasize that there is still a need to consider physical space in designing

collaborative systems. They argue that “to a large extent, apart from media space work,

collaborative system development in the 1990s ignored the relationship of people at

their physical space and the emphasis was put instead on creating online spaces for

distributed interaction and collaboration” (p. 91). For another example, Buxton (2009)

argues that much of the literature has focused on improving the design and usability of

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the interface to the technologies. He articulates the approach that he and his colleagues

have investigated, that is improving design by “exploiting some of the key properties of

architectural and social space” (Buxton 2009, p.217). Examples can also be found in the

research on telepresence systems and multi-display environments that I will describe in

section 2.1.8.

It is widely acknowledged that “the opportunities for media spaces result from the need

to support knowledge workers in specific tasks” (Baecker et al. 2008, p.2247). However

it is still a challenge to put a successful and usable media space into an organizational

setting (Luff et al. 2009). Standard commercial videoconferencing technologies have

been widely adopted in many organizations but behavioural issues still arise from the

ways videoconferencing is generally implemented (Baecker et al. 2008, Harrison 2009,

Olson & Olson 2013). Significant configuration work is required before a media space

system is developed and deployed to support people working together (Luff et al. 2009,

2014). There has also been a trend of expanding the collaboration context through

distributed teams, cross-organizational and large-scale collaboration and the resulting

problems of integrating systems across different organizations need to be addressed (e.g.

Olson, Zimmerman et al. 2008, Fitzpatrick & Ellingsen 2013, Bjorn et al. 2014).

2.1.8 Multi-display Environment and Shared Digital Workspace for Meetings and Information Sharing

This thesis is concerned with designing collaborative workspaces for group

collaboration in a complex work setting. It relates to the area of supporting high quality

audio-video communication and real-time information sharing by using sophisticated

video conferencing and shared digital workspace technologies. An overview of related

technologies and trends will be presented below.

The Access Grid has been used as a technology platform to support distributed

collaboration over the last decade (e.g. Childers et al. 2000, Corrie & Zimmerman

2009). It provides high quality real-time audio and video connections that support team-

to-team and multiple site communications via high-speed networks. Access Grid has

demonstrated successful distance collaborations in terms of video-conferencing support

for meetings and the ability to share complex data on large displays in scientific

collaborations (Corrie & Zimmerman 2009). One of the challenges for Access Grid has

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been to enable multiple participants to interact over visualizations and artefacts (Jirotka

et al. 2013). Also, some studies show the need for participants to have access to

another’s activities with respect to the data and simply juxtaposing video of participants

and dataset visualization is not enough (e.g. Fraser et al. 2006). Despite some positive

findings of Access Grid, Jirotka et al. (2013) in their review of distributed scientific

collaboration technologies argue that in order to improve the interaction experience it

requires a deeper understanding of work practices and embedding this understanding

into the collaborative system interface and interaction design.

Over recent years, telepresence video conferencing systems have focused on visual

collaboration configurations that closely replicate face-to-face interpersonal

communication, separating from the unnatural “talking heads” experience of traditional

videoconferencing. Systems such as HP Halo and CISCO Telepresence have

demonstrated an enhanced telepresence user experience in collaboration (e.g. Gorzynski

et al. 2009). These systems support a life-size view of remote participants, fluid motion

and natural eye contact. The physical configuration of telepresence systems also aim to

reduce the asymmetries and orientation disparities caused by cameras and screens that

we see in traditional video conferencing.

Shared digital workspaces are systems designed to enhance real time co-located

collaboration through, for example, file exchange and screen sharing (Streiz et al. 1999,

Biehl et al. 2008, Wigdor et al. 2009). Early work includes the i-Land environment

(Streiz et al. 1999) which demonstrates a technology augmented environment designed

to enhance free flowing collaborative activities where participants can flexibly combine

information from computing devices along with information from paper, whiteboards

and other physical materials. Tabletop and large display have been used in shared digital

workspaces and systems have been designed for people to work together in a co-located

situation (e.g. Wigdor et al. 2009, Mueller-Tomfeld 2010). For example, the WeSpace

prototype supports users to share scientific data and applications on their laptops using a

large data wall and a multi-user, multi-touch table designed specifically for

collaboration in a small co-located group (Wigdor et al. 2009).

More recently research has paid attention to how collaborative practices can further be

supported by the introduction of shared digital workspace elements into a telepresence

video conferencing environment. These systems allow the concurrent display of a

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number of different information streams including live video streams of participants and

a range of data including video data, still images and other documents. The designs have

also paid particular attention to the physical geometries of these environments. Several

systems have been reported in the literature. An example is our prior work in BISi (e.g.

Paay et al. 2011). Another example is a prototype, called t-Room, that Yamashita et al.

(2011) and Luff et al. (2013, 2015) studied in laboratory settings. It has eight spatially

configured large screens and uses image calibration and video-mixing techniques to

provide high definition video conferencing. It also incorporates two large tabletop

displays to allow remote participants to refer to displayed documents, slides, or moving

images.

Importantly, while sharing the design challenges presented in the last section (2.1.7), the

work around multi-display and shared digital workspace technologies has a particular

challenge which is the need to move beyond the generic research prototype level.

According to Baecker et al. (2008) and Luff et al. (2014) it still requires significant

effort to deploy innovative media space technologies and experimental prototypes to

real work environments. More recently, some researchers have reported short-term trials

and experiments of related research prototypes in real-world settings. For example,

Stevenson et al. (2011) demonstrate a whole-of-room system – RIDES which uses

multiple displays, shared annotation tools and gesture tools to support remote medical

consultation and test the system in an outpatient clinic in a hospital. In a similar way,

Olwal et al. (2011) and Frykholm et al. (2012) investigate the design of multi-display

and multi-input groupware systems in supporting the discussion of patient cases in

multidisciplinary medical team meetings and report on the interaction issues they

observed in the experimental studies. Stevenson (2011) illustrates the flow of design

decisions from concept to potential deployment of their multi-display collaboration

system in healthcare and highlights the gaps in understanding the design when transition

is made from the laboratory to deployment in the hospital. As O’Hara et al (2011) point

out, an understanding of actual work practice and behaviour within organizational

contexts is still missing from the developments in collaborative workspaces. They argue

that more empirical enquiries are needed to understand how and why particular details

and characteristics of work practice within particular organizational settings relate to the

geometrical properties of the distributed spaces.

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2.2 Collaboration across Different Local Settings

A collaborative system is always embedded in one or more settings. As Bly et al. (1993)

note:

We consider the setting to include the individuals using the technology, the

relationships among these individuals, and their activities. Factors affecting the

shape of a media space include group size, the working relationships within the

group, the physical proximity of members of the group to one another, the nature

of the work, and the group’s approach to work and social relationships. Different

settings require different media space configurations (p.41).

Distributed collaboration in work practice involves individuals or teams working in

different local settings across geographical, institutional and professional boundaries.

There are differences in resources for communication, particular physical spaces, social

contexts and organizational contexts where processes and practices need to be

connected and integrated in distributed collaboration (Dourish et al. 1996). Mark et al.

(2003) examine distributed scientific collaboration and use the metaphor of the “space

between” distant groups to describe connections, interdependencies and gaps that exist

among teams. Pinelle & Gutwin (2006) study the use of information system in hospitals

and point out that medical departments are often organized in a loosely coupled manner

that requires different design and deployment strategies for different configurations of

information systems. Olson et al. (2009) argue that given the wide variety of

environmental and contextual differences in the way individual remote collaborators

participate in their collaboration practices, the same strategies and technical solutions

that resulted from one setting may not generalize to another setting.

Researchers in CSCW and HCI have investigated issues relating to different local

settings for collaborative practices and to creating coherent environments for

collaboration. In this section, I will introduce a number of related issues that have been

explored. These include:

Variations in local practices and integration of technology across different

settings (e.g. Schneider & Wagner 1993, Ellingsen and Monteiro 2006, Balka et

al. 2008, Fitzpatrick & Ellingsen 2013, Monteiro et al. 2013)

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Constructing shared information spaces across different teams (Schmidt &

Bannon 1992, Bannon & Bodker1997, Reddy et al. 2001, Bossen 2002,

Ackerman 2013)

Flexible support for different interaction needs and work practices (e.g. Heath et

al. 1995, Schmidt 2007, Randell et al. 2011)

Configurations of physical spaces, environments and practices for technology-

mediated collaborations (Binder et al. 2004, Balka et al. 2005, 2008, Balka &

Wagner 2006)

2.2.1 Variations in Local Practices

A range of workplace studies have focused on unpacking the variability of local

practices in order to understand how the variations in local practices impact on

collaboration (e.g. Schneider & Wagner 1993, Symon et al. 1996, Mark et al. 2003,

Pinelle & Gutwin 2006, O’Neill et al. 2007, Randell et al. 2011). Variations in local

settings has been increasingly recognized as an issue that needs to be explicitly

addressed by designers during their design of a system (Schmidt et al. 2007, Fitzpatrick

& Ellingsen 2013). Variations in local practices have been investigated in different

work domains, particularly in healthcare, and can be categorized into a number of topics.

These topics include different forms of work practices, sources of variations, and

integration of technology across different local settings.

Different forms of work practice. O’Neill et al. (2007) in their ethnographic study of six

digital colour production print shops in the US and in Europe found that these shops

vary in size, customers, core business and workflow organization. There is a variety of

workflows and divisions of labour that can be found in digital print shops. These vary

across print shops. Different roles can be combined or separated out depending on the

context and history of the print shops. They argue that these differences make

standardisation of workflow across these sites difficult. Randell et al. (2011) report on

their multi-site workplace study of the handover process which happens when a patient

is transferred from one hospital or ward to another. They demonstrate that there are a

variety of collaboration practices that vary both in their form and content, for example

variation in the type of information transfered, how the information is organized, where

the participants are located, the access to and use of artefacts and the nature of

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communication. These variations reflect aspects of the setting in which they occur,

including workload, staffing level, the roles and responsibilities of the participants, the

artefacts and the goals of the participants.

Sources of variations. Schneider and Wagner (1993) relate the differences in

requirements between medical groups to the differentiation in hierarchies of

occupational knowledge and organizational fragmentation. They recognize that

clinicians live in medical departments and in many cases these departments are parallel

organizations which are “loosely coupled with the rest of the hospital” (p. 230).

Telioglu and Wagner (2001) examine work practices around picture archive and

communication systems (PACS) and report that different spatial arrangements construct,

sustain, constrain and transform the collaborative review on the radiology images.

Symon et al. (1996) in their study of cooperation and conflict in a hospital context found

that local variations influence coordination processes because effective work involves

coordination between participants with diverse and/or potentially conflicting goals.

They examine the effects of status differences on the experience and conduct of

coordinated work activities and argue that these differences should not be considered

solely in terms of hierarchical differences between staff within a department or

procedural trajectory, but should also take account of variations in the status of different

activities and departments. Abraham & Reddy (2013) in their study of coordination

work required in patient transfers explain that the effective functioning of individual

organizations depends on their ability to manage interdependencies both within (intra)

and between (inter) various departments. They highlight the re-coordinating activities

required to mitigate the effect of cross-boundary breakdowns.

Balka et al. (2008) draw on their studies in hospital environments to develop a typology

of eight sources of variations and group them into three main categories. These three

categories include: the political and policy-making context; the

institutional/organizational context for action which includes the patient population, the

space and spatial layout and internal and internal/external organization of work; and the

systems and workplace design context which includes existing technologies,

organization of information, temporal ordering and managing patient flow. These

categories reflect issues arising in local settings where designers and users usually have

no influence. Although this typology provides a high level tool that can be used in the

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entire process of design and implementation of technologies, Balka et al. (2008) point

out that it is not a substitute for ethnographic fieldwork and cross-case analyses. They

conclude that “how to identify essential sources of variation is still an open issue within

CSCW” (p. 523).

Integration of technology across different local settings. Using information technologies

and the standardisation of work practice are often seen as solutions to deficient

communication across organizations and disciplines (Winthereik & Vikkelso 2005).

Quite often, information technology is introduced in a standard form into different

departments or institutes by organization management. Within CSCW, attention has

been given to cross-boundary issues when integrating information systems across

multiple local settings. Researchers have studied the disorder caused by standardisation

efforts in different work domains. A number of examples of these studies are described

below.

As described before, O’Neill et al. (2007) examine asymmetric collaborations in the

standard print shop-customer relationship where customers prepare the material and the

print shop prints it. Service providers attempted to facilitate this interaction by using

standard forms and applications to automate the printing process. O’Neill et al. (2007)

observed that there is a boundary between customers and print service providers

because each has their own workflows and orientation. They found that although

technologies are introduced to standardize the workflow from customers to print shops,

different shops actually have ended up using their own ad hoc solutions.

Bos et al. (2007) investigate the sustainability of large scale distributed collaborations in

their review of a range of scientific collaboration projects. The barriers they identified

include the difficulty of aggregating scientific knowledge, the difficulty of cross-

institution work and the fact that scientists generally enjoy a high degree of

independence. They argue that standard tools for scientific collaboration “may presume

an ability to codify and disseminate knowledge that is not realistic in cutting-edge

scientific enterprises” (p.654). They argue that distributed scientific collaborations face

the challenges of adopting common toolsets and keeping different groups focused on

common goals.

Symon et al. (1996) question the work effectiveness of providing the standardisation of

activities and interactions through computer-based systems in hospitals. They point out

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that technology designers often seek a concrete representation of a formal work

procedure, identify breakdowns and then design a computer-based system which

prevents these breakdowns. They argue that designers may fail to realize that the

claimed existence of formal procedures by hospital employees serves some social and

political function. They suggest that potential problems caused by standardization of

activities and interactions through a technology could be eliminated by allowing “the

flexible definition of formal and informal practices that allow different departments to

regulate their relationships with one another and maintain important aspects of their

work/occupational identity” (p.26).

In a special issue of the CSCW Journal, “CSCW and dependable healthcare systems”,

Martin et al. (2006) show that the work of configuration, integration and testing

produces problems due to the boundaries between different local sites, impacting the

intra- and inter-departmental workflows which have to be reorganized. They maintain

that inconsistencies have to be “ironed out in order for successful integration to proceed”

(2006, p 471). In the same special issue, Ellingsen and Monteiro (2006) argue that

standardisation in one setting can “simultaneously produce disorder or additional work

in other locations for other users” (p. 443). It requires socio-technical understandings of

what needs to be integrated to balance the prevailing perception of integration as a

technical issue (ibid). They highlight that when a standard process needs to be shared

across variations in a setting, “a local setting is no longer local, but depends on design

decisions in other settings” (Ellingsen & Monteiro 2006, p.447). Monteiro et al. (2013)

revisit the standardisation issue, which is how local ‘fitting’ entails ‘unfitting’ at other

sites, and argue that CSCW researchers need to adapt to the new trend of increasing

integrated intra and inter-organizational systems to address the role and nature of design.

2.2.2 Common Information Spaces

Research into collaboration across different settings has also been concerned with the

construction of common or shared information space that can be shared across contexts

and communities of practice (e.g. Schmidt & Bannon 1992, Bannon & Bodker 1997).

Space here is used as a metaphor in relation to information. Introduced by Schmidt and

Bannon (1992), the notion of the common information space has been part of the overall

exploration of the relationships between people, artefacts, information and the situations

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in which these meet in CSCW and HCI research. Common information spaces draw

attention to the coordination work involved in using and reusing information in social

and organizational settings (Reddy et al. 2001, Munkvold & Ellingsen 2007, Hjelle &

Jarulitis 2008, Ackerman et al. 2013, Boden et al. 2014).

At the centre of this space is information of various forms that is the focus of the

collaboration. A common information space is created through an ongoing process of

mutual interpretation of single items of information by those people involved in the

collaboration. According to Bannon and Bodker (1997), a common information space

plays an open role within a community to support shared understanding across different

work practices. It also enables information sharing across different contexts and

communities. There is an important distinction between access and practical

understanding (Bannon & Bodker 1997). Participants need to be able to interpret the

information so as to collaborate and they must do this actively (ibid). Reddy et al. (2001)

continue this analysis by noting that participants interact with information through

different representations and coordinating their activities requires these representations

to reflect the same underlying information. This is important to enable a shared

understanding of the information to be negotiated.

Common information spaces can be constituted for individuals or teams that are co-

present in time and space or across time and space boundaries (Bannon & Bodker 1997,

Bossen 2002, Rolland et al. 2006, Munkvold & Ellingsen 2007). Based on Reddy et al.

(2001)’s work, Bossen (2002) proposes a conceptual framework through which specific

common information spaces can be analysed. He identifies seven parameters of a

common information space. These parameters include the degree of distribution of work,

the context of different cultures and professions, the level of required articulation work,

the intensity of means of communication, the coordination mechanisms, and the need

for precision and promptness of interpretation. Bossen (2002) points out that distributed

collaboration is a particular situation where the information space is distributed and

individuals or teams are separated in distance but are capable of negotiating a shared

interpretation through computer mediated communication. He suggests that there is

growing attention on understanding how to construct the common information spaces in

distributed situations.

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Rolland et al. (2006) argue that common information space is shared for a short period

of time during collaborative meetings between distributed teams. They conducted a

study of common information space in a “collaborative room” environment which

consists of smartboard screens. Their findings suggest that common information space

in a collaboration room appears to be temporary when a shared understanding of a

particular problem is negotiated through the information sharing practices of the

multidisciplinary participants. Munkvold and Ellingsen (2007) in their analysis of

nursing plans in a hospital show a similar finding that a common information space

exists only temporarily, as separated groups come together to work in a coordinated way

for a time and then return to their parallel work.

Rolland et al. (2006) in their study of the “collaborative room” also acknowledge the

challenge of constructing common information space in large-scale collaboration. They

argue that a common information space which integrates and cuts across geographically

dispersed communities of practice and heterogeneous collections of information is

likely to produce communication and coordination problems (p.499). Their findings

support Ellingsen and Monteiro’s (2006) argument that ordering in one context tends to

produce disorder in other contexts. Hjelle & Jarulitis (2008) conducted a study of a

Microsoft SharePoint based collaborative system within a large international gas and oil

company. Their results also show that a large-scale centralized and tightly integrated

common information space requires the development of custom components to increase

flexibility for the end users.

The relationship between common information space and personal information space

has been explored by Tang and Carpendale (2007, 2008) in their studies of information

flow during nurses’ shift handover. They use common information space and personal

information space to analyse how coordination is achieved through information

representations and interpretations of digital patient records, paper-based patient

summaries and information on displays. They describe personal information space as

an information space that is constructed, interpreted and manipulated by only one

person in the flow. Based on the understanding of the interactions between common

information space and personal information space, they designed a system employing

digital pens and paper so that nurses can retain their existing paper-based practice of

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constructing personal notes and summaries and can easily formalize the information

into the digital patient record.

Recent research also includes explorations of common information space in public

displays and internet-scale communities. Boden et al. (2014) investigate how to support

cooperative work and construction of common information space by using public

displays. They report on their design of public displays in a software company to bridge

the gap between the formal and informal coordination between software engineers.

They point out that these displays can be used cooperatively and thus can provide a

shared context and can address the flexible nature of software development

collaboration. Ackerman et al. (2013), in their review of knowledge management in

CSCW research, emphasize the importance of understanding the social and

organizational context of “closely intertwined” knowledge work and practice (p.532) as

well as the need to address communications among people. They report that with the

advances in networked and distributed systems, the information sharing model has

moved from the first generation repository model to the second generation model of

sharing expertise. They explain that while the repository model of information sharing

is rooted in document and computer records, the second generation model ties

communication among people into knowledge work, addressing the practices of

individuals engaging in knowledge or expertise sharing, and even extending to Internet-

scale systems and communities.

2.2.3 Flexibility and Design

The studies of variations, standardisation and common information space have raised a

question of how technologies can be designed to balance the variations and

commonalities and to support coordination work over different settings. As described

before, Heath, Luff and Sellen (1995) suggest ways to provide flexible support for

collaborative work from the interaction perspective. They emphasize the importance of

providing different forms of access to remote participants and their local environments

and of supporting interaction with various artefacts. They argue that participants in

collaborative work need flexibility to align their attention towards the focal point of

their activity – whatever and wherever that is. There have been growing concerns about

what forms and levels of standardisation are necessary (e.g. Jirotaka et al. 2005,

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Withereik & Vikkelso 2005), about the relationships between variations, commonalities

and coordination of practice (e.g. Schmidt et al. 2007) and about how to provide flexible

support for different settings (e.g. Schmidt et al. 2007, Randell et al. 2011), as described

below.

Jirotka et al. (2005) report problems in their study of the standardisation of breast cancer

screening practices using grid-enabled technology. Their analysis shows that while

standardisation may give the impression of uniformity of practice, the use and

interpretation of the screen is tied intimately to local practices. They found that greater

standardising of screening practice might eliminate some of the variations between units,

however the question is “how far the standardisation is desirable”. They argue that “a

degree of variation in practice is necessary to support variations in populations,

resources, skill mixes between different units” (p. 391). They also point out that in

relation to standardising data, there is a need to consider using translations between

locally embedded practices and to provide flexible selections for different user

preferences.

To explore how far standardisation is necessary, Withereik and Vikkelso (2005)

investigated how a semi-standardised discharge letter was employed to communicate

between two organisational settings, the hospital and the general practitioner. In this

particular communication situation, the discharge letter plays a double role as a

information sharing tool and accounting device. Withereik and Vikkelso (2005) argue

that there is a trade-off for further standardisation of the discharge letter content. Further

standardisation in order to facilitate electronic exchange will strengthen the letter’s role

in the organizational accountability but weaken it as a clinical tool for communicating

about a patient’s case.

Schmidt et al. (2007) conducted a comparative study of cooperative work practices at

two oncology clinics. They found variations of physical structure, computer-based

information systems and coordinative practices at the two clinics. In spite of these

differences, they also found some remarkable “higher-level” commonalities with

managing information practice- “the endless variations, combination and recombination

of a limited repertoire of formats and notations” (p.7). They discuss design implications

based on these findings of variations in work practice and commonalities that exist

across settings. They particularly distinguish between two different types of study for

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design: studies of specific settings for the purpose of developing specific systems for

that setting, and studies for the purpose of developing ‘more or less generic or

standardized technical building blocks’ that can form the basis of systems across a range

of settings.

Randell et al. (2011) examine the handover collaboration in patient transfer described

earlier to argue that the “one size fits all” approach to technology support is not

appropriate. They draw on the design arguments proposed by Schmidt et al. (2007) and

suggest that different handover situations can have different technology support,

particularly the flexible support for different needs of gathering information that enable

those receiving the handover to care for the patient effectively. For example, they

compare the level of detail of information required in the paediatric acute retrieval

service with that required in other settings and found that there is less certainty in the

information (e.g., diagnosis) in the paediatric acute retrieval service. They argue that for

the paediatric service setting an important design issue is how such uncertainty and the

views of different participants are represented by the system.

2.2.4 Configuring Technology, Practices and Resources

The intention in this section is to review a body of research about the configuration

work that is required for both successful technology use and successful collaboration

(Balka et al. 2005, 2008, Balka & Wagner 2006). There has been particular attention to

the configuration issues in designing and implementing information and communication

technologies in work practices (e.g. Martin et al. 2006, Balka et al. 2008).

An example of these explorations is in complex healthcare settings. Based on actor-

network theory, Aanestad (2003) demonstrates the design of a telemedicine system to

support surgery using a metaphor of design as “design of configurations” which is the

creation of a mix of people, practices and artefacts. Based on Strauss’s “articulation

work” (Strauss et al. 1985), Bardram and Bossen (2005) in their study of the “spatial

dimension of collaboration” at a hospital in Denmark introduce their concepts of

“mobility work” and “standard operation configuration” and apply these to mobile work.

They highlight the need for “the achievement of the right configuration of people,

resources, knowledge and place” (p.137).

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Balka and Wagner (2006) regard system configuration as “embedded in larger contexts

of organizations and physical environment” (p.229). They explain that one of the

motivations for configuration work lies in the fact that making technology work requires

interventions in the organisation and physical environment because technology,

organisation and environment are not necessarily well planned nor are they aligned with

each other. They point out that another motivation is the trend towards ubiquitous

technologies which require integrations of a diverse set of devices, physical space and

artefacts in particular environments. These lead to their arguments that configuration

involves different levels and dimensions with each of these involving organisational,

spatial and connectivity issues (Balka & Wagner 2006, p.235).

In this section I will first outline related configuration categories in the work of Gartner

and Wagner (1996), Binder et al. (2004), Balka and Wagner (2006) and Balka et al.

(2005, 2008). Following this, two major themes in these configuration categories will be

presented in more detail. One is the configuration of artefacts and physical spaces. The

second is to do with the configuration of the work practices and environment in which

technologies are used.

2.2.4.1 Configuration Categories

Drawing on the architectural notion of configurability, which concerns adaptability of a

space to a diversity of uses, Binder et al. (2004) explore different aspects of

configuration in designing a mixed-media collaboration environment. They classify

these aspects into four categories: associations of inputs, media and outputs; spatiality

and integration with artefacts; configuring furniture and work zones; and real-time

configuration of mixed objects (p.321).

Balka, Wagner, Bjorn and Jenson extend configuration work to the environment and

organizational level (Balka et al. 2005, Balka & Wagner 2006). They identify a range of

configurabilities that need to be supported in designing information systems for use in

complex organizational and technological work contexts. These include configurability

of organizational relations, configurability of space and technology relations,

configurability of connectivity, configuring as direct engagement and configuring as

part of technology use (Balka & Wagner 2006, p.231).

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Gartner and Wagner (1996) identify a framework for discussing the political and

organizational context of system design and participation by using the notion of “social

arena” – “a place in which different communities of actors meet to discuss shared or

overlapping projects and concerns” (p. 191). Their framework includes three design

social arenas: designing work and systems, designing organizational frameworks for

action, and designing the industrial relations context. They argue that designers not only

need to analyse existing actor networks but also redesign them in ways that help

establish an appropriate participatory structure. As described in 2.2.1, Balka et al. (2008)

present a typology for identifying possible sources of local variability of work practices

in a healthcare setting and use Gartner and Wagner’s framework to map these sources of

local variations into three social arenas. These arenas include the political and policy-

making context, the institutional/organizational context for action, and the systems and

workplace design context. They point out that each of these contexts requires different

approaches to generate design solutions.

2.2.4.2 Configuring Physical Space and Artefacts

From their observations of how architecture and interaction design students configure

their workspace and the relationship between design artefacts, Binder et al. (2004)

propose a design approach that emphasizes configurability as an important feature of

mixed-media environments. They explain that there are two meanings of configurability

when embedding digital media in physical environments. One is to adapt a space to

support the diversity of use and their specific arrangements by appropriating a space or

personalising it. Another is the configuration of artefacts within the physical space

taking account of the position of artefacts and the relations to and between the artefacts.

They argue that “the configurability of a space depends on its layout, the design of the

infrastructure and the design of the artefacts that populate it” (p.323). Their analysis

shows that integration of artefacts in a physical space needs to be carefully designed to

produce the right interplay between infrastructures, artefacts, shared understanding and

activities.

Their approach addresses the relationship between “space” and “place” as they explain

that “physical interfaces provide people with the means for producing configurations

that change spatiality and interactivity in transforming their social experience” (Binder

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et al. 2004, P. 323). This is a compatible approach to addressing the spatial

configuration to the work of constructing physical space that has been presented in

section 2.1, such as the configuration of task space, person space and reference space

(Buxton et al. 2009) and the spatial construction of video conferencing meetings

(Henderson & Henderson 2009).

The design solutions of Binder et al. (2004) include using physical infrastructure as an

integral part of the interaction technology as well as the integration of spatiality with

artefacts. Related work about constructing collaborative work spaces by integrating the

design of physical space and information spaces has been described in section 2.1 where

media space design challenges are presented.

Binder et al. (2004) emphasize the adaptability and flexibility aspects of configuring

space and digital media. They note that people usually configure space functions and

tools according to the situation and organise the use of these functions and tools in

unexpected ways. These need to be taken into account in integrating digital media and

space, both of which can evolve and change with the activities.

2.2.4.3 Configuration of Technology in Work Environments and Practices

Balka et al. (2005) extend Binder et al. (2004)’s work to address configurability as a

form of appropriation. Specifically, their work focuses on how people make

technologies work within a particular social and physical context. Their aim is not to

understand how to support configurability through attributes of technologies themselves.

Instead, they address questions “relating to the configuration of space and technology,

to co-operativity and to the transparency of configurable systems” (Balka et al. 2005,

p.79). They look at the range of effort required when users integrate a technology into

their work practice. Drawing from their studies of a hospital wireless call system and

supporting the learning environments of architecture students, they summarize

configuration work into two dimensions. The first dimension is configuring technology

in the environment and the second dimension relates to configuration support.

According to Balka and Wagner (2006), the first dimension addresses issues of how to

fit an application to a particular organizational setting and consists of three levels.

The first level concerns organizational relations. There is a complex

arrangement of technological environments (e.g. ICT infrastructure), technical

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support staff and various users involved and the social relations that brings these

parties together. There is a requirement at organization level to coordinate the

various roles and groups needed to support the system.

The second level is to do with the placement and assembly of space and

technology. Balka at al. explain that different tasks may require different spatial

set-ups and different configuration of hardware and software. They argue that

the allocation of space and spatial layout can be a source of work practice

variability.

The third level concerns connectivity of people, places and materials. It refers to

a capability for re-arranging connections (e.g. changing patterns of availability)

to other people and assembling and reassembling artefacts (e.g. patient

information) to shift perspective for a particular activity.

The second dimension addresses configuration support. It describes a set of activities

required to achieve the goal of using technologies to support collaboration practice, for

example, the direct engagement of users and configuring as part of technology use.

Drawing from their three studies in hospital environments Balka et al. (2008) highlight

the importance of “configuration activities focused at customizing generic health

information systems to fit particular local healthcare settings” (p. 515). Balka & Wagner

(2006) also regard configurability as being linked to the fact that in an evolving

environment the boundaries of activities are continuously moving since the settings,

around which work practice are organised, are constantly changing. Configuration

efforts require not only redesigning aspects of the technology, reconfiguring

organisational relations, work materials and physical environment, but also

incorporating configuration and the work it entails as an ongoing activity (ibid).

2.3 Summary

O’Hara et al. (2011) conclude their discussion of their vision for future work in

designing integrated collaboration and interaction spaces:

The current presentation of Blended Interaction Spaces…has focused on the

mechanical aspects of collaboration and conversation and how this is facilitated

by particular material properties and design characteristics of these

spaces…Through more ethnographic enquiry into these work practices, it should

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be possible to articulate further reasons why, in particular organizational

contexts, people do and don’t orient to common spatial references in the shaping

of their work practices and the ways embodied interaction within a range of

organizationally situated Blended Interaction Spaces creates meaning and the

production of “place” (p. 25).

This leads to the summary of the design issues that require further exploration in

supporting distributed collaboration and that are particularly important for the design of

collaborative workspaces. These issues include: the spatial configuration of

collaborative workspace in a particular organizational setting; the importance of

supporting shared interactions with information; the problem of asymmetrical access to

the remote participants, their environments and digital resources; the need for flexible

support for different forms of collaborative activities and organizational context; and

how to extend generic prototype designs and integrate them into actual settings and

work practices.

Common to those distributed collaborations which are defined by various asymmetries

and different local settings where processes need to be integrated, is the challenge to

configure available technologies, practices and resources to support mediated

collaboration. The issue of variation in local practices has raised questions of how to

identify essential sources of variation and what configuration work and design approach

are required to provide a balanced solution to support collaboration across different

local settings. There is an opportunity for my research to contribute to this growing

interest in CSCW and HCI.

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3 The Research Process

The aim of my research is to understand distributed collaborations in complex work

settings and provide guidelines for the design of collaborative workspaces which can be

used across local work settings. This research is based on the premise that

understanding work practice is essential for designing technologies to support people in

their everyday work and interactions with others (Bannon and Schmidt 1991, Schmidt

1998, Rogers et al. 2011). It is situated within the workplace study tradition of CSCW

and the need to study the real character of work has strongly motivated the use of an

ethnographic approach in this research. An ethnographical informed workplace study of

distributed collaboration was undertaken in each of the three case studies. My research

in each of these studies was part of a larger system-design-oriented project in CSIRO,

so my work was required to fit with the demands of the overall research and design

processes in the projects and the findings of my work to contribute to the design.

In this chapter, I will first provide an overview of the evolution of this research,

particularly how my initial research questions were inspired by the first case study and

refined during the research process in the other two case studies. I will then describe the

methodological context by reviewing the role of workplace studies in CSCW and HCI.

The particular methodological challenges and strategies in my research will also be

discussed. Finally the details of the research process, including data collection, data

analysis and data synthesis will be described.

3.1 Evolution of the Research

Interpretative case studies have been used to answer the research questions and

qualitative research is the basis of this thesis. According to Flick (2008), the initial

planning of a qualitative study involves developing research questions from a general

idea and interest in the topic and taking a research perspective appropriate to the

questions. Following this stage, researchers need to update themselves with relevant

theoretical and methodical literature as well as the issue of interest itself. This section

describes this evolution process. I will start with my original research interest and

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research perspective and then focus on how my research questions were evolved during

the research process over the case studies.

3.1.1 Original Research Interest

As described in Chapter 1, my research interest was inspired by my early work in

designing broadband telehealth systems and then by recent involvement in the design of

collaborative workspaces. When it was suggested that I might want to enroll as a

doctoral candidate, a series of projects related to the design and implementation of

collaborative workspaces in different work domains was planned by the CSIRO

research team at that time. The MDTM study was carried out at the beginning of my

PhD research. What impressed me from this study and my early work in broadband

telehealth was the complexity of work practices and collaboration. Healthcare work

often involves multidisciplinary teams and complex information sharing practices.

Healthcare work in Australia operates in private or public funding arrangements and

takes place across primary, secondary and tertiary care sectors. These contexts make

collaboration in healthcare practices, especially distributed collaborations, extremely

challenging. In my early work in telehealth research, no systematic CSCW study

approach was adopted in the design of telehealth systems. Although the prototype

systems (e.g., the ViCCU) were implemented in hospitals as clinical trials, it was very

difficult to argue for the appropriation of the study approach in those projects and

publications. When I had opportunities to work together with researchers in CSCW and

HCI fields and to design collaborative workspaces for use in a range of work

environments, I was motivated to develop an understanding of the relationship between

work practice and technology design. The research questions at the beginning of my

exploration were broad and covered the two dimensions:

What special characteristics of interaction do collaborative workspaces need to

support in complex work settings?

What guidelines might support the design of a collaborative workspace for a

complex work setting?

These questions were further reflected on and refined during the analysis of the MDTM

study and the research processes of the other two studies. I will describe this evolution

process in 3.1.3.

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3.1.2 Perspective

Flick (2008) summarizes three research perspectives which can be taken in qualitative

research:

The first is the bottom-up perspective. An example of this perspective is

grounded theory research (e.g. Glaser & Straus 1999) which explores

phenomena and practices to develop theory and explanation.

The second is the top-down perspective. An example of this is social

representation theory (e.g. Flick 1998) which uses theoretical concepts and

scientific models to explain everyday practice.

The third is the mid-level perspective such as biographical research which

explores events and coping strategies and can go either way: to develop theories

or look into how people cope with events in their lives.

The research presented in this thesis is a bottom-up perspective. It is interpretive

research - a particular form of inquiry that employs an approach of in-depth

understanding and deep immersion in the environment of the subject (Thomas 2011).

This research uses methods common in ethnographic approaches to describe and

interpret work practices in order to develop design suggestions and principles. A more

detailed review of the ethnographic approach and the particular methodological

challenges of this research will be presented in 3.2.

3.1.3 Getting Focused

My approach of developing focused research questions was to start with general

questions, as described in 3.1.1, and refine these in the course of the research over

multiple case studies. In this section I will give an overview of my multiple-case study

approach and how the research foci were updated with findings and theories in the

literature.

3.1.3.1 Case Studies

Yin (1994) defines the case study research method as “an empirical inquiry that

investigates a contemporary phenomenon within its real-life context; when the

boundaries between phenomenon and context are not clearly evident; and in which

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multiple sources of evidence are used” (p.13). A case study is an in-depth exploration of

the complexity and uniqueness of a particular phenomenon, such as a project, policy,

institution, program or system (Simons 2009). A case study “concentrates on one thing,

looking at it in detail” (Thomas 2011, p.3). These definitions stress particularity,

complexity and the real-life context within which the case study research occurs.

Case studies have been used in HCI and CSCW fields to obtain knowledge from

existing systems within real-world contexts, such as implementing systems and

technologies within organizational settings (e.g. Jirokta et al. 2005, Balka et al. 2008,

Olson, Zimmerman et al. 2008, Stevenson et al. 2010). Insights from these case studies

are used to enrich the collective knowledge in HCI and CSCW disciplines and to enable

key issues to be described and understood. The issues generated can be used to generate

hypotheses to propagate further research.

Researchers can use either a single-case or a multiple-case design depending on the

issue in question and opportunities available. Stake (2005) explains multiple-case study

this way - “a number of cases may be studied jointly in order to investigate a

phenomenon, population, or general condition…I call this a multiple-case study or

collective case study” (p. 445). In other words, in a single-case design, there is interest

in the case itself; in a multiple-case design, the focus is on the phenomenon of which

each case is an example (Thomas 2011).

Multiple case studies in my research offer opportunities for comparative analysis and

the building of common themes across different application domains. Each case is

treated as a single case first. Each case’s findings are used to contribute to those of the

research as a whole. The case studies and their analysis are the main vehicles for

identifying cross-cutting issues in these application domains and lead to a number of

principles and guidelines which address these issues in designing collaboration

technologies. A useful technique I used was to repeatedly refer back to the research

issues and focus attention on evidence that would satisfy the purpose of the study. This

approach, along with constantly moving between field observation, literature and

theory, helped to deepen my research questions and focus my research objective. This

process is illustrated in Figure 3.1 and further described in the next section.

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Figure 3.1. Getting focused

3.1.3.2 Getting Focused

One of the features of the research setting in the first case study, the MDTM study, was

the local difference in organizational structures, physical spaces and information spaces

of the study sites. Initial analysis of the study generated interesting findings about how

these different collaboration settings supported meeting practices in positive ways and

how they hindered collaboration in the distributed MDTMs. Inspired by these findings,

I paid particular attention to the ‘variation’ and ‘asymmetry’ features in this large-scale

multi-organization team collaboration while I was conducting the second study. This

was the study of distributed meetings between the emergency animal disease response

committee members. My focus was on understanding the specific practices of the

meetings and how these practices affected the technology design requirements for

different members and sites. The third study was conducted within a single

organization, a scientific laboratory that has a particular “distributed” setting. In this

setting are biocontainment barriers which act to ‘distance’ the scientists working in the

containment areas and their colleagues in the general office area. In light of those issues

that I explored in the first and second case studies, in the third case study I paid

particular attention to the actual work practices and work environment of different

groups and how these settings shape the particular collaborations between different

groups of scientists working in different areas across the biocontainment barriers. In

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addition, I was able to investigate the configuration issues in designing collaborative

workspaces and use the understandings gained to inform the actual design of the system

that was implemented at the laboratory.

This reflective, in-depth and at least partly iterative process allowed a more focused

research concern of “supporting collaborations across different local settings” to emerge

(Figure 3.1). It became clear that I needed to account for the ways in which different

local settings have impact on work practices and subsequently on the design of

collaborative workspaces for the particular setting. This led to the research questions

that can contribute to an important understanding of these issues in CSCW and HCI

fields:

What special characteristics of interaction do collaborative workspaces need to

support in complex work settings?

What are the socio-technical factors that shape the dynamics of the distributed

collaborations across different local settings?

What principles and guidelines might support the design of collaborative

workspaces for complex work settings?

How can collaborative workspaces be configured to support distributed

collaboration across different local settings?

3.2 Workplace Studies in a System Design Context

The intention in each of the three case studies was to use the understandings obtained

from the workplace study to inform the design of collaboration technologies to enhance

existing collaborations. In this section I will first give a brief overview of workplace

study in CSCW. After this I will outline the particular challenges of studying

collaboration practices in my research and how these shaped the study methods used.

3.2.1 Workplace Study in CSCW

Workplace study, intended to inform system design by understanding the sociality of

work and organization, has been common and “critical” in CSCW research (e.g. Hughes

et al. 1994, Jordan 1996, Schmidt 1998). Bannon and Schmidt (1991) stress that “an

adequate understanding of what is really going on in the workplace” (1991, p. 12) is a

prerequisite for the design of collaborative systems. Empirical studies in the 1990s’

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reported the impact of computer mediated communication on work practice and

highlighted the need to attend to the social context of work and to analyse the

collaborative work practices and activities (e.g. Bannon and Schmidt 1991, Heath and

Luff 1992b, Dourish 1993). The need to incorporate a social perspective in system

design and the need to study work practice have driven the use of an ethnographic

approach and corresponding methods in interaction design research and particularly in

the design of collaborative systems since the 1990s’ (Blomberg et al. 1993, Hughes et

al. 1994, Plowman et al. 1995, Randall et al. 2007, Rogers et al. 2011, Blomberg &

Karasti 2013).

Ethnography has traditionally been used in social science to understand the social

organization of activities within specific contexts (Anderson 1994, Denzin & Lincoln

2011). Traditionally, ethnographic studies within sociology are conducted from a

particular theoretical viewpoint and for the purpose of contributing to theory.

Ethnography is a naturalistic method based on fieldwork. It relies on material obtained

from the first-hand experience of an ethnographer in a particular setting. Ethnographers

spend a considerable time observing and immersing themselves in the natural work

setting in order to understand human attitudes and behavior and provide rich

descriptions of people, environments and interactions (Randall et al. 2007, Denzin &

Lincoln 2011).

The importance of ethnographic research in the design process has been well described

by CSCW researchers (e.g. Blomberg et al. 1993, Anderson 1994, Hughes et al. 1994).

Ethnographic study used in the design process aims for meaningful understanding that

captures the complexity of human practice, and to use this understanding to design

technologies that are useful and usable in human activities (e.g. Suchman 1987, Hughes

et al. 1994, Robertson 2000). Ethnography is particularly concerned with people and

their interactions in their individual contexts and provides designers with rich

understandings of a range of socio-technical issues in the particular political,

institutional and workplace design contexts (e.g. Balka et al. 2008). Investigation can

include: coordination - how people align and adjust their activities in relation to the

action of others; material resources for action - the ways artefacts (e.g. paper documents,

computer displays) enable people to work together; and how people share and interpret

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information resources collaboratively to enable collaboration (e.g. Blomberg & Karasti

2013).

Workplace studies in CSCW generally use a collection of ethnographic methods for

gathering and organizing field materials from observational studies (e.g. Dourish

2006a). Standard methods from ethnography and contextual data gathering include

observation, interviews, audio recording, video recording, note-taking, photograph-

taking and gathering site documents (e.g. Blomberg et al. 1993, Rogers et al. 2011). The

main feature of these methods compared to other data gathering approaches is that they

do endeavor to avoid assumptions about the activities or practices that are being

investigated prior to the observational studies (e.g. Rogers et al. 2011)

Workplace study using ethnographic approaches can provide deep understandings of a

work domain, a holistic understanding of users, their work, and their context, which can

then be drawn on in the technology design process (Hughes et al. 1994, Crabtree 2003).

Such workplace study is not simply about the collection of data in the field, it is also

about reflection on and interpretation of that field data. If the study aims to inform

design, then findings based on reflection and interpretation need to be summarized and

“design suggestions” or “design implications” need to be drawn out with particular

features that are related back to the findings. The role of researchers who conduct

workplace studies in design-oriented research is to obtain knowledge and

understandings of the relevant domain and communicate this to designers so that the

findings can guide the system design.

As already stated in 2.1.6, there is a lack of workplace studies to inform the

development of collaborative workspace technologies, especially in complex work

settings (e.g. Baecker et al. 2008, Stevenson 2011, O’Hara et al. 2011, Jirotka et al.

2013). These technologies are often initially technology-driven and built in an

“engineering manner”. This presents an opportunity for researchers to use ethnographic

study methods to explore rich real-world use cases, contexts and user needs in designing

these technologies. The motivation is that learning from disciplines that address real-

world phenomena can continuously provide important insights for the design of new

interaction technologies (e.g. Kjeldskov & Paay 2012, Blomberg & Karasti 2013).

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3.2.2 Challenges in Conducting the Studies

The particular challenges in conducting the workplace studies in this research include

time constraints of short design cycles, multiple field sites, the logistics of studying real-

time distributed collaboration and the constraints of each particular field site. These

challenges shaped the choices of methods in my field studies. The challenges, related

work and the research strategies to address these challenges are described below.

Details of the approaches taken in the individual case studies are described in Chapter 4,

5, 6 where individual case studies are presented.

3.2.2.1 Time Constraints and Ethnographic Approaches in System Design

One of the biggest challenges for workplace study in a system design cycle has been the

time required to conduct research in the field (Hughes et al. 1994, Millen 2000).

Traditional ethnographic research typically takes place over several months with at least

the same amount of time spent in analysis and interpretations of the observations

(Millen 2000). In most cases it is difficult to do this kind of study within a development

process. In addition communicating ethnographic findings to designers also takes time

(Hughes et al. 1994).

Researchers have proposed different ethnographic approaches to be used in system

design. Hughes et al. (1994), in a classic early CSCW paper, identified the following

ethnographic approaches:

Concurrent ethnography - incorporating an on-going ethnographic study while

developing a system. The iterative process of “fieldwork > debriefing >

prototype iteration > field work” precedes the design development of the system.

Each stage of the field work is intended to target issues raised by the designers

during the debriefing.

Quick and dirty ethnography - undertaking brief ethnographic studies to provide

a general and focused view for designers. Compared to the focused attention of

“concurrent ethnography”, “quick and dirty ethnography” is able to provide

knowledge of the social organization of work in a relatively large scale work

setting in a relatively short of time.

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Evaluative ethnography - using ethnographic study to verify a set of pre-defined

design decisions. It can be considered as a more focused version of “quick and

dirty ethnography” with the purpose of evaluating an already formulated design

proposal.

Re-examination of previous studies - re-visiting previous related studies to

inform design. Researchers can use experience built from a corpus of case

studies to better understand material concerning a domain or to inform previous

preliminary design.

Hughes et al. (1994) argue that prolonged fieldwork is not always necessary and it

would be more effective to direct fieldworker’s effort in accordance with design

objectives “once an effective understanding of the setting of the work and its

characteristics has been obtained” (p. 437). They also highlight the importance of the

focus of a workplace study and suggest the focus can be identified through a series of

“quick and dirty” ethnographic studies or findings from previous studies.

Similarly, Millen (2000) introduces a set of “rapid ethnography” approaches which can

help researchers to lessen time demands by undertaking short focused studies to rapidly

gain reasonable understandings of users and their activities and provide a wider design

context for systems under development. Methods of “rapid ethnography” include:

Focusing on key informants/users: Mullen (2000) suggests a user “sampling

strategy”. For example identifying a “field guide” user who can point out where

interesting activities are most likely to be observed; using a fringe member who

has had prior interaction with the group; developing good long-term user

relationships.

Interactive observations: One observation approach is to have more than one

researcher in the field at the same time. Another approach is to use more

interactive methods, including structured interviews, activity walk through, and

contextual inquiry.

Computer assisted analysis and collaborative data analysis: use computer

assisted analysis to assist the exploration of large amounts of qualitative data.

Time saving analysis also includes the analytical processes developed (e.g.

cognitive mapping, pictorial story-telling and scenario analysis) to allow

research teams to collaboratively understand the data.

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In the three case studies presented in this thesis, the approaches of quick and dirty

ethnography, focusing on key users, interactive observations and using computer

analysis software were adopted. In the AAHL study in which a system was installed,

concurrent ethnography was used in order to match the pace of the design and

development cycle. Interviews and observations were conducted in parallel to each

other to enable a quick understanding of the work practices. Each workplace study

involved a team of two to four researchers working closely and collaboratively.

Strategies used in the studies to improve the efficiency and quality of data interpretation

and analysis also included involving both ethnographers and designers in both the field

work and the conceptual design (e.g. Paay 2008).

3.2.2.2 Studies over Multiple Sites

There is a growing awareness of the need for multi-sited ethnographic study in system

design (e.g. Balka et al. 2008, Jirotka et al. 2013, Blomberg & Karasti 2013).

Collaborative work practices are increasingly large-scale and geographically dispersed,

and cross organizational boundaries (Fitzpatric & Ellingsen 2013). Ethnographic study

has a tradition of investigating the specificities of a particular work setting. Although

studies of bounded single-sites produce rich and detailed pictures of particular design

settings, they are not able to reflect the ways in which organizations and activities are

becoming increasingly unbounded (Blomberg & Karasti 2013).

Some researchers have conducted comparative studies over multiple work sites to

provide understandings about commonalities and variations in work practices (e.g.

Schmidt et al. 2007, O’Neill et al. 2007, Randell et al. 2011). Randell et al. (2011)

acknowledge the potential for multi-site workplace studies to contribute to CSCW and

call for more investigations into the detail of differences between settings. Blomberg &

Karasti (2013) in their “Reflections on 25 Years of Ethnography in CSCW” highlight

the approach of assembling “the field sites to allow horizontal comparison over several

single-sited studies” to cope with the challenge of studying unbounded and extended

settings (p.387).

The central theme of the research in this thesis and the analytic approaches used have

been closely aligned with this trend of exploring collaboration across different settings

and extended contexts. In my research, collaboration in MDTMs involved two work

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sites and CCEAD meetings involved a large-scale team with members located across

more than seven work sites.

3.2.2.3 Studying Real-time Distributed Collaborations

There are tensions when researchers use ethnographic approaches for studying

distributed collaboration, particularly in synchronous and real-time distributed

collaborations. Ethnography within one work site or a confined environment, such as a

control room, has relatively clearly visible tasks to observe. Scaling such observation to

spatially expanded settings and to processes distributed in real-time is much more

difficult (Hughes et al. 1994, Blomberg & Karasti 2013).

Millen (2000) points out that one of the valuable approaches to improve the efficiency

of field research is to have more than one researcher in the field at the same time. For

example multiple researchers in the field can split up and observe different activities or

groups; multiple views of the same events can be turned into a richer representation and

understanding of the situation. This collaborative observation and analysis strategy is

applicable to the study of distributed collaboration although it is expensive and not

always possible within a design project with limited resources.

I was fortunately able to work together with a group of researchers in the field studies.

For example, the MDTM study involved observations of real-time distributed meetings

in two hospitals so three to four observers split up at the two sites to observe the

meetings and met after the observation to debrief. Audio and video recordings of some

meetings at the two sites were collected simultaneously. I joined and synchronized the

two sites recordings using the Vegas computer software to allow the researchers to

review the distributed meetings during the data interpretation process.

3.2.2.4 Work Environment Constraints and Other Constraints

Conducting research in a complex work environment has particular constraints caused

by the specific work setting. Field work researchers not only require access to relevant

sites but also need acceptance from those who work in them and need to accept the

work regulations in these settings (Hughes et al. 1994).

The ethical issue of conducting a workplace study in a hospital was a particular concern.

During the MDTM study we worked closely with the key study participants to design

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the study and obtained ethics approval from the two hospitals. Issues regarding patient

privacy and video recordings were addressed by anonymising the data. All the study

participants were provided with an information sheet explaining that their and their

patients’ identities would be protected and the data would be used only for the purpose

of the study.

In the CCEAD study I was not able to observe the actual CCEAD meeting in action.

This was due to the unpredictable nature of emergency disease outbreak and, more

specifically, due to the high level confidentiality of the meeting. However we were able

to visit the meeting rooms. Where possible we conducted interviews and focus group

meetings in these rooms to allow the participants to better explain the meeting process

and resources used in the meeting.

The study at AAHL required me to follow the strict biosecurity regulations at the

containment areas in that laboratory, such as wearing laboratory clothing to go in and

having a proper shower to exit. There were also particular constraints and procedures on

getting data collection materials, such as the camera, audio recorder and notes, out from

the containment areas. I was not able to go into the most secure containment area at all

because wearing a fully encapsulated suit is required for entering into that area and a

chemical shower is required when leaving.

The CSIRO working context had practical constraints on my effort in data collections in

addition to the project time frame constraint described in Section 3.2.2.1. As a full-time

CSIRO employee, I worked in multiple projects at the same time. My involvement in a

study could be reduced if I was allocated to a new project by the managers. This

happened in the AAHL study as I will describe in Chapter 6. The part-time nature of my

PhD study also limited my time in conducting the data analysis, particularly the

synthesis analysis across the three case studies, after the completions of the individual

projects. I managed to make progresses by working closely with other researchers

involved to publish the findings of individual studies (the permissions of using the

photographs in this thesis for publications were obtained when we published related

papers). I kept on reading recent related work and used updated literature review to help

reflect my findings.

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3.3 Research Process

Conducting three case studies in this research was an iterative and reflective research

process and it needed to be considered as a whole process rather than individual study

followed by individual study. Figure 3.2 below outlines this process.

Figure 3.2. An overview of the research process

The research process in each of the case studies consisted of these components (Flick

2008, Thomas 2011):

Study design, which is proposed at the beginning of the study;

Data collection, which involves gathering data about work practice and

collaboration practice in individual domains;

Data analysis, which involves inductive analysis of field data;

Synthesis, which includes drawing the significance of individual findings and

merging together of three case study findings guided by theories in the literature.

The research in the AAHL study also included a stage of using the field study findings

to inform the design of a collaboration platform.

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Although the data collection in the three case studies was done in different calendar

years, the research process was not a linear one of one case study following another. As

described in section 3.1, multiple case studies and an iterative approach allowed the

refinement of the research questions and the research objective during the collection of

data and analysis process. There was a constant reflective process between existing case

analysis, previous data analysis, theories and synthesis, as described below.

This reflective process was particularly important for the study designs. In each study

considerable time was spent before conducting the workplace study in the field to

ensure appropriate research design. During this period, issues identified in earlier

studies were taken into consideration, including informing the investigation focus and

selecting of data collection methods.

The reflective process was not only required for cross-case design and analysis but also

within each study itself. Conducting interpretive research often begins with issues

researchers can not know ahead of time and the research focus sharpens during

immersion in the field. Interpretive research requires a degree of openness at the

beginning and constant moving between field observation, literature and theory

(Altheide & Johnson 2011).

Frameworks and theories from literature were used for analyzing and interpreting

findings in this research. For example, prior work utilizing insights from ethnographic

research and concerning variations in local practices (e.g. Ellingsen & Monteiro 2006,

Schmidt et al. 2007, Balka et al. 2008) is one of the foundations that shaped my

research. Another is the interrelated social, spatial and communicative interactions in

media space (Harrison 2009) that suggested dimensions of analysis for my case studies.

A third is the configuration needs and the categories of configurability (Binder et al.

2004, Balka & Wagner 2006) that have guided the development of three levels of

configuration work for designing a collaborative workspace as presented in Chapter 7.

3.4 Data Collection and Data Analysis

One recognized strategy to ensure the research quality of interpretive study is to use

triangulation techniques - verifying facts and interpretations through multiple sources,

such as methods, data and investigators (Cho & Trent 2006). Qualitative researchers

usually deploy a range of interconnected interpretive methods to understand the

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practices that are studied (Denzin & Lincoln 2011). Using a diversity of material allows

the researcher to approach the research questions from different angles and a broader

picture of work practices.

In the research presented in this thesis, multiple sources of information and methods

were triangulated to ensure the credibility of the qualitative research. I was the key

researcher in each study and worked through the whole workplace study process in

each, while other researchers participated in different studies and in some parts of data

collection and analysis of the studies.

3.4.1 Data Collection

A range of data collection methods was used throughout the research process that

included interviews, focus groups and direct observations. Interviews were useful to

determine participants’ perceptions and explanations of processes whereas direct

observations (including video recordings) helped to identify phenomena that

participants may not have reported (Denzin & Lincoln 2011). The aims of both

interviews and focus group meetings were to gather details about the collaboration

practices that participants had with other people; issues around their existing

collaboration and information sharing practices; their design ideas and expectations of

new systems. The following is a description of each of these data collection methods:

Interviews: Semi-structured interviews were conducted in each of the case studies. They

were conducted in situ in conjunction with the observations or site visits in the MDTM

and AAHL studies. Telephone interviews were used in the CCEAD study since the

CCEAD members were located in seven states and territories. For consistency semi-

structured interview schedules and basic scripts were prepared before the interviews so

that the same topics were covered with each participant. These interviews were audio

recorded and transcribed for later analysis.

Focus groups: A focus group was used in the CCEAD and AAHL studies. One large

focus group meeting with 10-20 participants was held at the beginning of each study. It

allowed diverse or sensitive issues to be raised by participants in a supportive

environment and in a social context by talking to others (Rogers et al. 2011). The focus

group discussions were audio recorded and analyzed in a similar way to the interviews.

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Direct observation: Direct observations in the field have helped to capture details that

were not elicited from the interviews. They provided context for the tasks and important

information about why activities happen in particular ways (Rogers et al. 2011). In the

MDTM study observations of the meetings were carried out once a week over a three

month period by multiple researchers. Observations focused on different aspects of

interactions suggested by Jordan and Henderson (1995), including the structure of the

meeting, temporal organization of the meeting, turn taking, trouble and repair, and the

spatial organization of activities, artefacts and documents. Pointing and gesturing were

particularly examined. There were no opportunities to directly observe the collaborative

meetings in the CCEAD and AAHL studies, but during the site visits physical settings

and arrangements of artefacts were investigated and photographed. Notes were taken

during the observations. Video recording methods were used in the MDTM study.

3.4.2 Data Analysis

Data analysis methods adopted in each of the case studies included thematic data

coding, video reviewing and analysis with writing. The first two methods were common

across the case studies and the last one was used in the MDTM study only. The

qualitative analytic process is cyclical rather than linear (Saldana 2009). The first step is

to gain an overall impression of the data by looking for patterns (Randall et al. 2007).

Some recurring patterns or themes may have emerged during the data gathering process.

Since I worked closely with a couple of other researchers I was able to have discussions

with them after each observation and interview to identify the patterns that emerged. In

my three case studies, initial data were analyzed and discussed while data collection

continued. The following is a description of each of these analysis methods.

Data coding: Interview transcripts were coded in each of the studies. I was the

researcher working on the data coding. Coding data is a process of investigating the data

to identify codes and categories and of organizing and analysing these to identify

themes (Saldana 2009). Coding is an iterative process from data, to code, to category

and back to data. There were several iterations in the analysis process of each case

study. I first worked on the initial data coding based on the interview structure. A code

table was generated either using paper or using NVivo software. Key issues were

identified and grouped into categories relating to aspects of the particular local setting,

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the practices of participants and information sharing issues. Based on the categories,

several sub-themes were identified. These themes were then closely examined by using

findings from other data collection methods and literature reviews. The data were also

reviewed by the other researchers involved to validate the categories and themes. A list

of core themes and sub-themes were identified by this iterative process. This inductive

approach allows research findings to emerge from the frequent, dominant or significant

themes inherent in raw data.

Video reviewing: The video recordings of the distributed MDMTs were synchronized

and annotated using Vegas software. Due to the limited number of video recording

sessions that we were able to obtain, formal video analysis was not involved in the

study. The videos were reviewed and discussed together by multiple researchers

drawing on the “interaction analysis” framework introduced by Jordan and Henderson

(1995). Video materials were helpful to understand the particular actions with regard to

the immediate context and a particular interactional environment in which they arose.

Analysis with writing: Initial findings of each case study were summarized into reports

to present to the design team. Insights were carefully written into research papers and

published following the in-depth analysis process and while conducting the next study.

During this paper writing process, theories from literature were used to further reflect on

and interpret findings. Importantly, this provided a concrete iterative feedback between

studies and was useful for the cross-case analysis.

3.4.3 Synthesis

The synthesis process included synthesis in an individual case study and synthesis

across case studies (see Figure 3.2).

At an individual case study level, this was done by using data triangulation, as described

above, and by constantly moving between field observation, literature and theory. Prior

to the cross-case synthesis process, each case was analysed as one entity (a within-case

analysis). These analyses involved detailed write-ups of each as a coherent entity to

cope with the diversity of data collected from each case. The results, therefore, included

in-depth empirical descriptions of work practices in the three cases.

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At a multiple case study level, based on results from the individual cases I conducted

cross-case analysis for patterns which occurred across the cases. All cases were

workplace studies of collaboration in particular settings that shared some basic

characteristics such as variations of practices in the collaboration sites. Categories based

on literature were selected and combined with the themes emerging from the three cases

during the analysis. For example, the three dimensions of social, spatial and

communicative interactions in media space (Harrison et al. 2009) have been helpful

when I investigated different aspects of interactions and information sharing practices in

a particular collaboration setting; the design principles identified in media space

research (e.g. Luff et al. 2003, Buxton 2009, Paay et al. 2011) were referred to when I

considered the designs related to physical space and gesturing in supporting the access

to remote participants, their environments and digital resources; and the configurability

categories (e.g. Binder et al. 2004, Balka & Wagner 2006, Balka et al. 2008) have been

one of the key related works that inspired me to think about how to provide flexible

support for different forms of collaborative activities and organizational context. I used

these dimensions as a means to bring together results from the case studies and

construct design guidelines concerning designing collaborative workspace to be used

across different local settings.

The data collection and analysis processes in each of the three cases will be described in

more detail in the Method sections in Chapters 4, 5 and 6.

3.5 Summary

This chapter has focused on the purpose, approach and process of this research. The

evolution of the research questions after a reflective process was presented. Workplace

study in CSCW was reviewed along with a rationale for the methods adopted in this

research to address particular methodology challenges. To address the research

questions, three case studies were conducted in an iterative and reflective research

process which involved moving between study design, data analysis, literature and

theory. The data collection and data analysis of these three empirical studies led to the

final synthesis process from which design guidelines for collaboration technologies to

support different local settings were generated.

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4 Case Study: Collaboration in Multidisciplinary Medical Team Meetings

This chapter describes the study of multidisciplinary team meetings (MDTMs) in two

groups of breast cancer care teams in two hospitals - a large public teaching hospital and

a smaller private hospital. Regular MDTMs were held at each hospital for the treatment

and on-going management of its breast cancer patients. Some clinicians at the public

hospital were responsible for the care of some patients at the smaller private hospital

and the MDTM discussion of the ongoing treatment of these patients was done via

video conferencing between the two hospitals. The focus of the study was to investigate

how the MDTM participants collaborated in their local meetings in each hospital as well

as in the video conferencing meetings between the hospitals. The study examined the

MDTMs from various perspectives, including organizational context, physical setup of

the meeting, collaboration technologies used, medical information sharing practice and

technology-mediated conversation in both local meetings and distributed meetings.

Implications of designing collaborative workspace to support distributed collaboration

in MDTMs were explored. I was particularly interested in understanding how local

variations shaped the particular interactions in the distributed meetings, how different

local arrangements and practices arose and how to address the collaboration issues

caused by these differences.

4.1 Multidisciplinary Team Meetings

Multidisciplinary care is an integrated team approach to healthcare in which relevant

healthcare professionals collaboratively develop a treatment plan for individual patients.

They are considered important for the treatment of cancer since there is increasing

evidence that multidisciplinary care improves cancer patient outcomes (Zorbas et al.

2003, Bain et al. 2013). Cancer care involves a range of services including screening,

diagnosis, treatment (surgery, chemotherapy and radiotherapy), rehabilitation and

supportive care. Multidisciplinary cancer team members commonly include surgeons,

radiologists, pathologists, medical oncologists, radiation oncologists, psychologists,

oncology nurses and social workers.

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Regular multidisciplinary team meetings are an integral component of multidisciplinary

care (Marsh et al. 2008). A central theme of the meetings is for clinicians from different

disciplines to get together to review patient cases, establish diagnosis, and decide upon

the management of cancer patients. Patient case details, including patient records and

medical images are presented and discussed by the team in the meeting. A typical

procedure of patient case discussion (e.g. Kane & Luz 2006, Kane et al. 2013) begins

with the cancer patients’ details being read out to the team, followed by the presentation

of relevant medical images, such as radiology and pathology images. The clinician in

charge of each patient leads the discussion of the case and the proposed treatment.

Oncologists, surgeons, radiologists and pathologists then contribute their points of view

about treatment and management options. Nurses, psychologists and social workers

contribute other relevant information. Eventually a decision is made about future care

and treatment.

MDTMs play an important role in the care coordination between different hospital

departments or different health institutes and provide clinicians involved with

opportunities to discuss their recommendations with the rest of the team (Kane & Luz

2009b). The main outcome of the MDTM is to reach a decision on cancer patient

management. Besides the formal review activities, patient referrals for clinicians

working in different hospitals, recruiting cancer patients for clinical trials and related

research advances can be discussed in the meeting. A MDTM also provides an

education environment for medical students and junior doctors who attend the meeting.

In addition, the meeting serves a social function to support the development of collegial

relationships, particularly through the informal interactions before and after the

meetings.

Video conferencing has been increasingly used in MDTMs to facilitate communications

between team members based in different hospitals or cancer centres (e.g. Delaney et al.

2004, Kane & Luz 2006, 2013). Collaboration technologies have extended the

traditional MDTM, with local case discussions and other local activities involving

people in the same room, to enable collaboration with remote team members.

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4.2 Related Work

Collaborations in MDTMs have been investigated by Kane and Luz (2006, 2008, 2009a,

2009b, 2011, 2013) and other CSCW and HCI researchers from various perspectives.

Kane, Groth & Randall (2011) summarize related research in a special issue of the

Journal of Behaviour and Information Technology where a collection of papers

investigating MDTMs are presented including one of my publications Li and Robertson

(2011). In this section I will describe three related themes in MDTM research: the

practices of communication and decision-making, comparison of co-located meeting

and video conferencing and the design of collaboration technologies to support

information sharing.

The importance of efficient communication and coordination in the practices of

MDTMs has been reported by Kane and Luz (e.g. Kane & Luz 2006, 2008, 2009a, b,

2013). They conducted a long-term ethnographic study in MDTMs for lung cancer

patients at a teaching hospital over several years. Some of their investigations include

the MDTM’s role in the diagnosis and treatment of patients, the practices in MDTMs

within the broader context of pre and post meeting activities and the social and

organisational contexts of the different participating hospitals. The practices of

assimilating information and decision making and how diagnosis is collectively

achieved have been also explored in detail (Kane & Luz 2009a, b). In providing

technological support for the MDTM, it needs to be recognized that the task of patient

management discussion through interaction and communication is one of the main

functions of the meeting (Kane & Luz 2009a). For any solution to be satisfactory,

account also needs to be taken of the organizational and social factors (ibid). Recently

Kane and Luz (2013) studied the changes, in particular the rhythms of discussion, when

introducing electronic patient record (EPR) and picture archive and communication

systems (PACS) (Kane & Luz 2013). They found that the number of patient cases in a

meeting has increased and there is less information and less time used in a patient case

review. They argue that although more information is potentially available at MDTMs

because of PACS and the EPR implementations, it is not as easy to access the electronic

information as it is to review a paper chart. However clinicians still value “being there”,

being co-located with their multidisciplinary team colleagues, and having the chance to

interact with one another. By comparing and contrasting MDTM practices in three large

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teaching hospitals in Europe, Kane and Groth (2014) highlight the complex nature of

interpersonal collaboration at MDTMs and the importance of individual role

participation, communication and team cohesiveness.

The effects of the use of video conferencing on different aspects of the meetings and the

differences between co-located meetings and video conferencing meetings have been

explored by various researchers. Studies have shown that each case discussion takes

significantly longer in video conferencing meetings when compared with the local

meetings although the structure of the patient discussions remains the same (Kane &

Luz 2006, Groth et al. 2009). Delaney et al. (2004) report similar findings in their study

of MDTMs in an Australian hospital by showing that there is a slower and more formal

presentation and discussion of the case information when using video conferencing.

Kane and Luz (2006) argue that the formal style had less benefit for the core MDTM

members while this gives other participants opportunities for obtaining information and

making contributions. In their study of the effectiveness of MDTM, Kane and Luz

(2013) examine the timing of a MDTM in the context of using PACS and EPR. They

point out that video conferencing still takes more time per case, hinders interaction

dynamics (such as turn-taking) and causes difficulties in coordinating information

sharing.

Although video conferencing technologies have enabled relevant disciplines to

participate in discussion, the collaboration in MDTMs has not yet been achieved in a

satisfactory way (Kane & Luz 2006, Kane & Groth 2014). One of the improvements

needed is the use of more powerful systems and designs, such as pointing devices and

tools that allow for rapid manipulation of medical images (Kane & Luz 2009). Kane and

Luz (2008, 2009b, 2011) and Groth et al. (2008, 2009) have investigated the design of

collaboration technologies to support information presentation and sharing in MDTMs.

These investigations include the following three aspects:

Clinical information workspace. In their discussion of a “clinical information

workspace” for MDTMs, Groth et al. (2009) recommend the use of collaboration tools

for individual participants for the visualisation of, and interaction with, patient

information during meetings (see also Frykholm & Groth 2009). Groth and her

colleagues have developed a multi-display groupware system by incorporating multi-

user multi-model interaction techniques in personal handheld devices to support

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MDTMs (Olwal et al. 2011). They evaluate the use of tablet devices for individual

meeting participants to view patient case details, which is a summary of a patient’s

electronic patient record (Frykholm et al. 2012). They found that using a summary

prepared before the meeting is more efficient than directly browsing through electronic

patient records but the use of the tablet distracts them from following the meeting

discussion. The drawing and annotation functions on the tablet devices and showing

these annotations on the shared large displays are very helpful for meeting participants

to discuss radiology images.

Text-based recording of the case discussion. With an aim to obtain a real-time text-

based recording of the meeting discussion as a communication record, Kane and Luz

(2008) investigate the use of visual display for text data in addition to the audio resource

to support co-located and teleconferencing discussion. They also look at using text-

based recording of case discussion as an electronic record for patient files (Kane et al.

2013). They point out that it is a challenge to develop a record that will not detract from

the synchronous collaboration between clinicians and that is easily processed.

Displays and pointing devices. Kane and Luz (2008, 2011) argue that collaboration can

be enhanced by the development of architecture spaces that are integrated with tools

supporting interaction and the exchange of information, such as large shared interactive

areas. Kane and Luz (2008, 2011) analysed the configuration of the video-displays and

offered a number of recommendations about how new configurations might facilitate

improved discussion and decision-making during video-mediated MDTMs. In their

discussion of an “ideal room” for a MDTM, Kane and Luz (2009b) suggest a range of

technologies that could equip the room to improve MDTM services. These include, for

example, suggestions about pointing technologies, the use of multiple screens for

concurrent display of medical information and ubiquitous devices to record the presence

of individuals.

The series of papers published by Kane and Luz have demonstrated that the MDTM is a

valuable setting for research into collaboration. Research themes around cooperation

and coordination, roles of participants, time, information sharing, space and place, and

technology employed are all relevant to the general CSCW issues. Exploring how the

teams work in MDTMs and the problems they encountered provide insights into

collaborative work that can be applied in other work settings. Although substantial

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CSCW research has engaged with MDTM settings, Kane et al. (2013) point out that

some of the CSCW issues that arise when collaboration technology is employed at

MDTMs are still not fully understood.

4.3 Research Context and Motivation

The healthcare system in Australia is a complex mix of public and private systems.

Large tertiary teaching hospitals are funded and operated by state governments. Private

hospitals owned by private companies are usually small with no teaching functions.

Some specialists, such as surgeons, radiologists and pathologists, work in both the

public and private sectors and divide their time and their sources of income between the

two sectors.

There is a mixed practice and referral network for cancer patients in Australia. Cancer

patients can be referred by their general practitioners, who are a patient’s fist contact

with the health system, to specialists at public hospitals, private hospitals or private

practices. Specialists can refer their cancer patients to other discipline specialists for

investigation (e.g. radiology) or treatment (e.g. chemotherapy, radiotherapy). In public

hospitals, patients are treated by specialists nominated by the hospitals. Private patients

can choose their own specialists but need to pay for the service gaps which are not

covered by government funding. For example, a private patient can be referred by his or

her surgeon to a senior radiologist who works at a public hospital. Or a private patient in

a small private hospital can be managed by a surgeon at a large public hospital.

In Australia MDTMs have been held regularly in many hospitals as an integral part of

multidisciplinary care (Marsh 2008, Bain et al. 2013). The operations of MDTMs

present some unique features because of the mix of private and public health delivery

and shortage of specialists (Marsh 2008). The specialists work in different hospitals or

different sectors and are sometimes required to travel to attend case discussion sessions

at different hospitals. To minimize the need for travel, video conferencing has been

introduced to multidisciplinary cancer care settings as a solution to support case

discussion across sites (Delaney et al. 2004, NBCC 2005).

The MDTM study presented in this chapter was conducted in two hospitals in Sydney, a

large public teaching hospital (hospital A) and a smaller private hospital (hospital B). At

both hospitals the weekly meetings began with discussion of those cases in which all

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patient data are held locally. These local meetings were followed by a distributed

meeting supported by video conferencing where the focus of discussions was those

cases where the patient data were distributed between the two hospitals. This was

because there was a mixed public and private service provision in the multidisciplinary

team between the two hospitals. Some of the surgeons at the public hospital A also

spent time working in hospital B to treat the private patients. If MDTMs involved the

discussions of these patient cases, that is, hospital B patients treated by a surgeon at

hospital A, the two meetings were joined via video conferencing for the discussion of

these patients. ISDN connection at the speed of 256kbit/s was used for the video

conferencing meetings.

In order to improve multidisciplinary team functioning and patient outcomes, the breast

cancer teams at the two hospitals proposed and implemented a number of quality

assurance strategies, such as the employment of a breast cancer nurse at each hospital

for the coordination of the meetings. The strategies also included technical improvement

of their video conferencing meetings between the two hospitals. This strategy led to the

collaboration between our design team and the breast cancer clinicians with an aim of

designing an enhanced collaboration platform to support the distributed MDTMs. Initial

conversation with a number of key clinicians in the two hospitals revealed audio and

video problems relating to video conferencing technology. The list was interesting to

the design team because the clinicians referred to each problem mostly as a technical

one, but further investigation revealed a more complex socio-technical issue. A field

study was then planned in order to have a better understanding of the team collaboration

over distance and to identify possible technical interventions to improve the

effectiveness of the meetings and team communication. However due to a number of

management and funding issues there was no system development activities after the

completion of the study.

There were a large number of meeting participants at hospital A and a smaller number

of participants at hospital B. The meetings at hospital A were held in a large multi-

purpose meeting room with a standard commercial video conferencing system while at

hospital B they were held in a smaller, dedicated room with integrated video

conferencing facilities.

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It was clear from the early field work that there were differences in organizational

structures, physical setup of the video conferencing environment and the ways of

presenting medical images in the two hospitals. I was motivated to understand these

differences, to trace them to their various sources within their particular socio-technical

context and understand how these differences affected the meeting practices.

This research focus relates to a number of themes in the literature on the design of

coherent environments for distributed collaboration as described in Chapter 2. These

include the relationship between people, physical space and information space in

technology-mediated interaction (e.g. Bannon & Bodker 1997, Harrison 2009),

variations in local practices in healthcare (e.g. Schneider & Wagner 1993, Balka et al.

2008, Randell et al. 2011) and integrating technology across different settings (e.g.

Ellingsen & Monteiro 2006, Monteiro et al. 2013, Fitzpatrick & Ellingsen 2013). This

focus also extends related work in MDTM research by exploring the role played by

variations in local settings, particularly physical settings and information sharing

practices. Furthermore, studying the basic collaboration technology - video

conferencing - in use gave me a valuable understanding of the fundamental issues that

need to be addressed in designing collaborative workspace. This study and its results

directly impacted on my research questions and their necessary focus.

4.4 Methods

The three-month workplace study combined semi-structured interviews with

observations and video recordings of the meetings. A similar qualitative approach was

used by Kane and Luz (e.g. 2006, 2009a, 2009b, 2011) in their studies of MDTMs and

has been shown to be effective in understanding the mechanics in this environment. A

team of four researchers observed twelve meetings and interviewed eleven of the key

participants, six in hospital A and five in hospital B. The use of different methods,

conducted in parallel, was intended to enable a quick review items of interest from the

observations and, if needed, to provide evidence to interview participants of their

exhibited behaviours.

This study was conducted in a design-oriented context and in order to match the pace of

the design cycle, “rapid ethnography” techniques (Millen 2000) were used, such as

focusing on interviewing the key participants to quickly identify the basic requirements;

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working with a “field guide” participant (in this case the breast cancer nurses); and

developing good relationship with participants. I coordinated the study schedule with

support from the hospital breast cancer nurses who suggested a list of interview

participants and helped to contact these participants. It was important to build up a good

relationship with the meeting participants and to obtain their trust as the meeting content

was sensitive and confidential. Researchers attended the weekly meetings and

communicated actively with meeting participants before and after the meetings and via

telephone and email at other times.

Observations focused on group behaviour, the group activities and interaction, in both

the local meeting and the distributed meetings, and the roles played by various

technologies and artefacts used in the meetings (Jordan & Henderson 1995). Members

of the research team split into two groups to attend both local meetings and swap around

from week to week so each member had an opportunity to observe both sites. A debrief

session for the observers was held after each meeting to share initial understandings and

perceptions of the meeting. The debrief session was helpful to maintain research focus,

reflect on findings and direct further stages of work.

Observations notes were taken by each of the researchers. These notes also included

interesting issues discovered during the informal talk with the clinicians before and after

the meetings. Audio and video recordings were collected in some of the meetings. The

video stream from the video-conferencing system was directly recorded, and in

addition, one or two video cameras were used for recording in each of the meeting

rooms. The recording equipment was set up and tested one hour before the meetings.

The positions of the room cameras were arranged to obtain the best views while

minimising the intrusiveness to the meetings.

Table 4.1. Participants interviewed

Role Hospital A Hospital B

Surgeon 1 1

Medical oncologist 0 1

Radiation oncologist 1 1

Pathologist 1 1

Radiologist 2 0

Breast Cancer nurse 1 1

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Eleven meeting participants were interviewed as shown in Table 4.1. They were from

both hospitals and from each of the key clinical disciplines represented in the team. I

worked with another researcher on the semi-structured interviews. The interviews

focused on participants’ perspectives on their work in general and specifically their

comments on the meetings, the functioning of the group and how these might be better

supported. Interviewing medical staff in hospital is not straightforward. A number of

interview strategies were employed:

Participants in this study were busy clinicians and work under constant time

constraints. So the interview questions were prioritised to ensure that the most

important information, generally individual practices and routines, was captured

in even the shortest interview

Some of the participants might be on-call when we conducted interviews. For

example the interview with a pathologist was stopped several times since she

had to work on an urgent diagnosis request from a surgeon waiting at the

operating theatre. It required the balance between flexibility and consistency to

deal with work-related interruptions during the interviews

Interviews with the radiologists and pathologists were held in their departments.

This provided us with an opportunity to see their work environment and

appreciate the difficulties and complexity of their preparation work before the

meetings

Interviews were held immediately after the multidisciplinary team meetings if

possible because clinicians usually had some time available after the meetings

and had a fresher memory about their experience of the meetings

Snapshots taken from the video recordings of the meetings were found to be

helpful in prompting participants to discuss their experiences in the meetings

As part of the interviews, participants were encouraged to create draft layout

diagrams of the new collaborative system based on their expectations

Interview transcriptions and observation notes were read by all of the observers and

interesting issues were identified and discussed. I was responsible for the data coding

based on the interview structure and issues identified. Video editing software (Vegas)

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was used to synchronise and annotate recordings of each side of the video-mediated

meetings. Videos were reviewed by the researchers during the various stages of

analysis.

The research team included Tim Mansfield from NICTA, Susan Hansen from CSIRO

and Toni Robertson from University of Technology, Sydney. Tim led the research team

and all team members contributed to the study design. I worked with Susan on

designing and conducting the semi-structured interviews. All members of the team were

involved in the observations although I was the only researcher who participated in all

the observations. I coordinated the field studies and led the data analysis.

4.5 Meetings Within and Between the Hospitals

The MDTMs at both hospitals started around 8am and lasted two to three hours every

Wednesday morning. The formal discussion of patient cases was firstly conducted

locally at each hospital. The timing of the shift to video conferencing meeting was

coordinated by the breast cancer nurses at each hospital. When the patient discussions

ended the video conferencing also ended. The meetings become local once more.

Participants went on to other meeting agendas such as new research in breast cancer and

management matters that were relevant to the group.

The weekly MDTMs at both hospitals followed the standard MDTM guidelines and

protocols that had been developed by the healthcare government authority (NBCC

2005). Both hospitals had implemented the MDTM program for breast cancer care for

eight years before the study while the video conferencing meeting between the two

hospitals was introduced two years before our study. Case discussions were chaired by

one of the senior specialists who ensured the patient cases were presented and discussed

by clinicians of different disciplines. The presentation of each patient case followed the

same order: clinical case summary, radiology findings and then pathology results. These

materials were prepared before the meetings and presented in the meeting by related

clinicians. Other members of the team such as surgeons, oncologist, nurses,

psychologists and social workers expressed their opinions. Discussions about the

treatment and management of a patient can require references to relevant evidence bases

and guidelines. The outcome of these discussions was agreed recommendations about

ongoing treatment and care. The chairperson summarised the recommendations at the

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end of each patient case discussion. The breast cancer nurses recorded the

recommendations and coordinated with responsible clinicians to inform the patients at

the patients’ next visit to the clinicians. Our interview participants told us that an

effective meeting constituted the following aspects: all relevant patient issues are well

presented; everyone has the opportunity to provide input to the management of patients;

participants work as a team to make decisions and support each other; participants could

learn something about the meeting; and patients were actually effectively treated as a

result of the decision made in the meeting.

The presentations of the radiology and pathology images were central to the discussion

which led to the agreement on the diagnosis, the disease stage and treatment plan (e.g.

Kane & Luz 2006, 2008, Groth et al. 2009). The presentations structured the flow of the

discussion and references to the images made them the central focus of the discussion.

Radiology images included X-ray, CT scan and MRI, either on film or disk. Pathology

images were samples of affected body tissue stained on a glass slide and captured by

microscope. These two types of images needed to be transformed and displayed for the

participants to look at.

The video conferencing meeting was actually embedded in the two local settings. There

were a variety of differences between the two local settings, such as physical setup, size

of the team and the way of preparation and presentation of medical information.

Interaction problems emerged when the local practices of the two local settings were

joined. All interview participants indicated that they were satisfied with the presentation

and discussion of the local meetings but ten out of the eleven interview participants

expressed negative sentiments about the presentations and discussions in distributed

meetings. For example one of the medical oncologists commented:

“The meetings are pretty efficient until you go to the video link and then their

efficiency drops off dramatically and people disengage at that point”.

While the overall research goal was to suggest intervention in the distributed meetings,

it is essential to develop an understanding of the differences in the local meeting

practices and why various arrangements were developed in the particular ways. When

presenting the results of the study, I will first describe the processes of presentation and

discussion of patient cases in the two local meetings in section 4.6. Then I will present

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the distributed meetings in section 4.7 to develop the discussion of how variations in

local practices affected the interactions in the distributed meetings.

4.6 Local Meetings

The findings will be structured into the categories of physical setup, preparing

information, presenting information, context of different information practices and

conversation and case discussion. These aspects of each local meeting are presented

“side by side” in order to highlight the different processes and practices between

hospital A and hospital B.

4.6.1 Physical Settings

There were twenty to thirty meeting participants at hospital A and ten to fifteen

participants at hospital B. Large public teaching hospitals typically have more

participants due to the MDTM’s role in education, while highly specialized groups, such

as the teams in private hospitals, have fewer people in attendance (Kane & Luz 2009b).

Table 4.2 and Table 4.3 list the participants at hospital A and B. These include “key”

participants who had a formal role in the meeting and “non-key” participants who had

no formal responsibility. There were more non-key participants in hospital A, such as

junior doctors and registrars who might transfer from different departments and medical

students who might be new to the meeting. At hospital A, a surgeon chaired the local

meetings. At hospital B, a surgeon and a medical oncologist took turns to chair the local

meetings each week.

Table 4.2. Participants at hospital A

Key participants Non-key participants two breast cancer surgeons one senior radiologist and one junior radiologist one pathologist one medical oncologist one radiation oncologist one breast cancer nurse

nurses psychologists social workers registrars junior doctors medical researchers medical students

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Table 4.3. Participants at hospital B

Key participants Non-key participants One or two breast cancer surgeons one radiologist one pathologist one or two medical oncologists one radiation oncologist one breast cancer nurse

one project officer one psychologist one social worker one researcher occasionally one or two junior doctors or medical students

The MDTMs at hospital A were held within the radiation oncology department in a

large “lecture room” which was a common meeting room. This room was used

primarily for presentations so its furniture, console and projection facilities were

organised primarily for this purpose (Figure 4.1). A large projector screen was set up at

the front. The default seating arrangement was rows facing the projector screen. The

video conferencing system and its related artefacts were positioned in a way that could

be accommodated within this arrangement. A table was positioned across the front of

the room. The video conferencing system was set up on the left side of the table with a

75cm TV screen and a video camera. The conference microphone was situated on this

table.

The chairperson sat in the front of room and faced either towards the rows of chairs or

the front projection screen. The four or five key participants sat in the first row of the

audience. The remaining participants sat in the rows of seats at the back of the room and

faced towards the main projector screen at the front. A junior pathologist and radiologist

stood at the console of the room, facing the audience and sometimes turning to see the

projection screen at the front.

At hospital B, the MDTMs took place in a small dedicated meeting room where the six

or seven key participants sat around a semi-oval table with two large TV screens side by

side on the wall at one end (Figure 4.2). The table was shaped so key participants could

easily see their local colleagues as well as the TV screens. There was a light box

mounted on the wall adjacent to the presentation screens. Other participants sat around

the periphery of the room.

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Figure 4.1. Site plan of the local meeting at hospital A

Figure 4.2. Site plan of the local meeting at hospital B

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4.6.2 Preparing Information

Usually there were between five to ten cases discussed at each local meeting. The

number of cases for the video conferencing meeting varied each week but usually

around five cases needed to be reviewed. The preparation work involved radiologists,

pathologists and breast cancer nurses. There were commonalities and differences in the

preparation processes in the two hospitals.

Patient history. Surgeons initiated the list of patients to be discussed and informed the

breast cancer nurses. The nurses at each of the hospitals coordinated with their

respective surgeons and circulated the list to the relevant radiologists and pathologists

before the early afternoon on Friday. Since radiology and pathology examinations of the

patient might be performed at different hospitals, the nurses needed to assist in ordering

appropriate materials. The nurses also looked for patient records to generate patient

summaries. There was no electronic patient record system used in the two hospitals at

the time of the study. At hospital A each anonymized summary was put into a

PowerPoint presentation that was used in the meeting and at hospital B each summary

was presented in the form of a cover sheet to be distributed to meeting participants

(Figure 4.3).

Figure 4.3. Preparation of patient histories

Radiology image. At hospital A, radiology images were included in the PowerPoint

presentation. It took six to eight hours, sometimes after work hours, for a junior

radiologist to prepare medical radiology images before the meeting. Since a digital

medical image database - PACS was not used in either of the hospitals, films needed to

be located from physical storage, reports needed to found or faxed from where the

imaging was originally done. Then the radiologist analysed the films and reports, found

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appropriate images for illustration, captured these images by digital camera, uploaded

the camera images to a computer, used Photoshop to produce the best quality images

and annotate the area of interest using a red circle etc, and put the images into a

PowerPoint presentation (Figure 4.4). At hospital B, radiologists were only involved in

the local case discussions and brought films with them to present directly on the light

box during the meeting.

Figure 4.4. Preparation of radiology images

Pathology image. Before the meeting, the pathologists located the slides and reports

required from various storage places and then looked for the best slides and areas of

interest for the discussion. At hospital A, a pathologist captured the pathology images

by a camera attached to a microscope, uploaded the images to a computer, and inserted

the images and a summary of the diagnosis into a PowerPoint presentation (Figure 4.5).

The total process took around two to three hours. At hospital B, the pathologists spent

around ten to twenty minutes per case to review the pathology slides and mark the area

of interest directly on the slides before the meetings, then brought the pathology slides

to the meetings and presented them directly from a digital microscope which was

integrated with the video conferencing system.

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Figure 4.5. Preparation of pathology images

4.6.3 Presenting Information

At hospital A, the patient summary was presented by the patient’s responsible surgeon

sitting in a chair in the first row of the audience while the radiology results and

pathology results were presented by a junior radiologist and a pathologist who both

stood at the console. A PowerPoint file incorporated the patient summary with selected

radiology and pathology images. The areas of interest in the PowerPoint radiology

images were annotated before the meeting to assist the multidisciplinary audience to

follow the presentation. The computer used for the presentation was on the console and

the junior radiologist and pathologist were responsible for presenting and navigating

through the slides to support the case discussion. A senior radiologist sitting in the first

row often took over the junior radiologist’s discussion to add his interpretation. He used

a laser pointer on the projected display to make reference to the areas of interest to

support his discussion. The pathology images were presented by the pathologist at the

console who was generally the only pathologist at the meeting.

At hospital B, cases were presented by the surgeons responsible for the patient. The

radiologist used the light box to directly display the radiology films for each patient to

the rest of the participants. She stood beside the light box and pointed directly to parts

of the film during discussion. The pathologist used a digital microscope with a camera

attached to present selected pathology slides. These were displayed on one of the

screens at the end of the table. Areas of interest in the slide were highlighted by

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physically moving the slides under the microscope so the parts under discussion were in

the centre of the display. This direct slide projection was used both during the case

presentation as well as when questions raised by the other participants in the local

meeting were discussed. When answering questions, the pathologist sometimes referred

to the printed pathology reports placed on the table and adjacent to the microscope.

Slide selection and presentation were then tailored to fit with the immediate needs of the

case discussion.

4.6.4 Context of Different Information Practices

The interview and observation analysis revealed a number of reasons why these specific

preparation practices had developed in each hospital. Firstly, hospital A was a public

teaching hospital where the senior radiologists and pathologists had support from junior

medical professionals. Although the preparation of the presentation was time

consuming, it did not incur any further financial cost. For a private hospital, there were

no teaching responsibilities and neither the senior nor the junior staff was salaried. So

there were no staff to facilitate the preparation of images and their integration with the

various patient summaries in hospital B. Secondly, the situation of a smaller number of

people in a smaller room at hospital B allowed the radiology images on the light box

and pathology images on the TV screen to be clearly visible to people in the room.

Within this setting, there was no need for large projection. However the size of the

meeting at hospital A meant that the images had to be transformed so they were able to

be viewed by presentation on the large projector screen. Finally, hospital A was a

teaching institution and the senior clinicians usually had academic roles in universities.

The materials used during the meeting served as an important resource for subsequent

teaching and research purposes.

Participants at hospital B preferred the way of moving slides around to look at areas of

interest during the meeting as it provided the opportunity of accessing images that were

not prepared previously and therefore better positioning the pathologist to address

unanticipated questions at the meeting. However the PowerPoint presentation method

was highly valued by hospital A interview participants who felt that it was a more

cohesive and straightforward way to present, especially in a meeting which might have

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ten patients cases to be discussed in one hour. The preferences of participants at hospital

A are captured in the following interview comment made by a pathologist:

“It’s much better to be able to just show – even though it’s a lot more work for

us to do it like that it’s much better for the meeting… a few select areas

photographed and you can just demonstrate it straight away. It’s a much more

cohesive way to present a meeting.”

4.6.5 Conversation and Case Discussion

At hospital A, the overall atmosphere of the meetings was professional and cooperative.

People explored issues of interest in a relaxed way. They shared jokes, sometimes left

their seats to get drinks and lean backward or forward to gossip to the people

surrounding them. The discussion itself was formal and was mostly among the

surgeons, oncologists and radiologists who may from time to time turn to talk to the

psychologists, social workers or nurses who sat at the back rows and had less input to

the discussion. It was a large teaching hospital and there was a hierarchical structure

both within the hospital and also within each of the disciplines. Any individual’s place

in the hierarchy tended to be reflected in where they sat in the room. Medical students

and junior doctors and the majority of these people sat at the back observing and did not

participate in the discussion.

At hospital B, the communication in the local meeting was informal and free flowing.

There were fewer people who all sat around a semi-circular table with good eye contact

with each other. This seating enabled better management of interruptions and general

conversation flow. Organisational hierarchy was much less prevalent than in hospital A.

Participants appeared to be quite relaxed and willing to express uncertainties or

disagreements. For example, the pathologist at hospital B typically received more

questions from the team than the pathologist at hospital A. If necessary he or she looked

for the answers in the reports and moved the slides around on the microscope while

answering.

4.7 Distributed Meeting

Patient cases discussed in distributed meetings involved clinicians from both of the

hospitals. These patients were from hospital B and either the responsible surgeon was

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from hospital A or the reviewing radiologist was the senior radiologist at hospital A.

The junior radiologist at hospital A was responsible for the preparation of selected

radiology images in PowerPoint including marking the areas of interest with red circles.

The pathologist at hospital B was responsible for the pathology images for the

distributed meetings. Similar to the way of presentation at local meetings, the

pathologist brought the original pathology glass slides to the meeting and presented

them directly from the digital microscope. The image from the digital microscope was

made available to hospital A via the video conferencing connection.

The two breast cancer nurses phoned each other to coordinate the video conferencing

connection after local meetings. When the two sites joined together, participants moved

to a different meeting setting. As mentioned earlier most interview participants reported

a drop in the level of discussion in the distributed meetings compared to the local

meetings and major technical and interaction problems.

I will first describe how both sites organized their physical setups and presenting

information in distributed meetings. Following this, the technological and interactional

problems in video-mediated conversations and interactions will be presented.

4.7.1 Physical Settings

Positions of participants at hospital A. During the distributed meetings, the chairperson

and the other key participants (one surgeon and two oncologists) moved from the rows

of seats to sit around the table in front of the TV screen and camera (Figure 4.6). The

other participants remained in the rows of seats at the back of the room and faced

towards the main projector screen at the front. Similar to the local meeting, the junior

radiologist stood at the console in the front right corner, facing both the participants at

the video conferencing table and those in the rows of seats.

The camera in the video conferencing unit pointed towards the table and the console but

not to the back of the room. The core team members could be seen by the remote

participants at hospital B. However those peripheral participants sitting in rows towards

the back of the room could not be seen by the people at hospital B. These peripheral

participants were also a long way from the microphones on the table at the front and it

was difficult for their voices to be heard at hospital B.

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Figure 4.6. Site plan of the room for distributed meeting at hospital A in distributed meeting

Screens and information on the screens at hospital A. The video conferencing screen

showed video streams from hospital B which automatically switch between a view of

the participants at hospital B or the pathology images from hospital B. The project

screen showed either the local PowerPoint presentation or the video feed of the

participants at hospital B or the pathology images from hospital B. However, this switch

between views needed to be done manually by the junior radiologist standing at the

console.

The core members, seated at the table, either turned to the projection screen or the video

conference screen. The participants in the rows of seats watched the projection screen

only. They relied on the junior radiologist standing at the console to manually switch

between different views.

Positions of participants at hospital B. Participants were already seated facing the video

conferencing system in local meetings so there was no seating change (Figure 4.7). The

key participants sitting at the shaped table could easily see their local colleagues as well

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as the display screens. The smaller size of the room, the smaller number of participants,

the appropriate sized displays and purpose-built video conferencing setup at hospital B

meant they could all be seen and heard by the remote participants at hospital A.

Screens and information on the screens at hospital B. The two display screens at

hospital B were well positioned so that everyone in the room could see what was

displayed on them, that is, they all watched the same material displayed at the same

time. However only one of the screens was used to display both the video feed of the

core participants at hospital A and the radiology or pathology images being discussed.

The remote room view reduced to a small picture-in-picture display when the medical

images were being displayed. The second screen always displayed the video feed from

their own camera – the view of themselves which was clearly not helpful. This display

configuration was set up by the company supplying the video conferencing system.

While the participants at hospital B were vocal in their criticism of this configuration

nobody in the team knew how to change it.

Figure 4.7. Site plan of the room for distributed meeting at hospital B

4.7.2 Presenting Information

Presentation. Both hospitals used the patient summary and images they would normally

use in local meetings. The prepared PowerPoint presentation of radiology images from

hospital A was used in the presentation and discussion along with the pathology slides

from hospital B. A typical discussion started with a surgeon (either hospital A or

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hospital B) verbally reporting the case. In hospital A, the junior radiologist displayed

the prepared radiology PowerPoint slides while presenting the patient summary. The

pathologist at hospital B presented the pathology slides directly from the slides on the

microscope.

Focusing group attention. When the junior radiologist at the console presented the

PowerPoint slides he used the computer cursor as a pointer to the relevant area of

interest. The cursor movements were visible on the projection screen and the video

conferencing displays at hospital A and B. The senior radiologist sitting in the audience

provided further explanation and used a laser pointer to point at relevant parts of the

images displayed on the projection screen at the front of the room. At hospital B the

PowerPoint presentation was shown on the video conferencing screen. In order to make

the senior radiologist’s referencing gestures visible to the participants at hospital B, the

junior radiologist had to move the computer cursor over the image displayed on the

computer screen following the laser pointer gestures made by the senior radiologist on

the projection screen.

Similar to the practice in the local meeting, at hospital B the presenting pathologist

verbally indicated areas of interest on the images while moving the slide on the

microscope so these areas were in the centre of the display. No computer cursor was

used to facilitate this activity.

4.7.3 Technology-mediated Conversations

In comparison to the local meetings, distributed meetings appeared to be more formal.

Participants in general were perceived by other members to be less willing to ask

questions, discuss issues and resolve disagreements. Besides the inter-personal

relationships between the clinicians at these two different institutions, another reason for

this lack of engagement was the participants’ “gap” felt introduced by the setup of the

rooms and video conferencing facilities. These problems resulted in interruptions to the

flow and ease of the conversation. The following comment made by a surgeon

exemplifies the sentiments expressed by the participants:

“In the local meeting, I think people feel that they have the opportunity to

express their views…everyone’s views are listened to and valued. I think any

disagreements about management can usually be appropriately resolved without

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any aggravation….people who attend our meeting actually get on well with each

other and get on in a cooperative manner that’s in the interests of the

patient…there is much less cross-interaction between the two groups than there

should be.”

As described before, the peripheral participants at hospital A sitting in the rows of seats,

including the senior radiologist, were outside the camera capture area. Their

participation in the discussion was compromised by the fact they needed to get up and

move to the table at the front of the room if they were to be seen and heard by those at

hospital B. The issue of lack of social and spatial awareness due to this limited visual

information was evident from the instances of unawareness of individual people’s

presence, such as asking “Is X there or not?”, “Is Y sitting in the background?”.

Interview participants (e.g. a breast cancer nurse) expressed their desire to see the whole

room of the remote site this way:

“It certainly does limit… The body language is not often seen on a video link,

particularly if not everyone in the room is able to be seen on the screen, and that

could be part of why one end doesn’t talk so much because people can’t see you

know somebody on the screen”

4.7.4 Synchronising Conversation and Image Sharing

As explained in section 4.7.1, at hospital A the key participants watched the video

conferencing screen where the views of hospital B participants and hospital B pathology

images switched automatically in response to the pathologist operation of switching

on/off the camera display from the microscope. However, for the peripheral participants

to see this change, it required the junior radiologist at the console to manually switch

between the room view of hospital B and pathology images to be displayed on the

projector screen. There were a number of occasions during the meeting we observed

that this manual switch did not occur because the radiologist forgot to do so. This meant

the various participants were not seeing the same things. It caused frustrations of the

peripheral participants but neither the key participants at hospital A nor those in hospital

B were aware of this breakdown.

Another related problem was extra work required for the junior radiologist to use the

computer cursor to trace the gestures of the laser pointer being used by the senior

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radiologist at hospital A so they could be seen at hospital B. This synchronization relied

on the junior radiologist to have a quick understanding and response to the laser

activities in order to allow participants at hospital B to see the references to areas of

specific interest while listening to the senior radiologist.

Another source of frustration for participants at hospital A stemmed from the direct

display of pathology slides at hospital B. The pathologist moved the slides round

according to the ongoing discussion so that the area of interest was in the centre of the

display. This practice worked well for those participants at hospital B who experienced

this selection and movement of slides in real time. However the transmission time lag

between these actions at hospital B and the actual display of the images at hospital A

meant that the image rendering often lagged behind the actual talk. It led to the

decoupling between what was visible to participants at hospital A and the talk

accompanying it. This caused both frustration and eventually disengagement for the

participants at hospital A who all identified it as major problem in the distributed

meeting. A radiation oncologist expressed it:

“They relay down to us the pathology which they’re looking at down a

microscope… then they move the slide and it goes all out of focus and it takes

two or three seconds to come back into focus…”

In summary, there were regular breakdowns in the synchronization of different

subgroups of participants to follow the conversation and images. These were

compounded by the fact that this breakdown was not always visible to the other

subgroups for whom the synchronisation of conversation and images was not affected.

4.8 Exploration of the Physical Setup

Interview participants were encouraged during the interviews to think of solutions to the

problems. Two of the participants drew their designs of the physical setup based on

their expectations and experience. A medical oncologist from hospital B generated a

sketching of a new layout arrangement at hospital A (shown at the left of Figure 4.8)

with the rows of seats at the back of the room arranged in semi-circles around the main

table. Another example was drawn by the senior radiologist at hospital A who illustrated

an advanced system supporting the multidisciplinary team meeting he had seen in

Switzerland (shown at the right in Figure 4.8). It shows a ramp-seat room with a good

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setup of microphones and displays, access to digital imaging database and a seamless

way of presenting in the meeting.

Figure 4.8. Examples of clinicians’ design sketching

Frustrations with the “technical” problems led to attempts by the team members to

improve the situation by changing the physical setting at hospital A. They tried to

arrange the rows of seats at the back of the room into semi-circles. They turned around

the video conferencing unit and the central table, so that the camera faced the central

table and the rest of the participants were sitting in semi-circular rows of seats. This

layout is similar to that of the left picture of Figure 4.8. With this new arrangement, the

participants in the rows of seats were able to participate more actively in the discussion

and did so. However because this meeting room was a shared common facility then

everything had to be returned to its original position after the meeting. Despite the

acknowledged improvements, the rearrangement of the space before the meeting did not

continue after these initial experiments.

4.9 Discussion

The study has shown that the MDTM collaboration between different settings using

collaboration technology is characterized by a range of asymmetries caused by

variations of local practices. Relating to the asymmetry of physical space were the

physical layout of the room, the size of the room, the arrangement of the camera and the

microphone and the size and position of the displays. The context of different teams in

different hospitals contributed to another set of asymmetries: the numbers of

participants (large vs. relatively small), the structure (hierarchical vs flat), the

presentation of medical images (static vs dynamic) and preferences about how the

images are displayed or transmitted to the others. The analysis presented here highlights

how these variations in local settings impact on the interactions in the MDTMs.

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Importantly, in presenting the findings I have shown how these different local

arrangements and practices had developed in the two hospitals.

I will discuss the implications these particular practices and settings have for the design

of collaborative workspace, focusing on design of physical spaces in distributed

MDTMs and design to support the information sharing practices. Challenges of

integrating a collaborative workspace into a healthcare context and enabling particular

local practices will also be discussed.

4.9.1 Designing Physical Space

Social interaction. One of the issues that emerged from the study relates to social

interaction in media space which has some core aspects relating social cohesion of the

group and awareness of remote participants’ presence and the communication and task

status in distributed meetings (Aoki & Tang 2009). Kane and Luz (2006) and Groth et

al. (2009) have revealed issues in coordination and awareness in video-mediated

communication based on their analysis of vocalization patterns in MDTMs. The study

presented in this chapter showed how particular spatial arrangements affect the

dynamics of the interaction, participant’s awareness of who was speaking and the

coordination of the discussion. There were problems of visibility and identity of remote

participants and audibility of remote participants, especially for the hospital A

peripheral participants who were not visible to the participants at hospital B. These

problems were caused by the setups of the seating and the audio-video devices,

limitation of the audio-video quality and especially the multiple displays where

sometimes what was displayed was not necessarily the same for different participants.

The study showed that in distributed meetings, these problems affected the spontaneous

conversation and open discussion which are important features of an effective meeting.

One of the fundamental design challenges is to tackle the visual and perceptual issues

that are caused by the asymmetry and fracture ecology in video-mediated

communication for individuals (e.g. Gaver 1992, Luff et al. 2003). The integration of

audio-video devices in the physical space needs to be carefully designed to produce the

right interplay between infrastructures, artefacts, shared understanding and activities

(Binder et al. 2004, Buxton 2009). Effort to support synchronous communication is also

required to concentrate not only on ‘same time, different place’ issues, but also to better

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support ‘same time, same place’ co-located communication in distributed meetings

(Kane et al. 2013).

Function-space relationship. The meeting space arrangements in MDTMs were affected

by the division of roles and activities of the different participants (Kane & Luz 2013). In

MDTMs, different roles can correspond to different locations in the room (Frykholm et

al. 2012). For example, radiologists and pathologists presenting images sat either at the

console or equivalent, or next to the devices used to display medical images, the person

chairing the meeting sat at the central table, the other key team members sat at the

centre of the camera view and the less involved participants sat in the peripheral areas.

The study has shown that the spatial arrangement of the participants could influence the

interaction patterns in distributed MDTMs. For example, the involvement of peripheral

participants was improved with seating re-arrangements in hospital A where peripheral

participants were more visible to the remote team and had better visual access to both

the remote and local participants. These arrangements could also ensure, by the design

of the physical setting that participants all look at the same thing at the same time

(Henderson 2009). Note that the point here is not to change the various social functions

of the various participants. It is instead to think about how space can be used to support

these functions particularly the interactions which enable them (Fitzpatrick et al. 1996,

Nova 2005, Luff et al. 2009).

This study has shown how the shared visual space influenced the interactions between

team members and the sharing of information, for example the problematic positioning

and control of the visual spaces in hospital A. An optimal arrangement with the right

size and position of the display could support participants’ sense of co-presence,

including their perceptions of non-verbal cues like gesture and gaze, and their

awareness of others’ reactions.

However I am not arguing for the requirement of a sophisticated telepresence setup in

specialised "board" meeting room applications. The purpose that defines an appropriate

physical space in distributed MDTMs is to support the construction of a common

information space among team members (Bonnon & Bodker 1997, Bossen 2002). The

job of the technology is to enable people to negotiate shared understandings across

differences in disciplines by mediating their capacities to see, talk and gesture with each

other (Robertson 1997, 2002, Buxton 2009). Any computer-mediated technology

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introduced into MDTMs needs to reflect and respect the space-function relationship so

that appropriate information can be distributed at the appropriate locations within that

space.

Challenge of local constraints. The study has also shown that different room settings

were constrained by their organizational contexts. The facilities in hospital A evolved

from pre-existing common meeting rooms and did not necessarily provide an ideal

environment for distributed MDTMs. While the teams at hospital A noticed

improvements after reconfiguring their seating arrangements, there were tensions

between the demands of the local meeting and the distributed meeting as well as

tensions arising because the MDTMs were held in a multi-purpose room that was also

used by other members of the hospital. The issue here is not that optimal setups can

better support particular demands of distributed MDTMs but that what constitutes an

optimal setup needs be considered within the broader set of arrangements and evolved

work practices that define these spaces (Fitzpatrick et al. 1998, Dourish et al. 2006b).

The tensions between these arrangements introduce additional work and effort for

participants that can be barriers to the implementation of more optimal settings (Martin

et al. 2006, Ellingsen and Monteiro 2006).

4.9.2 Supporting Information Sharing

Challenges of variations in information practices. Different ways of presenting medical

images in distributed MDTMs had both advantages and disadvantages and there were

always tensions between traditional ways of viewing medical images and computer-

supported alternatives. For example pathology images could be projected directly from

slides or digitized and displayed using digital display and presentation technologies,

radiology images could be digitized for computer access or directly shown from a light

box. Manually digitizing medical images so they could be embedded in a PowerPoint

presentation was time consuming. However PowerPoint presentation was

straightforward and saved time searching for images during meetings. Both ways work

sufficiently well in their local settings that there was no local imperative to change.

However there were interaction and communication problems caused by different local

practices in the distributed meetings.

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The medical image presentation and preparation practices in the two hospitals varied in

both format and content and this issue had its source within different health service

structures. There were differences in the availability of resources to support MDTM

preparation between public and private hospitals. The underlying issue is the particular

mix of public and private health service structures in Australia and the particular

relationships and practices that had developed to integrate the two systems. These

include very different funding practices and responsibilities. While participants at

hospital A considered their way ‘the better way’, participants at hospital B were quite

happy with their own solution. A public, teaching hospital might consider recording the

material presented in MDTMs for research and education purposes. Private hospitals do

not maintain the infrastructure that enables resources to be allocated to the preparation

of images for presentation in MDTMs. Moreover, there were no existing mechanisms at

hospital B to change this particular practice. Any technical solutions will need to be

sufficiently flexible that these very different requirements in the sharing of medical

images can be accommodated and integrated (Schmidt et al. 2007, Randell et al. 2011).

Interaction needs. The study highlights the importance of providing an "interaction

space" for the person chairing the meeting and the radiologists and pathologists who are

the “human mediators” in distributed MDTMs (Bannon & Bodker 1997). These key

participants not only assist in the production of content for the information spaces in

MDTMs, but also play the major role in interpreting the meaning of information for

those who might wish to use it (Kane & Luz 2013). As already discussed, their physical

position affects their interaction with other team members both co-located and

distributed. They need to position themselves to enable easy access to devices and

materials at the appropriate time (Buxton 2009, Luff et al. 2009). The study has also

shown that different meeting participants had different roles and their interaction needs

varied. Most of the non-key participants only needed to observe the information being

shared while key participants engaged in the interactions with information.

The study supports the recognition that participants need the support of technology to

synchronize their interactions with information across physically distributed sites, in

particular to support the pointing and other indexing gestures (Luff et al. 2009, Olwal et

al. 2011) as well as to solve the fractured ecologies problem in viewing images (Luff et

al. 2003, Zuiderent et al. 2003). In the design of technology to support distributed

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collaboration these indexing actions need to be simultaneously available to those acting

and those perceiving the actions in the shared work space (Robertson 1997, Buxton

2009). Interaction problems resulted if these human mediators were not near the

computer displaying the images and/or if they were using a microscope or light box

which does not have a pointer that is represented in the shared workspace. Otherwise

some other participants needed to manually translate these actions to a form that can be

visible in the shared space, such as, in our studies, controlling the direction and zoom of

the camera capturing film images or using the computer cursor to follow the path of a

laser pointer.

4.9.3 Challenges of Integration

Kane and Luz (2009b) suggest an ideal room for distributed MDTMs – the room “will

have high speed wireless network, utilise ubiquitous devices to record the presence of

individuals, will maximize the visual display area potential of the space and have

enhanced audio support. The room would be equipped with enough visual display area

to allow comparison of several images at once, and allow for the simultaneous display

of the bronchoscopy image, microscope image and/or video taken in the operating

theatre. A record, or outcome, of the discussion will be available for review, as needed,

afterwards.” (p. 388). Multi-display environments and shared digital workspace

technologies and prototypes that seamlessly integrate information interaction in large

interactive displays and dedicated physical setups might potentially solve the problems

in supporting collaboration in distributed MDTMs. However the design of a

collaborative workspace to successfully support distributed MDTMs requires more than

the provision of elegant architectural solutions and advanced interactive display

technologies (Kane & Luz 2009b). People's behaviour and interactions, including their

information sharing practices in a complex healthcare environment, are different to

those that might have been possible in the controlled settings where these technologies

are often designed.

It is not just physical layout alone that can provide a solution to the coordination and

communication of MDTMs. It is the arrangement of the physical spaces that are suitable

to participants and particular practices. There are differences in the preparation before

the meeting, the way of running the material and coherent narrative in the meeting. The

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interaction design for an integrated workspace will require new technologies that can

support a wide variety of existing local practices including, for example, the integration

of image viewing practices using a light box and the support of live presentation of

pathology images at hospital B. Again, the problems arising as these practices were

brought together may suggest particular solutions, such as facilitating digital image

systems or increasing network bandwidth to solve the image delay problems. However

it is important not to just consider these solutions in the context of the immediately

available local arrangements and any possible re-configurations. It is also important to

understand the complex social, technical and organizational factors that shaped how

these arrangements and configurations emerged and were experienced in the first place.

The ways in which these practices may evolve in the future will be influenced by

changes in technology and health policies. PACS can provide direct access to digital

images and solve the issue of the work involved in digitising images. There was a clear

interest from the radiologists at hospital A in introducing a PACS to the MDTM to

lighten the meeting preparation work and to support the research and teaching activities

of the hospital. However, a radiologist at hospital B expressed concern that a PACS

would introduce technical problems into a setting. Kane and Luz (2006) observed that

PACS would not resolve problems with maintaining image integrity and exchange due

to the lack of standards in different institutes. It also causes inefficiency because

searching for unprepared images from large amount of data in PACS during the meeting

is not straightforward (Kane & Luz 2013). Similar to PACS, the development of

electronic patient records poses special challenges for their use in MDTMs (Groth et al.

2009, Frykholm et al. 2012). Electronic support for case summaries and record keeping

of the meetings will need to be developed. These challenges still relate to the

relationship between the information space and the meeting practices in MDTMs as

well as configuration issues (Binder et al. 2004, Balka & Wanger, Balka et al. 2008)

that need to be supported in the design of collaboration technologies for MDTMs.

4.10 Conclusion

This study examined the MDTMs in the two hospitals and particularly focused on the

variations in local practices both in the local settings of each hospital and in the

distributed setting when the local meetings were linked. The results have shown how

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key factors such as the physical setup of the meetings, the presentation of the patient

cases, the preparation of images used in patient discussion and the asymmetries of these

factors across the sites clearly influenced the dynamics of collaboration and experience

with the distributed MDTMs. Designing a collaborative workspace for MDTMs needs

to take account of how these arrangements and practices arise and the implications these

have for technical interventions.

The study has shown that careful configuration of physical space can potentially

improve the social interaction and communication within MDTMs. Design also needs to

consider appropriate integration of information sharing functions and interaction tools to

allow for effective patient information discussion which is the centre of the

collaboration. Importantly, this study has highlighted that designing collaborative

workspaces to support MDTM collaboration across variable local settings needs to

accommodate local constraints and to provide appropriate solutions to support the

configuration of available technologies and resources to enable local practices.

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5 Case Study: Distributed Collaboration in Emergency Response on Animal Disease

In this chapter I present the study of collaboration in emergency animal disease

response which focuses on the work of high-level analysis and decision making by the

Australian Consultative Committee for Emergency Animal Disease (CCEAD). CCEAD

is a geographically distributed committee established to recommend action plans during

animal disease outbreaks at a national level. The study investigated the ways in which

the CCEAD members shared and analysed information together, with particular

emphasis on their teleconference meetings across multiple sites. The aim of the study

was to develop understandings of this work that could inform decisions about where

appropriate collaborative workspace intervention could be made to facilitate the

information sharing and decision-making performed by this committee. This study

allowed me to explore the collaborative practices of a highly distributed set of teams

across a large number of sites and the particular design challenges this entails.

5.1 Emergency Response on Animal Disease

Emergencies are critical situations that can cause damage to life and property and

require immediate response to minimize adverse consequences (DHA 1992). Examples

of emergencies and responses include firefighting (Jiang et al. 2004, Denef et al. 2008),

emergency medical care (Reddy et al. 2001, Kristensen et al. 2006), search and

evacuation, natural disaster and crisis (e.g., hurricane, nuclear disaster) (Palen & Liu

2007, Pipek et al. 2012). The main characteristics of emergency events are their

unforeseen occurrence and the need for coordination and immediate response

(Kristensen & Kyng 2009).

An emergency response activity usually involves several teams from different

organizations working cooperatively to eliminate or reduce the impact of the event

(Diniz et al. 2008). Management and response to emergencies requires fast and effective

action in collaboration between different teams in order to meet the dynamic challenges

in the situation (Kyng et al. 2006). These teams usually follow established procedures to

deal with emergencies contained in emergency plans. Factors such as speed of events,

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number of teams involved, time available to make decisions, resource availability and

stress create challenges to team collaborations in complex situations (Pipek et al. 2012).

This case study was of a particular sector of emergency response, namely that of

emergency response for infectious animal disease outbreak. Diseases such as foot-and-

mouth disease, mad cow disease and Hendra virus are examples of emergency animal

diseases. The consequences of infectious disease outbreak within an animal population

are potentially enormous. In addition to the basic concerns about animal welfare, such

outbreaks can cause significant social disruption and environmental damage through

ecological imbalances introduced. The economic consequences of these outbreaks are

huge. The epidemics of foot-and-mouth disease in the UK in 2008 were estimated to

have cost in the order of several billion dollars. This is not simply the immediate costs

of the livestock or disease intervention programs but also the costs of ongoing

disruption to trade links that extend well beyond the disease outbreak itself.

Given the potential consequences of such emergency animal disease outbreaks, a strong

national biosecurity management infrastructure for emergent animal disease has been

developed by the Australian government. One component of the initiative has been the

establishment of the Consultative Committee on Emergency Animal Disease (CCEAD).

CCEAD is a technical and operational committee devoted to the operational

management of emergency animal disease. It is a coordinating body set up to provide a

technical link between the Commonwealth, States, Territories and affected industries for

decision-making during animal health emergencies.

Membership of CCEAD comprises the Commonwealth Chief Veterinary Officer (CVO)

in Canberra, state and territory CVOs, management representatives from the

Department of Agriculture, Fishery and Forestry (DAFF) in Canberra and the Director

of the Australian Animal Health Laboratory (AAHL) which is in Geelong (Figure 5.1).

In addition, relevant expertise is drawn in as necessary, such as diagnostics experts from

AAHL. According to the particular disease there will also be representatives from

affected industries. For example, in the case of equine influenza, representatives from

the horse-trading and horse-racing industries will be included. In the case where there is

also a threat to human health, the Chief Medical Officer may also be present as in the

case of the Hendra virus outbreak.

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Figure 5.1. Membership of CCEAD

CCEAD is chaired by the Commonwealth CVO and coordinated by a couple of

dedicated secretaries working at DAFF in Canberra. The Commonwealth CVO and the

management team in Canberra lead the overall work on risk assessment, surveillance,

laboratory diagnostics, veterinary epidemiology and administration. State CVOs

maintain emergency animal disease monitoring and control at the state level based on

the epidemiological data analysis of the disease distribution. AAHL provides diagnostic

services based on its expertise and facilities to support evidence-based decision making

which is one of the major tasks of the committee. Industry representatives are involved

in decisions about the management of animals and trade. These representatives can help

provide an economic perspective on how particular interventions such as movement

restrictions or a culling policy would impact on the affected industry.

The committee is essentially a distributed set of representatives that collaboratively

analyse information and discuss the strategies for dealing with an emergency animal

disease outbreak. The committee represents various vested interests and its membership

includes core members as well as ad hoc members drawn in as necessary for a particular

disease or point during an outbreak. CCEAD members are geographically dispersed

across Australia. CCEAD meetings using teleconferencing are held throughout the

entire outbreak course of an emergency animal disease until the disease is demonstrably

eradicated.

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5.2 Related Work

There is a growing interest in CSCW and HCI research into the role information

technology can play in supporting emergency response. Sociological, organizational and

technical issues have been identified as major obstacles that need to be addressed in the

development of effective emergency information and collaboration technologies (Manoj

& Baker 2007, Kristensen & Kyng 2009). Research efforts have sought to understand

the challenges of time-critical communication and coordination as well as the

collaboration between disparate groups in a variety of different emergency response

domains (e.g. Palen & Liu 2007, Chen et al. 2008, Pipek et al. 2012, 2014). To my

knowledge no study has been reported on the emergency response for infectious animal

disease in CSCW and HCI. Each of the different sectors under the broad umbrella of

emergency response has its own unique characteristics and socio-technical challenges.

The work of the CCEAD is not about in-moment coordination activities. Rather it deals

with higher-level strategic recommendations for intervention and involves distributed

meetings and information sharing across multiple organizations. Issues of collaboration

across different settings have been reviewed in Chapter 2. In the context of supporting

communication and information sharing in CCEAD, this section will outline three

related social-technical challenges: collaboration across multiple organizations,

common information space and collaboration technology development.

One of the socio-technical challenges has been supporting intra- and inter-

organizational collaborations involving different teams. Klann et al. (2008) and

Kristensen and Kyng (2009) explore the design of interaction technologies to support

communications in emergency response and highlight the need to understand the

organization and division of work as well as the characteristics of collaborations and the

ways in which they have unique implications for technological interventions. Pipek et

al. (2012) at a workshop of the CSCW conference argue that emergency response can

be considered as a “continuous social process of a network of interdependent actors and

organizations” (p7). Studies of how technology design may be undertaken to achieve

interoperability in emergency response suggest the importance of understanding the

loosely coupled structures and highly heterogeneous environments (e.g. Mendonca et al.

2007, Pipek et al. 2012, 2014). Olson et al. (2009) in their paper of “What still matters

about distance” illustrate three classes of distributed work typologies by using a team of

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four: hub-to-spoke (3-1), hub-to-hub (2-2) and fully distributed (1-1-1-1). Collaboration

practices of different sized teams can be significantly different in several ways (Mark et

al. 2003). These include multiple actors, subgroup interaction, physical environment and

the display settings required (ibid). Most of the literature focuses on understanding the

collaboration in hub-to-hub configuration in which there is a critical mass represented at

the headquarters and remote hubs (Hinds & McGrath 2006). Koehne et al. (2012)

conducted a study to investigate how individual remote members develop strategies to

cope with the challenge of working alone with other remote members. They argue that

the same strategies and technical solutions that resulted from the symmetrical hub-to-

hub setting may not generalize to the other settings. There is a need to understand the

collaboration in the other types of configuration, especially the mechanics of how the

asymmetrically configured groups collaborate across distance in real time (Koehne et al.

2012, Olson & Olson 2013).

Another social-technical challenge relates to the issue of information sharing. For the

work of CCEAD, there is a particular challenge in constructing common information

space across large scale and distributed communities. Studies have shown that

coordination problems in emergency responses are generally caused by breakdowns in

information sharing and the communication process (Diniz et al. 2008, Ley et al. 2012).

Information is disseminated within and between different actors and organizations through

different channels and entities. Contextual information is generated from the

development of the events and actions carried out by the teams. The prompt distribution

and sharing of related information can play an important role to build shared

understandings between different teams and support the actions carried out by different

teams (Denef et al. 2008). Ley et al. (2012), in their study of improvisation work in

inter-organizational emergency response, found that there is a lack of awareness about

what information is available for the team involved since information is mostly

distributed. They outline implications for the design that focus on geographically

visualized data about information and collaboration resources for collaborative situation

assessment. Importantly, supporting the construction of common information space is

not just to provide access to information (Bannon & Bodker 1997). Harrald and

Jeffereson (2007) explore how to achieve common situation awareness for emergency

response teams in the information sharing process and highlight that the emphasis

should not only be on the data transformation process but also the sense-making

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processes of the team. Supporting common information space for a large-scale team

also requires the development of custom components to increase flexibility for the end

users as reviewed in Chapter 2 (e.g. Rolland et al. 2006, Hjelle & Jarulitis 2008). Ley et

al. (2012) suggest solutions for individualization of information composition to allow

individual users to annotate and add new information for their personal needs when

sharing information in emergency response.

A range of technologies have been investigated in different types of emergency

responses. These include formal control rooms, mobile and wearable computing, large

public displays for group coordination and mobile incident command, distributed

collaborative systems, geospatial technology and more recently the social networking

sites and crowd sourcing approaches (Jiang et al. 2004, MacEachren et al. 2006,

Landgren & Nulden 2007, Heard et al. 2014, Ginige et al. 2014). Among these, there

are a number of explorations in designing collaboration technologies. Kyng et al. (2006)

in their study of emergency incident response investigate the challenges of designing an

interactive system for time-critical collaboration. The challenges they identified range

from equipment and communications to the professionals and information technology

supporting these. Ginige et al. (2014) demonstrate a spreadsheet-based collaborative

system built in mobile devices to support information sharing among disaster

responders. Heard et al. (2014) present a real time information gather and share system

which is a web-based visual collaborative environment and is designed to facilitate

teleconferencing over maps. They emphasize the needs to support flexible

customization of shared information according to roles of participants and integration of

a variety of data to be overlaid onto a map.

5.3 Research Context and Motivation

When there is a disease outbreak, the CCEAD convenes and members begin to meet

regularly. Depending on the nature of the disease, likely prognosis and economic

impact of a particular disease, the meetings happen more or less often. In the case of a

major outbreak such as equine influenza, the group initially would meet for several

hours every other day with this gradually slowing down to weekly and fortnightly

meetings as the disease begins to show signs of being under control. Because the

CCEAD consists of members located in different states, and because of the frequency

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with which these meetings have to occur during an outbreak, it is not logistically

possible for all of the groups to get together in a co-located setting. Rather, it is a

necessity to conduct these meetings in a distributed manner. The CCEAD meeting can

be considered a hub-to-spoke setting and the Canberra site can be considered a hub site

given the chairing role by the Commonwealth CVO. A significant challenge faced by

the committee is for its members to collaborate, across multiple locations and groups,

representing different sectors and states, to share information in a timely manner and

make effective and appropriate evidence-based decisions.

An effective collaboration platform was identified by key members of the CCEAD as

one of the solutions to enhance the connectivity and information management in

emergency animal disease response. In order to understand the work practices of the

CCEAD and provide insight into what and how appropriate ICT interventions can be

made to facilitate their collaboration, I worked with a senior researcher in CSIRO to

conduct the workplace study in CCEAD and their distributed meetings.

It was interesting to me at the beginning of the fieldwork that such distributed meetings

were conducted with very basic collaboration and information technology. For

example, the core technology for communication was teleconferencing facilities which

supported audio connections only while a large number of documents were also

presented on paper with no basic capability for sharing these in real time. Fax machines

were a necessary part of the communication infrastructure. Given the apparent lack of

sophistication in these information and communication technologies, I was keen to

understand why they remained, how they supported work practices in positive ways and

how they hindered any communication, analysis and decision-making.

Findings from the MDTM study had showed differences in local practices and how

technical, organizational and procedural factors shaped the particular ways of

interactions in distributed collaborations. The understandings obtained from MDTM

study helped me to develop the investigation focus of the collaboration practice in

CCEAD, including particular ways information and communication artefacts were

configured and arranged during particular situations and why such arrangements came

about.

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5.4 Methods

The study included a series of interviews with key members of the CCEAD and

supporting groups and was conducted over a period of five months. In total twelve

participants from four different sites were interviewed. These participants included the

Commonwealth CVO, two CCEAD secretaries, two state CVOs, three key members of

AAHL in Geelong and four members of the management team at the DAFF in

Canberra. Where possible these interviews were conducted in situ at the place of work

and lasted approximately one hour – though some participants were interviewed via

telephone. A larger focus group meeting involving 15 participants from the DAFF was

conducted in Canberra at the beginning of the study. The participants worked in various

jobs supporting the work of the committee, including core members of CCEAD, the

secretariat for the committee and the administrative managers. The purpose of the focus

group meeting was to understand collaboration practices relating to CCEAD and the

physical environment of the Canberra site. I worked closely with Kenton O’Hara, a

senior CSIRO researcher, in conducting the interviews and focus group meeting. I was

responsible for the data analysis and Kenton provided overall guidance on the study.

The interviews focused on the distributed collaboration practices of the CCEAD during

teleconferences but also in the surrounding work before and after particular meetings. In

building a picture of the work practices, efforts were made to ground the discussion in

the details of actual disease outbreaks and the major focus of the work for the

committee in recent years. These details provided richer descriptions of the work than

discussing the work purely in terms of abstract generalisations. The articulation of the

work also included particular ways information and communication artefacts were

configured and arranged during particular situations and why such arrangements came

about.

In situ interviews were combined with site visits to the DAFF in Canberra and the

AAHL in Victoria. The physical set-up and the arrangement of various artefacts in the

key rooms, where committee members participated in the meetings, were documented

through photographs.

Interviews were audio recorded and transcribed for later analysis drawing out key

themes relating to why work practices were organised in particular ways and the

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implications this had for future ICT interventions in support of their distributed

collaboration. The focus group discussion and site visits were video recorded and

subject to similar analytic orientation.

It is worth mentioning again the difficulty in the study of collaboration in emergency

response in general and in this study. Since emergency response meetings cannot

always be anticipated, systematic research is difficult to plan for. The intention of this

study was to combine interview with observations of actual meeting practices of the

CCEAD. Unfortunately due to the unpredictable nature of emergency disease outbreak,

there was no opportunity to observe the committee meeting in action.

There were no design activities carried out for supporting CCEAD collaboration

immediately after this study. This was because the management of AAHL was keen to

introduce collaborative workspaces to support the collaborations within AAHL and the

CSIRO design team decided to focus on the AAHL work first. However, the CCEAD

collaboration was revisited two years later when a collaborative workspace was

developed and used in AAHL. Some of the CCEAD members at Canberra were

interested in setting up a similar collaborative workspace at the Canberra site to support

the CCEAD collaborations. A one-day workshop was conducted by me and a second

CSIRO researcher at DAFF to explore this potential development. Two CCEAD

members, three biosecurity service managers and two IT infrastructure managers of

DAFF participated in the workshop. Although this workshop was not planned as part of

the original study, the findings were related to the overall study of the collaboration in

emergency response work of CCEAD and will be presented in section 5.6.

5.5 CCEAD Meetings

At the time of the study, the members making up the group were distributed across at

least eight sites and sometimes more. There were differences in terms of numbers of

meeting participants at each site as well as participants’ responsibilities and

involvements. A unique feature presented in this large-scale committee was the

combination of different groups with different sizes and structures across multiple sites.

The hub site, which is the Canberra site, has a larger number of participants involved.

The other sites, namely the state CVOs and the AAHL, can be considered satellite sites

and were smaller in terms of the size of the physical spaces and number of participants

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attending – usually somewhere between one and three participants per site. The physical

settings of the meeting rooms and findings relating to communication and information

sharing activities in the meetings will be described in this section.

5.5.1 Physical settings

The group at the Canberra site used a large meeting room, the Emergency Meeting

room, to accommodate around fifteen participants sitting in a big meeting table at the

centre of the room (Figure 5.2). The Commonwealth CVO, a couple of key management

representatives and one secretary sit close to the speaker phone which was in the middle

of the big table. They are the “active” meeting participants because they respond to the

agenda items. Most of the management team staff were not CCEAD members but had

indirect roles in CCEAD related activities, such as ministerial liaison and public

communication. They were observers of the meeting, taking notes and minutes for their

own records. There was a seat close to the speaker phone for participants to move to

when they needed to speak.

Figure 5.2. A large meeting room

The Emergency Meeting room was a common meeting room shared by different teams

in DAFF. Six to eight small tables formed the big meeting table in the middle of the

room. All the small tables had wheels, so the size and shape of the big table were

configurable. It was intended to keep this flexibility because the meeting room was used

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as a meeting room for different emergency response meetings involving different

committees concerning different areas, such as food, plants. There were meeting

facilities, such as white boards and projector screens for general meetings. There were a

number of information resources available for co-located participants to access and

view necessary information: during an outbreak, the walls were used to display various

paper artefacts such as a range of different maps depicting geographical representations

of data relevant to a particular disease; computers on the side table allowed access to

related information if needed during the meetings. These information resources

provided useful common references during the meetings. However the shared visual

information for the co-located members was unavailable for view by remote

participants, as I will describe further in 5.5.3.

Three fax machines were placed on the side table for sending and receiving meeting

materials during the meeting. While fax could be considered an old fashioned

technology, it particularly related to the ways that real-time information could be shared

securely. Information security was of high priority because of the confidentiality of the

information. In managing disease outbreaks, the way that any information was

presented externally needed to be well managed. This was because of the economic

consequences of information being leaked in an uncontrolled manner. It was also to do

with political sensitivities in relation to particular intervention strategies and animal

welfare. For example it could create a sense of panic for individual farmers because of

the economic impact on themselves due to the intervention strategies such as movement

restriction or regional slaughter. These security concerns were also reflected in

restrictions on wireless Internet access within the DAFF building. The security concerns

could impact on information access practices and potential ICT solutions.

The participants of the state CVOs and AAHL sites typically attended the meetings

from the individual offices of core CCEAD members of their local sites. These offices

were fairly standard and had small meeting tables where CCEAD members sat with a

couple of other representatives as needed for particular meetings. Figure 5.3 shows the

office of the AAHL Director. The office had a small oval meeting table where a

telephone was placed. Participants had Internet access through personal desktop

computers, laptops or mobile phones that were brought to the meeting. The Personal

Assistant (PA) of the AAHL Director was in an office close by. While not participating

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directly in the meetings, the PA assisted in gathering the large amount of meeting

information before the meeting and collecting incoming documents during the meeting.

The assistance from PAs was an important factor in the way that real-time information

was monitored, received and managed at the state CVO and AAHL sites.

Figure 5.3. The office used for the meeting

For the more ad hoc industry representatives participating in the meeting, information

and communication infrastructure was often more compromised. For example, during

the equine influenza outbreak a number of industry representatives would have to

connect from remote rural areas. Low bandwidth and unreliable networks in these

remote regions impacted on the ways that these representatives could participate. Some

of the industry participants had difficulty in receiving documents in a timely fashion

because of the poor network connectivity. It also created extra effort for the secretaries

at DAFF to organize the sharing of information with them. The key point here is that the

sites within this collaboration were operating under asymmetrical conditions in terms of

their information and communication access. This potentially undermined equitable

participation for some of the groups and industries. In this context, the design of a

platform to support collaboration across multiple different local settings is extremely

challenging. It includes the design complexity of each local setting, especially the large

group in the Emergency Meeting Room in Canberra, and also the linkage between the

asymmetries and multiple sites. One of the reasons why teleconferencing offered some

value (in spite of its limitations) was because it was a “lowest common denominator”

technology equally accessible by all participants.

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5.5.2 Decision Making

The work of the committee during the meetings was essentially analysing large amounts

of information updated from multiple sources and debating appropriate courses of

action on the basis of this information. Representatives from the different groups and

sectors had different views and expectations. States might be differentially affected by

the disease outbreak and have different responsibilities for implementing programs and

interventions. Each state had certain vested interests in terms of economic consequences

of decisions. Likewise, industry representatives who wish to protect their industries

might have different perspectives on certain intervention strategies because of the

immediate effects on the ability of the industry to operate effectively. The issues being

discussed in the meetings were inherently controversial, as commented by one the

CVOs:

“It is almost impossible for people to not come to CCEAD with some invested

interest in terms of protecting their own position… So the whole response, right

through the equine influenza response, a lot of it was trying to get the right

balance between disease control and enabling the industry to operate effectively.

The biggest debates we had in CCEAD were about movement conditions and

what were acceptable…There were lots of different views… a lot of debate”.

There were also inherent uncertainties with some information, such as climatic

conditions that might impact the spread of airborne diseases. These uncertainties add to

the potential for debate and interpretation in terms of particular vested interests. As one

participant pointed out, the analysis was a process of “managing risks”. The decision

making was about getting a balance between the different perspectives.

While there was potential for conflict, the decision making was actually well managed

in the group according to the CVOs we interviewed. This was partly due to a good

working culture within the group. The good relationship was established through other

work that the CCEAD members did together such as meeting regularly when serving on

other animal health committees. Importantly, the decision making was also facilitated

by the provision of a national biosecurity strategy called AUSVETPLAN (AHA 2010).

This strategy outlined particular courses of action and guidelines during certain

scenario. It also outlined important cost sharing measures across the states so that

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affected states did not have to bear the full costs of implementation so long as certain

criteria were followed by the affected states. It raised the concerns up to a shared

national level and effectively reduced potential economic conflict impacting on the

decision making process.

5.5.3 Information Sharing

Information was a central component in the CCEAD meetings in supporting the

evidence-based debate and decision-making. The meetings were document-centric.

Understanding these practices and the role of documents in them were important factors

in design decisions for potential ICT solutions for such meetings.

The document set used during a meeting was prepared by various members especially

the CVOs of the affected states. Typical types of documents included situation reports

and implementation reports from each of the affected jurisdictions, for example

epidemiological data, graphs and maps of new movement conditions between different

zones. There was a variety of computerized documents in different formats which

included Word, PDF, Excel sheets and PowerPoint presentations. Occasionally short

video clips of sick animals were sent for the members to watch before the meeting.

Figure 5.4 shows the process of information access and distribution. The documents to

be used for the meetings were collated by the CCEAD secretariat based in Canberra.

Due to confidentiality concerns, documents were not allowed to be sent in email

attachments. There was a common repository for the CCEAD members. Microsoft

SharePoint was used as a platform to support the document management and document

sharing across organizations. The access control of the documents was centralized at

DAFF in Canberra. The secretariat administered the database and established access

permissions to SharePoint for each participant. The key secretariat who worked closely

with the Commonwealth CVO acted as an information gate-keeper to maintain the

SharePoint and documents.

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Figure 5.4. Information access and distribution

Getting documents onto the common information repository was a cumbersome

process. After the document owner logged into the password-protected SharePoint

website and submitted documents, he/she needed to send an email to inform the key

secretariat. The secretariat then sent an email to the list of contacts to notify them of the

updated documents. Since there were a large number of documents sent from different

groups at different times, this communication process increased the effort of each

CCEAD member and has been considered as a barrier to the requirement of near real-

time information sharing. Some of the members had to rely on their PAs to monitor the

updates. One of the interview participants commented that “the way things work in an

emergency situation is less than ideal.”

Relating to this issue, due to the quick changes in a disease situation and various data

requirements, some of the documents were sent very close to the beginning of the

meeting or even during the meeting. At times some meeting participants did not even

receive all the documents. This was because the responsibility for many of the

documents lay with the affected states. The time pressures were particularly acute for

these affected states since they were involved with the day-to-day management of the

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outbreak. This issue was a source of frustration for meeting participants. It affected

their pre-meeting analysis of the contents but also could lead to communication

difficulties during a meeting since there was no common resource. The cumbersome

nature of the document distribution was a key issue to be addressed. There would be

great benefit gained from collaboration technologies to support real-time sharing of up-

to-date information during the meetings in order to maintain the flow of conversation.

Without any computational means for shared visualization of the documents during the

teleconference, all the participants brought printouts of the documents to the meeting.

Not having the common visual resource could lead to conversational inefficiency since

there was continual effort necessary to orient all the members to the appropriate places

in the document resources. Second, because of the last minute preparation of the

documents the circulated documents sometimes had errors in them. The presenters often

found areas that needed to be updated or corrected as they read through the documents

in the meetings. This was very frustrating for other members to find those places and

make same changes in the paper in front of them. The issue of shared visualisation

could be especially difficult for data in graphical format, such as maps and graphs, when

communicating by telephone. When we asked about the possible solutions to these

problems, most of the interview participants believed that apart from the improvement

in the coordination across multiple organizations, technology could play an important

role in mediating the information sharing and communication. A state CVO emphasised

that the support for interactive sharing of documents, maps and graphs was necessary:

“Need to have some kind of feature there, once the document was edited, you

could all see the edits being done…that document should then be able to send to

everybody…. The other thing is that it would be very good if we could all view

a map simultaneously, and someone could explain the map and we could see and

understand what he was explaining”.

In spite of these difficulties, the paper format of the documents also had a certain value

in the way that the analytic work and discussion were achieved. Paper documents were

important personal resources that were annotated both prior to and during the meeting in

support of particular conversational contributions the individual members wished to

make. Paper documents as personal resources also allowed each participant to view

different parts of the document set according to their individual needs while other

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people were looking at different documents. Interview participants discussed the

importance of being able to see multiple documents at the same time in order to be able

to fully synthesise information from multiple sources and :

“Particularly when there are situation reports such as these, each state is talking

individually and often you want to look at a map, two maps side by side and

work out if they have the same bits on either side of the border”..

“It is not easy jumping around multiple documents on the laptop either, it saves

on paper but it is not necessarily faster”.

In addition, the paper documents supported co-located sharing practices at the

individual sites. For example, a participant might check some information detail to get

consensus from colleagues before talking to the remote teams. They looked over the

same paper and muted the telephone while doing this. These practices were an

important part of managing side-work during the meetings and facilitating the fluid

development of different conversational threads.

5.5.4 Background Work and Multi-tasking During Meetings

Because of the amount of information to be discussed and certain inefficiencies in

information sharing, the CCEAD meetings sometimes were very long. In some

situations it could last up to 3 or 4 hours. Although there was a structured agenda

prepared by the key secretariat at DAFF, the complexity of the disease, the cross

discipline knowledge required to understand the content and the tensions between

different interests and controversial opinions were all factors that could lead discussion

away from the agenda and make it difficult to coordinate the flow. This was one of the

common sources of frustration among the meeting participants because during the

disease outbreak there was a high workload that they had outside the meeting context.

Access to personal computing resources during the meeting was considered useful in

dealing with some of these concerns. Some of the meeting participants at AAHL and

state CVO offices brought laptops to the meetings or, on occasions, used the phone

while sitting at their desks. The laptops were not being used for reading the meeting

materials but rather for monitoring incoming information and accessing background

work or other materials. The use of teleconferencing (rather than video conferencing)

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and the use of paper materials provided some of these participants with greater

flexibility in choosing where the meeting was held and greater flexibility to access their

personal computing resources. As well as monitoring incoming information, this access

provided a means by which some participants could manage their background workload,

in particular those participants whose key inputs were only required at certain points

during the meeting. These participants were able to peripherally monitor the

conversation and continue with other important background tasks through the use of

their personal computing resources. One of the values of teleconferencing was that it

reduced the visibility of this activity to other meeting participants, allowing people to

participate when necessary but still manage their other important work tasks.

5.6 Exploration of the Physical Setup

A workshop was conducted at DAFF after the CSIRO design team developed and

deployed a collaborative platform at AAHL to support the collaborations within AAHL

(detail of this development is described in Chapter 6). The aim of the workshop was to

explore the potential of integrating a collaborative workspace into the CCEAD meeting

for the Canberra group. This one-day workshop was conducted in the Emergency

Meeting room where the CCEAD meetings were held. The participants included the

deputy Australian CVO, one CCEAD secretary, three biosecurity service managers

from DAFF, two IT infrastructure managers from DAFF and one diagnostics manager

from AAHL. The collaborative workspace developed for the small group discussion

meetings (four participants) within AAHL was presented at the workshop and how to

extend this solution to fit CCEAD meeting was discussed.

One of design issues that the workshop participants pointed out was to support the

peripheral meeting participants of the large group at the Canberra site. Similar to the

setting of MDTMs at hospital A, there were two different types of people in the

CCEAD meeting at the Canberra site. As described before, one was the key participants

which included the Australian CVO and another two to three people. The other twelve

to fifteen people were observers or peripheral participants. The workshop participants

expressed their concern that those peripheral participants might feel excluded if they

were not able to see the information showing on the digital displays or had a narrow

field view of the video conferencing. Although there was a difference in terms of level

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of participation between the key participants and non-key participants, it was important

to make sure that all the participants felt involved in the meeting. In addition, the design

solution would be providing all meeting participants with appropriate views of the

remote people and information discussed.

Possible locations of the screens and room layout were investigated during the

workshop. The tables with wheels in the meeting room were easy to move, combine and

recombine. This means that it would be possible to flexibly configure the existing tables

and chairs for the best seating arrangement and put them back to normal positions after

the CCEAD meeting. We experimented with different layouts during the workshop.

The tables and chairs were set up around the workspace displays to allow key staff to sit

at the main table close to the displays and observers to sit at the other tables around

them. As shown in Figure 5.5, one of the arrangements was that the tables of the

observers were arranged in an L-shape around the main table where key staff sat. The

workspace displays, mimicked by an electronic white board in the exercise, were placed

next to the column in the room. Another arrangement (Figure 5.6) was that the displays

were envisioned to be between the two electronic white boards with the main table in

front of it. Other tables were grouped around the main table for the observers.

Figure 5.5. Room arrangement 1

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Figure 5.6. Room arrangement 2

The workshop participants pointed out that an additional display may need to be

installed at a position close to the observers for showing information being discussed

because the observers may not be able to see the details showed on the main workspace

displays. They felt that the video conferencing (the views of remote participants) may

not need to be visually replicated for the observers since the remote participants’ audio

was available in the room. They also pointed out that the Australian CVO needed to

chair the meeting and the secretary needed to taking notes so they were not able to

manage the device operation, such as opening files using the mouse of the platform

during the meeting. An alternative assistant responsible for controlling the information

flow on the displays would be required.

5.7 Discussion

Through this study I have been able to explore different aspects of the collaboration in a

geographically distributed committee which has responsibility to make high-level

strategic decisions when there is an outbreak of emergency animal diseases. These

aspects relate to the issue of coordination across loosely coupled teams in emergency

response (e.g. Pipek et al. 2012, 2014) and other distributed collaboration situations

where social and communicative connections are important (e.g. Kane & Luz 2006,

Olsen, Zimmerman et al. 2008, Jirakta et al. 2013, Fitzpatrick & Ellingsen 2013). It also

echoes the information sharing challenges identified in designing interactive systems for

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a large-scale team (e.g. Rolland et al. 2006, Hjelle & Jarulitis 2008, Kristensen & Kyng

2009). Combined with what is known about emergency response in general and

collaboration challenges in inter-organizational collaboration, the findings from this

case study contribute to my overall exploration in supporting collaboration across

different local settings. It allows me to further explore the issues of asymmetries in

physical settings and differences in local information sharing practices that I have found

in the MDTM study.

5.7.1 Coordination and Working Together

Responding to animal disease emergencies required multiple decision makers who must

reason, communicate, and make decisions about complex systems and material

resources. The time pressures that the group was under to make decisions and the

enormous potential impact of these decisions influenced the way that the work was

done. The distributed nature of the collaboration was a pragmatic requirement for this

group of people given their large geographical separation and other ongoing work

commitments during emergency disease outbreaks. One of the coordination problems in

this distributed collaboration concerned inter-organizational mechanisms of document

sharing, particularly the difficulties arising from a rapidly evolving set of information.

We saw how breakdowns and communication inefficiencies arose out of cumbersome

methods for delivering up-to-the-minute documents. While these methods had their

particular reasons, such as the security concern, there was a need for efficient ICT

solutions which could better support the real-time sharing of documents and less

cumbersome but secure methods for document exchange.

The study findings also show how the collaboration involved individuals, groups and

organizations who had different backgrounds and interests working together.

Researchers (e.g. Olson, Hofer et al. 2008) have shown that there are two particular

challenges of coordinating across diversity and distance for collaboration: the greater

the diversity, the less common ground and trust, which together impede the

understanding of each other; and the larger the scale, the greater the coordination

overhead. One of the related issues for CCEAD collaboration is the division of work in

the inter-organizational coordination in emergency response. Definitions about

competencies and responsibilities are important for smooth interaction. Pre-negotiation

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routines and improvisation work are also required in order to better coordinate the

decision making process. Although in CCEAD there was a common high level goal of

managing the disease outbreak, the different perspectives and vested interests of the

represented organisations can lead to intense debate over action plans that balance their

sometimes competing needs. While technology could play a role in facilitating

consensus building, solutions would not be simply technical. One of the important

features of allowing consensus building in these situations was the introduction of the

AUSVETPLAN. This actually helped mitigate some of the factors that would

otherwise have led to more partisan interpretation and representation of the data, for

example by removing some of the economic concerns underlying these vested interests.

5.7.2 Supporting Information Sharing

Gathering and analysing information, assessing the potential impacts of the animal

disease outbreak and executing related actions were the main activities of CCEAD.

These activities involved a complex process of constructing common information

spaces (Bannon & Bodker 1997, Reddy et al. 2001). The study identified the challenges

in aggregating information (as discussed in 5.7.1), supporting shared visualisation of

information and individualisation of information for different users. Specific

implications for designs to support shared visualisation and support individualisation of

viewing information resources will be described below.

This study has shown the difficulties arising from not having shared visual access to

information being discussed in the distributed meetings. Similar to the findings of the

MDTM study, analysing information with colleagues in the same room usually worked

well, especially if a large situation map was available on the wall for co-located

participants. One of the key design considerations has been enabling shared

visualization and interaction over the network for participants located at different sites.

There have been existing systems for document sharing that could be introduced.

However, given the complexity of the information and sense making, it is important that

new technologies need to support the concurrent visualisation of multiple documents at

the same time and not simply the sequential presentation of single documents. New

technologies will also need to support real-time shared interactions across different

sites, especially the references over maps and graphs. The design will need to address

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the functionalities of audio-video communication, presenting information, visualizing

information and interacting with information as we have seen in other work in the

broader media space research (e.g. Boxton 2009, Luff et al. 2009, 2013).

Likewise, such shared visualisation in itself would not solve all the problems. The study

showed that individual participants had particular ways of being involved in the

discussion of information. It should be recognized that paper versions of the documents

would remain an important part of the work practice during such meetings, particularly

for the role paper resources play in concurrent visualisation across multiple information

sources. Similarly, the use of personal computing resources would also play an

important role in the ongoing management of work during the meetings, whether

immediately relevant to the conversation at hand or whether directed at tasks outside the

meeting agenda. Efforts could be made to link these personal resources to the shared

resources, such as through the real-time sharing and visualisation of up-to-date

information accessed via personal computing resources.

5.7.3 Different Settings and Existing Mechanisms

One of the challenges for the design of technology to support CCEAD collaboration is

the context of multiple teams of different sizes, multiple locations with different

physical settings, loosely coupled participants and a requirement for relationships

demanding a high level of trust. This context introduces a complex set of asymmetries

in the system that needed to be accounted for in any technology interventions proposed

for this group. Any system introduced needs to be able to work across these different

sites and within the context of different information, network and communication

resources.

Designing collaboration technology for a distributed meeting involving different teams

relies on understandings of how current technology and mechanisms are used in the

current meeting setting. One of the reasons why teleconferencing was used was because

of its status as a “lowest common denominator” technology that was equally available

to all parties, including co-located and distributed participants. Similar to the findings of

the MDTM, this study has shown that any technology introduced needs to take account

of disparities in information access that it introduces into the socio-technical system

which makes up the CCEAD and any consequential biases it introduces in terms of

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different participants being able to participate equitably. The potential solution of a

collaborative workspace needs to provide participants with equal access to audio, video

and shared visualization of information so efficient participation in the functions of the

meeting can be achieved.

It is also important to maintain local differences since specific settings have their own

social and functional meanings that can be valuable in the distributed collaboration

practices of individuals and individual sites. Adding personalization of information

viewing functionality to the basic shared workspace is one of the considerations to

maintain individual preferences. Another consideration is the physical design of each

local setting, for example the hub site in Canberra which had a larger number of

participants. Similar to the physical setup re-arrangement exercise done in hospital A in

the MDTM study, the workshop described in this chapter has shown potential practical

solutions to support both the key participants and peripheral participants by allowing

both types of participants to have common views of information and to have better

visual communications with remote participants.

The extent to which new technologies can close the gap of the “space between” settings

and groups is a challenge when enabling a distributed large-scale group to engage in a

meaningful collaboration. Technology can serve to close the gap of the space between

groups, but it can also introduce its own gap (Mark et al. 2003). The uncertainty of the

value of participants seeing each other in this study is an example of potential problems

when introducing a video-based environment which provides better visibility of the

remote situation. The valuable aspect of multi-tasking work during a long meeting is a

consideration in any video-mediated solutions that could render this work more visible.

The abilities to mute or walk away, that we have seen in a teleconferencing meeting,

would also be limited.

A collaborative workspace itself will not solve the problems of information aggregation

and distribution process. Accessibility to information is a challenge in inter-

organizational collaboration. Existing security policies required a centralized procedure

which hindered sending and updating information to CCEAD members in a timely

manner. This impacted on the efficiency of the collaborative situation assessment

process for the distributed members of CCEAD. One of the fundamental design

requirements for supporting emergency response work for the inter-organizational level

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is to provide a complementary information infrastructure, not a tool to replace existing

infrastructures (Ley et al. 2012). One of the solutions and possible future work (see

Chapter 8) can be maintaining the existing shared repository and integrating existing

authentication and authorization mechanisms into the design of a collaborative

workspace so that the access, read or write policies can be predefined and protected at

the collaborative workspace level.

5.8 Conclusion

In this chapter I have described an investigation of collaboration within the emergency

animal disease response committee in their decision-making and management meetings.

Issues around the coordination and information sharing in the collaboration involving

the large-scale multi-site multi-organizational committee have been presented and the

related design implications have been discussed. The importance of understanding the

existing social-technical context and mechanisms that affect the particular collaborative

practice in the committee has been highlighted. Similar to the findings of the MDTM

study, the specific implications for technological support for the emergency response in

the animal disease domain will have broader implications for other settings where

collaborative information synthesis is across different organizations with different local

settings.

.

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6 Case Study: Distributed Scientific Collaboration across Biocontainment Barriers

This chapter presents the study of distributed scientific collaboration within the

Australian Animal Health Laboratory (AAHL). Collaboration in this setting is

challenged by physical containment barriers which ensure the safe handling of animal

diseases. The aim of the study was to understand how the scientists communicate across

the barriers, particularly how they share information and collaborate on its analysis. The

study was part of a large design project which has delivered the outcome of developing

and deploying an integrated collaboration platform in AAHL. In this chapter I will first

briefly review related work in distributed scientific collaboration and describe the

research context of this study. Following a description of the research methods, the

work of AAHL and collaborations between the scientists at AAHL will be presented.

This chapter will discuss how these findings shaped the design of the integrated

collaboration platform that has been used in AAHL. This study allowed me to explore

distributed collaboration across different settings within a single laboratory.

6.1 Distributed Scientific Collaboration

Scientific work is collaborative in nature. Sharing a wide variety of data and

collaborating on its review and analysis are central to scientific research (Finholt &

Olson 1997). Research work can be shared among scientists in various ways. The tasks

usually are divisible and can be performed either sequentially or concurrently

(Sonnenwald 2007). For example, in the natural sciences, one scientist may develop

data samples and a second scientist may analyse the samples using specialized scientific

instrumentation (ibid). In the social sciences, scientists may jointly develop data

collection instruments, separately collect data using the instruments in different

geographical areas and then analyse the results together.

Scientific collaborations have increasingly involved research teams which are

distributed over distance. It is common today for scientists to work together with their

colleagues from different disciplines and institutes (Ackerman et al. 2013).

Interdisciplinary collaboration involves the coordination of scientific work and the

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integration of knowledge from different areas of expertises. The complexity of scientific

collaboration, the coordination work it relies on and the increasing need for scientists to

collaborate with other groups and over distance have made this a particularly rich

domain for investigation (Olson, Zimmerman et al. 2008).

Computer-supported systems have been developed to enable scientists to work with

each other, with a range of research facilities and with shared data repositories without

regard to geographical location (e.g. Finholt & Olson 1997, Chin & Lansing 2004,

Jirotka et al. 2006, 2013). The terms of “collaboratory”, “e-Science” and “e-Research”

have been used by researchers to refer to collaborative systems and their applications in

scientific collaborations. These systems have been explored in various domains such as

the physical sciences, biological and health sciences and the earth and environmental

sciences (e.g. Mark et al. 2003, Fraser et al. 2006, Lee et al. 2006, Olson, Zimmerman et

al. 2008, Steinhardt & Jackson 2014).

6.2 Related work

Finholt and Olson (1997) reviewed scientific collaboration systems in various domains

and identified three core capabilities for technologies to support it: linking people with

people, linking people with information and linking people with facilities. These

capabilities require technologies to support, enable or mediate not only audio-video

communication, but also the collaborative analysis of information from various

resources, including instruments, and from specific work environments (Finholt &

Olson 1997, Olson, Zimmerman et al. 2008). Information sharing is the focus of

scientific collaboration and it relates to the issues of access to a remote material

environment, common information space and understanding the socio-technical context

of scientific collaboration as I will describe below.

The requirement to access information from scientific instruments and resources relates

to the research in media space in the area of accessing physical resources and

environments in media space research (e.g. Luff et al. 2009). As stated earlier in

Chapter 2 (section 2.1.6 and section 2.1.7), Heath et al. (1995) argue that early media

spaces only focused on linking people together and provided weak support for the

sharing of work objects. More recently, Luff et al. (2009, 2013) re-emphasize the

importance of providing different forms of access to remote participants’ local

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environments as well as the flexibility of interaction with the various artefacts and

resources such as paper or screen-based documents, drawings and views of objects.

The requirements of information sharing in scientific collaboration also relates to the

issue of constructing common information spaces (e.g. Jirotka et al. 2013, Ackerman et

al. 2013). A particular feature in this type of collaboration is that the scientific data

needs to be contextualized with information regarding experimental conditions, setup,

constraint and how those constraints are addressed during the process of sharing and

analysis (Chin & Lansing 2004, Faniel & Jacobsen 2010). Recent reviews of scientific

collaboration have highlighted the challenge of supporting the complexities of data

practices as socio-technical practices, that is, to focus on configurations that comprise

collaborative activities around the collection, sharing and analysis of data (Olson,

Zimmerman et al. 2008, Jirotka et al. 2013). Ackerman et al. (2013) in their review of

CSCW work in knowledge management over the last 20 years emphasize the

importance of understanding the contexts of knowledge work and practices as well as

the communication among different disciplines in the knowledge sharing process.

There has been a shift from a focus on technical design in early scientific collaboration

research to considering how technologies will be embedded into the context and

everyday work practices of scientists (Sonnenwald et al. 2003, 2007, Jirotka et al. 2006,

Ackerman et al. 2013). Sonnewald (2007) highlights the aspect of social contexts in his

definition of scientific collaboration which is “human behaviour among two or more

scientists that facilitates the sharing of meaning and completion of tasks with respect to

a mutually-shared superordinate goal and which takes place in social contexts”

(Sonnenwald 2007, p.645). Olsen, Teasley et al. (2002), in their study of supporting

distributed science in HIV/AIDS research, state that although collaborative systems

present opportunities for distributed scientific research, they are also “a challenge to

human organizational practices” (p.44). They point out that pre-specifying data sharing

rules and a clear understanding of the common benefits are essential for the success of a

collaborative system and its implementation. Olson, Hofer et al. (2008) identify five

factors which contribute to the success of a collaborative system supporting scientific

collaborations. These factors include the nature of the work, common ground,

collaboration readiness, management and technical readiness. They point out the

collaboration technology has its effect by allowing diverse and distant groups of

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scientists to communicate with each other so that their collective work is coordinated.

Researchers have conducted workplace studies to analyse scientists’ interactions and

practices and used these analyses to inform the development of systems to support

scientific collaboration (Fraser et al. 2006, Jirotka et al. 2013). Results from studies of

scientific collaborations have suggested that a number of socio-technical issues are

critical to the success of collaborative systems (e.g. Sonnenwald 2004, 2007, Olson,

Hofer et al. 2008). These issues include trust among participants, support for situation

awareness and the role of plans in coordinating rhythms at local levels of practice

(Sonnenwald 2004, Steinhardt & Jackson 2014).

Designing technology to support distributed scientific collaboration needs to move

beyond developing general tools and audio-video communication systems (Jirotka et al.

2006). As described in Chapter 2, telepresence video conferencing systems may not be

suitable to support scientific collaborations since they have limited support for sharing

and working with artefacts. Scientific collaboration is driven by the need to share data

and to exchange knowledge about the data. Information needs to be “at hand” to be

reviewed and interpreted by different discipline experts at the same time. This is a

different interaction model to the one-to-one or one-to-many lecture style presentations

that are supported by video conferencing systems. Access Grid and shared digital

workspaces and multi-display technologies are able to provide rich support for both the

sharing of data and its analysis in scientific collaborations (e.g. Corrie & Zimmerman

2009, Wigdor et al. 2009, Paay et al. 2011). However the uses of these technologies in

scientific collaboration have been mostly explored for ‘generic’ scientific collaboration

and an understanding of how to design these technologies to fit into particular contexts

and work practices is still a challenge (Jirotka et al. 2013, Ackerman et al. 2013).

6.3 Research Context and Motivation

The Australian Animal Health Laboratory (AAHL) is based at Geelong in Victoria,

Australia. AAHL is one of the most sophisticated laboratories in the world for the safe

handling and containment of infectious micro-organisms. It plays a vital role in

maintaining Australia's capability to quickly diagnose exotic, new and emerging animal

diseases and to prevent the economic impact of livestock disease outbreaks. AAHL

provides a wide range of laboratory services, including diagnostic services (agent

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identification and characterisation), histology, protein and nucleic acid sequencing, cell

culture and microscopy. There are also facilities for the housing and handling of

laboratory and large animals. It has ongoing research programs in developing the most

sensitive, accurate and timely diagnostic tests to support eradication campaigns in the

event of disease outbreaks. AAHL also undertakes research to develop new diagnostics

tests, vaccines and treatments for animal diseases of national importance.

Collaboration within AAHL is similar to other scientific collaboration in that it is driven

by the need to share data as well as knowledge about the data across different work

groups (Chin & Lansing 2004, Jirotka et al. 2006, 2013). This means that there are basic

requirements for robust and flexible communication support, the ability to access and

share different kinds of files from a range of sources, to look at images and other data in

these files with others and to annotate or otherwise capture the shared understandings

that characterise successful interaction.

However, AAHL is a biosecurity laboratory with very sophisticated biocontainment

facilities. These containment facilities are fully enclosed physical spaces designed to

ensure the safe housing and handling of animals and any micro-organisms the animals

may be infected with. Scientific staff move in and out of the containment areas through

a range of airlock doors that require specific containment practices of them. For

example, they are required to wear personal protective clothing before moving into

containment areas; they must change out of their protective clothing and take

compulsory showers on exit; and any equipment leaving the containment areas needs to

be decontaminated. These practices pose additional and particular challenges to

effective communication and data sharing between staff working inside the containment

area and staff working outside, particularly in the context of an emergency animal

disease outbreak. The scientists are working within the same building. However the

containment barriers act to "distance" individual scientists and work groups from those

on the other side of the barrier by imposing very specific constraints on physical

movement and the sharing of information within the building.

The AAHL management recognised that an effective collaboration platform could

support communication and the efficient sharing of information within and between

different work groups. This led to the “Biosecurity Collaboration Platform” project

which involved the design team from CSIRO and design representatives from AAHL.

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There were three stages in the project: a field study to understand the collaboration

practices of the scientists at AAHL; an interactive design process to fit the platform to

the specific requirements of this setting and a longitudinal evaluation of the platform in

use. The major component of the platform, a shared workspace, was installed on each

side of the main containment barrier and has been continuously used after the project. I

was the key researcher responsible for the field study before the design. I also

conducted an evaluation study two months after the shared workspace was installed and

used. Although a study was planned to find out trends and issues after the longer-term

of implementation, it was not completed due to project management and resource

changes. I left the project and was not able to be involved in the later phases of the

platform development and evaluation.

On my first visit to the containment area I was struck by the particular distributed nature

of the work in this laboratory. In addition to the usual challenges for supporting

scientific work in this novel context, there were additional challenges in the work

setting. This context has provided an interesting opportunity for reflection on the ways

technology can support team collaborations in complex work environment. This study

also offered me an opportunity to further explore my PhD research questions concerning

distributed collaborations between different teams and between different work settings.

Based on the analysis of the MDTM study and the CCEAD study, in this study I paid

particular attention to the specific work of different teams and work areas and how these

differences affected the collaborations. The results contribute to my explorations of

what design approach and configuration issues are relevant when technologies are

appropriated into specific settings (e.g. Balk et al. 2006, Schmidt 2007). Unlike the

previous two case studies, there was an actual design and deployment of a collaborative

platform after the field study and the findings from the study have informed the design

of the collaboration platform.

6.4 Research Methods

The field study was conducted over a period of three months at the early stage of the

project. It included a focus group meeting with twenty scientists and twelve semi-

structured interviews during four site visits. The interview participants included three

diagnostics scientists, two veterinary officers, four research scientists and three

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microscopy scientists. I led the study and was responsible for the study design, data

collection and data analysis. Christian Muller-Tomfeld, the lead of the CSIRO design

team, participated in the focus group meeting and some of the interviews. Toni

Robertson from University of Technology, Sydney participated in the analysis of the

results that are presented in this thesis. Again concurrent ethnography (Hughes et al.

1994) was used in this study to keep pace with the rapid design cycle. Findings from

fieldwork were discussed in the design team meetings and issues raised by the designers

during the debriefing were then explored in the field work.

Participants were asked about their work and how it was accomplished within the

AAHL. They were also asked about their expectations of collaboration technologies and

their collaborative work, particularly how information artefacts were arranged and

shared in and between groups in different work situations. The focus group and

interviews were audio recorded and transcribed. Visits to the containment area were an

important part of the site visits. Field notes were taken by the researchers during the

visits. The physical setup of the workspaces was documented through photographs and

notes.

Because of the biosecurity regulations I was not able to go into the most secure

containment area at all. Even so there were particular constraints on getting data

collection materials, such as the camera, audio recorder and notes, out from the parts of

the containment area we could enter. The notes we took inside were scanned and sent

to me by email. A digital camera that AAHL scientists kept inside the containment area

for general purposes was used and photos were sent to me by email. The audio recorder

had to be decontaminated and posted to us later. This gave us important insights into the

information sharing issues faced by the scientists and some of the current strategies and

resources they used to work around them.

Transcriptions and field notes were analysed using thematic coding (Saldana 2009) in

NVivo software as described in Chapter 3. Four major, closely related issues were

identified in the data. Two were concerned with defining aspects of this particular local

setting: the physical work setting, including the containment barriers, and the roles,

responsibilities and practices of the different workgroups within AAHL. The other two

were concerned with aspects of collaboration within AAHL: collaboration issues

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between and within different workgroups and issues of information sharing between

individuals and groups.

Further analysis identified three broad collaboration requirements that needed to be

supported by the collaboration platform. These were reviewed with the AAHL design

representatives, including two senior specialist scientists, a project officer and an IT

manager. They were then mapped to three design distinct stages of technology

development. The first addressed the more generic requirements that would be common

to many settings where distributed collaboration was required. The other two addressed

specific requirements of the particular setting that related to the biosecurity work of

AAHL.

An evaluation study was conducted after the two-month trial at AAHL to understand the

early usage of the shared workspace. The study methods included questionnaire and

semi-structured interviews. The scale and analysis of this early deployment study was

limited due to the change of my engagement in the project. Details of the evaluation

study including some findings reflecting the design considerations will be presented in

section 6.8.

6.5 The work of AAHL

The work of AAHL is vital to protect Australia from the threat of exotic and emerging

animal diseases. Various groups of scientists in the laboratory work together to deliver

diagnostic and research services in animal health. AAHL has large, microbiologically

secure, physical containment facilities. The practices and equipment in the physical

containment level 3 facilities, known as PC3, are designed for work with hazardous

micro-organisms where there is a risk of serious infection to humans and animals. The

physical containment level 4 facilities, known as PC4, are the highest level of physical

containment available and are only accessible via PC3. PC4 practices and equipment are

designed for work with even more dangerous micro-organisms which could pose a high

risk of life-threatening disease.

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6.5.1 The Physical Setting

Figure 6.1 shows the different physical work areas established by the physical

containment barriers. These work areas are located on the same floor of the main

building.

Figure 6.1. The physical layout of the work areas at AAHL

The general office area is outside the containment areas and includes offices, meeting

rooms, lecture theatres, canteen and reception. Each staff member has a workspace and

a dedicated personal computer in this general office area, including those who spend

most of their time working in the containment areas. The containment areas include

both the PC3 and PC4 facilities. These facilities are fully enclosed spaces, separated

from the general office area by a corridor with a range of airlock doors. There is a

change in/shower out facility between PC3 and the general office area. Before entering

PC3, staff need to change their own clothing and wear clean, standard laboratory

clothing including underwear, overalls, polo shirts and sneakers. A full three-minute

shower must be taken before changing back to their own clothing when exiting the

secure area. There are three laboratory suites, a large animal facility and an area of

canteen and meeting rooms in PC3. Each of these is separated from the other by airlock

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doors. The three suites, research, diagnostics and microscopy, are the major laboratory

work areas of AAHL. Each suite is configured into multiple rooms for equipment and

for the particular groups to conduct their work. Rooms within each suite are separated

by normal doors. The large animal facility includes rooms for animal accommodation. It

is maintained by animal technicians and allows scientists to conduct studies on animals,

for example trial a vaccine. Canteen and common meeting room facilities are available

in PC3. The canteen is the only window area where staff in PC3 can see the outside

world.

PC4 is a smaller area that is separated from PC3 by a second physical containment

barrier. The scientists in PC4 change their PC3 clothing and wear fully encapsulated

suits with their own oxygen supply. When they leave the PC4 they are required to have

a chemical shower and then a regular shower before changing back to their PC3

clothing and re-entering PC3.

6.5.2 Work Groups

The core work of AAHL is conducted by three major scientific work groups -

diagnostics, research and microscopy. The responsibilities of each work group are

described below.

Diagnostics group: The diagnostics group provides diagnostics services for a range of

animals and animal diseases, such as equine influenza, foot-and-mouth disease and

other emergency animal diseases of national importance. This work group includes

diagnostics scientists and diagnostics management team. Diagnostics scientists work in

PC3 to undertake tests using cell culture, virus and pathogen identification techniques,

and optical microscopy. Their results include text or table-based reports, pathology

images and microscopy images. The diagnostics management team (e.g. veterinary

officers), working in the general office area, is responsible for preparing and delivering

text-based reports to the clients who submitted samples, based on analysis of the results

from the diagnostics scientists and the microscopy group within the containment area.

Research group: The research group conducts research to develop improved diagnosis,

vaccines and anti-viral drug targets from molecular, cellular and animal levels. Some

research scientists need to spend most of their work time in the containment areas. Their

work can include, for example, using genetic sequencing facilities and techniques, such

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as gel electrophoresis, to generate genetic sequences of pathogens from copies of

genetic materials, and reporting these data in table-form in a document such as an Excel

worksheet and recording the digitized sequencing gel images. Other research scientists

spend most of the time working in the general office area though sometimes they need

to enter the containment area for observations of tests and studies. They undertake

research to develop early outbreak detection tools by investigating the interactions

between animals and viruses. Data involved in their work include the genetic sequence

data and various analysis results such as graphs based on software and web-based

analysis tools.

Microscopy group: The microscopy group uses advanced electron microscopy

equipment and expertise to provide microscopy diagnostic services and research

capability. Most microscopy scientists spend most of their time in the microscopy suite

in PC3. However, as with the other work groups, the team leader needs to complete

management and coordination work in the general office area in addition to engaging

with the work inside the containment areas.

6.6 Collaboration within AAHL

The diagnostics and research work in AAHL often involves collaboration between

scientists from different groups and from different sides of the containment barriers. In

this section I describe these collaborations and the collaboration and information

sharing issues identified from the study.

6.6.1 Collaboration within and between Groups

At the time of the study, collaboration within and between groups at AAHL was a mix

of concurrent, sequential, partly within and partly between groups, partly co-located and

partly distributed, sometimes involving conversation and often involving discussions of

data. Figure 6.2 shows the distribution of work groups across the main containment

barrier, the approximate number of staff in each groups and interactions between and

within groups. I describe the collaborations around diagnostics, research and

microscopy work in this section.

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Figure 6.2. Overview of the work groups and interactions between them

Diagnostics collaboration. There was a standard procedure in handling samples and

diagnostics requests received from clients. Figure 6.3 illustrates this diagnostics

procedure, the data generated by each related group and the information sharing

process.

Figure 6.3. Diagnostics collaboration between related work groups

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Samples that arrived at AAHL were tested by diagnostics scientists and examined by

microscopy scientists in PC3. This was followed by a group discussion meeting

between these scientists and the diagnostics management team. Participants brought

paper printouts to this meeting and used them to collaboratively interpret the tests and

microscopy results. During the meeting the diagnostics management member led the

case introduction and discussion, diagnostics scientists and microscopy scientists then

contributed their points of view based on their results. After the meeting the diagnostics

management team generated a report for the client.

Text-based case details and reports were maintained in a wiki by the diagnostics

management team, usually the veterinary officers, for all related groups to access. There

was a shared information system, Lab Information Management System (LIMS), where

diagnostics scientists recorded the text-based diagnostics test results and reports.

Related diagnostics management team members, microscopy scientists and research

scientists could access this system. Test-related pathology images which were stored in

the databases belong to the diagnostics scientists. Digital and scanned microscopy

images were stored in databases which could only be accessed by the microscopy team

members.

The diagnostics work was a group effort based on individual work and collaborative

analysis. The data generated by different teams contributed to the coordination of this

process. The results and status of the diagnostics process needed to be communicated

and understood by groups involved not only during the face-to-face meeting, but also

before the meetings. For example microscopy scientists might need to access LIMS and

refer to the diagnostic test results when making their microscopy diagnosis decisions.

The analysis conducted by the diagnostics management team relied on the accurate

interpretation of various diagnostics results.

Research collaboration. Research in AAHL involved collaboration between research

scientists on both sides of the main containment barrier and microscopy and diagnostics

scientists in PC3. Research scientists in the general office area needed to understand the

results of the tests conducted inside PC3 to modify their research directions or methods.

In turn, the results of this work would guide scientists inside PC3 to adjust their test

settings. For example, the research scientists in the general office area worked on new

tests for viruses or new drugs at a RNA molecular level. They needed results from

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scientists in PC3 including microscopy results to see drug effects in cells and animals

and diagnostics results to identify a virus or to see the effect of drug treatment. They

also worked closely with research scientists in PC3 for genetic sequence data in cell

engineering and animal model studies. At times they needed to go into PC3 to observe

data that needed to be viewed in real-time and in situ, such as fresh sequencing gel

images, and to work with scientists in PC3 to build shared understandings of the

meaning of the results.

Microscopy collaboration. Microscopy scientists interacted with diagnostics and

research groups in two processes that often took place in parallel: communicating

microscopy results to related groups and understanding other groups’ data to make

appropriate decisions on microscopy diagnosis. There were also situations when

microscopy scientists in PC3 needed to consult the microscopy group leader who

sometimes worked in the general office area. Data involved in the microscopy

collaborations could be microscopy diagnostics results and saved digital and scanned

images. There were also discussions of images from fresh sample slides under a

microscope when the microscope scientists had particular findings of interest to share,

or needed input from others, based on the fresh samples. By sitting together to discuss

real-time microscopy images, microscopy scientists could move the slide to show areas-

of-interest, receive other scientists’ feedback to make adjustments before recording the

digital image and effectively decide on further investigation of the sample.

6.6.2 Collaboration Issues

Scientists on different sides of the main containment barrier used telephones for quick

discussions and email for sharing data via attachments (Figure 6.4). Face-to-face

meetings had been the usual means for communication and sharing information. This

required staff to spend time and effort going through security procedures to cross the

containment barriers. To avoid multiple “change-in” and “shower-out” and the resulting

interruptions to workflow, organised group meetings were regularly held in the general

office area, either early in the morning or late in the afternoon, that is before or after

staff worked in the containment areas.

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Figure 6.4. Communication and information sharing between work groups

The effort required to cross the barriers affected the ways that these scientists were able

to discuss the details of the data effectively. For the diagnostics collaboration the issue

of concern was the capacity for real-time interaction and data sharing between the

diagnostics management team, diagnostics scientists and microscopy scientists. This

was critical to AAHL's delivery of timely diagnostics tests to identify and characterise

infectious agents, particularly during an emergency animal disease outbreak. Another

particular concern was that the discussions around real-time laboratory data such as

fresh sample images under a microscope could be especially difficult when the

microscopy group leader or other related scientists in the general office area were not

able to go inside PC3 in time.

While the containment barriers posed physical constraints on collaboration, these were

further complicated by the need to share information, in the form of test results and

other kinds of data produced by and used in the work of AAHL, between different

groups. That is, there were collaboration difficulties caused by the physical separation

and access to shared data that impacted access to other scientists and to the work of the

presentation and shared interpretation of the data. Data from different workgroups, on

both sides of the containment barrier, needed to be shared to coordinate the different

work practices and processes and to ensure timely progress in each group’s activities.

The three core capabilities that Finholt and Olson (1997) identified as being necessary

for supporting scientific collaborations, namely, access to others, to information and to

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facilities, also apply within the work of AAHL. Findings from this study showed that

support for the sharing of data and its analysis would greatly facilitate not only quick

diagnostics and similar tasks but also the general and ongoing collaboration between the

work groups. These issues are explored in more detail in the following section.

6.6.3 Information Sharing Issues

The field study identified a number of issues with information sharing practices

including: shared data repositories, shared visualisations, accessing remote computing

resources, accessing real-time scientific images and the particular challenges of working

in PC4. The first three were issues related to the difficulties of sharing information

between groups and in their group discussions. The last two were mainly caused by the

containment barriers.

Shared data repositories. Each work group had its own data repositories which could

usually be accessed only by group members. For example, microscopy images were

stored in databases which could only be accessed by the microscopy team members.

There were necessary data access security rules and configurations for each repository.

As described in section 6.6.1, there was a shared Lab Information Management System

(LIMS) for text-based diagnostics results. Staff could also log on to the intranet to

access web-based animal monitoring data, such as animal video from the large animal

facility and animal physiologic information from telemetry monitoring facilities in PC3.

However these common shared repositories did not include a range of other data

involved in various intergroup discussions or meetings, such as microscopy images or

image results from sequencing gel.

Even when a common repository, such as LIMS was available, some results could be

difficult to understand by other work group members if explanations were not provided

with them. One of the diagnostics scientists commented:

“Our results are entered in and then that is available to anyone … If there are

any contentious results, it is very difficult for LIMS to describe them because the

duty veterinary officer only sees the yes or no, positive or some sort of value. If

there is any question, that cannot be recorded in LIMS, where in our hand-

written and notes sheets – the results can be recorded.”

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Shared visualizations. Documents were sometimes exchanged by email and then

discussed by telephone across the main containment barrier. In face-to-face meetings

people usually brought printouts of related documents. Similar to the findings of the

MDTM study, there were issues with communication breakdown when participants

could not see a common representation of a relevant file, particularly when images and

graphs were involved (Robertson et al. 2010). Group discussions also often required

simultaneous viewing of multiple documents.

Accessing remote computing resources. Even when scientists met in face-to-face

meetings and brought documents with them, there were still situations when they

required access to data that were not readily accessible on a data server, for example the

data being processed on individual computers or instrumental computers. One of the

research scientists commented:

“Generally we just bring paper notes and a pen and sit and talk. A lot of time it

was not a major problem, but quite often in the middle of something someone

says: ‘Oh I saw that happen when I was doing that.’ ‘Oh what did it look like?’

‘‘I got that image here somewhere.’ ”

Accessing real-time scientific data. Microscopy scientists in the general office area,

such as the leader of the microscopy group, could access their databases for stored

microscopy images during discussions with microscopy team members working in PC3.

However, at times there was a need for scientists to look together at real-time scientific

images from fresh samples or results from fresh samples. This was not always possible

as all those involved needed to coordinate their on-going work in order to meet in PC3

at the right time.

PC4 work. For scientists working in PC4 it was particularly difficult to share data in

real-time with scientists outside PC4 (in either the general office area or in PC3). There

was a major challenge to enable scientists wearing fully encapsulated suits within PC4

to effectively communicate and share information with their colleagues outside PC4.

This challenge was very specific to the biosecurity work of AAHL and of a higher order

to those facing other parts of the laboratory.

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6.7 Informing the Design

The study identified three broad collaboration requirements that needed to be met within

AAHL: general group discussion, specialized real-time scientific data discussion, and

collaborative work in PC4. The first requirement was to enable a group of scientists in

PC3 to communicate and share data with a group of scientists in the general office area.

The second was to support collaboration during real-time consultation of scientific data,

such as microscope images and those that needed to be viewed ‘in situ’ and in real-time.

The third was to support scientists working in PC4 to share their information with

scientists outside PC4. While the first was relatively common to scientific meetings

between distributed groups, the second and third were specific requirements for

collaboration within the local setting of AAHL because of the work it did and the

physical setting in which the work was done.

These three requirements were mapped to three ‘scenarios’ of cooperative work. Figure

6.5 maps the three scenarios to the collaboration within AAHL.

Figure 6.5. Three design scenarios to drive the design of the collaboration platform

These scenarios drove the iterative design and development of the collaboration

platform. The final platform was designed to consist of components to support these

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three scenarios. Each scenario was to be addressed in a distinct design stage of the

technology development. The design for the first scenario, which was the major

component of the collaboration platform, had been developed and implemented during

my involvement in the project.

The ultimate goal of the design was to enable information from various data resources

(e.g. microscopes) and work areas (e.g. PC4) to be shared and discussed by individual

scientists or groups of scientists who were on different sides of the barriers. The

proposed solution was to use integrated communication and shared digital workspaces

over the AAHL network for various collaboration needs.

6.7.1 Scenario One: General Group Discussion

This scenario supports two groups of scientists to share information and access to a

range of data resources in their distributed group meetings across the main containment

barrier. As already described, face-to-face group meetings within AAHL were used as a

solution for physical separation. However even in the face-to-face meetings,

collaboration issues still existed given the complexity of information sharing.

Information sharing activities involved in the group discussion include accessing data,

shared visualization for meeting participants and the needs for seeing multiple resources

and interacting with them. Support was needed for flexible visualization beyond just

the sequential presentation of pre-prepared single documents.

Two shared workspaces to support distributed group meetings were introduced as the

first stage of the implementation, one in PC3 and another in the general office area

(Figure 6.6). The design of the shared workspaces was adapted from our prior work on

the Blended Interaction Spaces prototype and incorporated technical solutions for the

deployment at AAHL. Each workspace was connected to the AAHL network. Meeting

participants can access various data resources, such as animal physiologic monitoring

information from the large animal facility in the PC3 area, LIMS and desktops of

specific microscope computers which run microscope applications. Different group

members could access their data resources using their existing access credentials.

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Figure 6.6. Shared workspace at the general office area in AAHL

AAHL management decided that this shared workspace was to be a shared facility for

the different workgroups. One shared workspace was located in a small common

meeting room in the general office area and another was in a large common meeting

room close to the canteen in PC3. Similar to the different local meetings in the MDTM

study, different group meetings in AAHL had different settings in terms of the number

of participants, the purpose of the meeting, the ways of presenting information and

interaction activities (e.g. verbal communication or interacting with digital information).

The shared workspace needed to provide not only common functionalities for different

group meetings but also flexibility for these variations. According to the interview

participants, each workspace needed to cater for up to four participants.

Each shared workspace had high-resolution, large displays so that multiple digital

information and remote participants could be displayed and clearly seen by a group of

participants. Enabling this shared visualisation in a multi-display environment and over

the network supported simultaneous viewing of multiple data resources and

synchronous interaction with the shared applications. Also the displays and high quality

video cameras which were placed in their designed positions enabled nearly ‘life-size’

video-conferencing communication between the two distributed groups. Design details

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of the physical setup and the feature of integrated video-conferencing space and shared

digital workspace are described below.

The design considerations included the physical setting of the shared workspace, the

size and position of the displays and the position of the cameras. The platform consisted

of four 42 inch diagonal Liquid Crystal Displays (LCD) units, each with a pixel space of

1920x1080. The table in front of the display was long enough to accommodate up to

four participants (see Figure 6.7). The table also allowed participants to bring laptops

and all sorts of artefacts, such as pen and paper, to the meetings. To avoid

uncomfortable viewing angles for the top displays we decided to lower all the displays

as much as possible and to tilt the top displays (see Figure 6.7).

Bottom displays

Camera position

Table

Head position

Top displays

Figure 6.7. Side view of the physical setting of the shared workspace

The bottom two displays were lowered to the height of 60 cm after tests. Based on the

technical specification of optimal viewing distance of the displays, the display panels

were placed 1.25 m away from the table. This gap between the edge of the table and the

bottom displays made sure that all the participants sitting at the table can easily oversee

the whole display space. A keyboard and three mouse input devices were provided on

the table. Each site had two High Definition (HD) cameras which captured the

participants sitting in from of the displays. The cameras were mounted in the 10cm gap

between the two rows of displays and were positioned to allow good eye contact for

participants. The two HD cameras created a near life-size video of remote participants

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and were arranged to maintain spatial continuity of the two (left and right) video

images. Each site had two microphones positioned on the table and connected to one of

the two video conferencing units.

Appropriate integration of video-conferencing space and shared digital workspace was

one of the key design considerations of the shared workspace. The study showed that

participants needed to be able to make adjustments to the information spaces on the

displays as well as their view of their separated colleagues so they could tailor the

workspace to the demands of particular activities of the meetings. For example, the

participants were able to use all of the display space for multiple data visualization

when focusing on data sharing, or use some of the space to show life-size, high-

definition video of remote participants when the conversation was less data-focused.

There were three remote video display modes, “full view”, “picture-in-picture”, and

“hide” mode. In the “full” mode, the entire two bottom displays were used to show the

remote site. In “picture-in-picture” mode, the video of the remote site was reduced to

25% (compared to full mode) and positioned on the top displays and in the middle at the

lower edge of the top displays. In the “hide” mode no remote video image was

displayed and audio communicate remained on.

6.7.2 Scenario Two: Real-time Scientific Data Discussion

This scenario specifically supports individual scientists sitting in front of their

workstations in PC3 to share real-time scientific information from their instruments

with staff working outside. For example, a microscopy scientist working on sample

slides in PC3 could share images from the microscope computer screens with the

microscopy specialist or research scientists in the general office area. Individual

scientists sitting at their personal computer or a group of scientists at the shared

workspace on the other side of the containment barrier can interact with the shared

microscopy images and the associated application windows. They can see and talk to

the scientist in PC3 while looking at the image of the current microscope slide. The

advanced electron microscopes are specific and expensive instruments. The hardware

and software interfaces to the microscope computers need to be carefully assessed

during the design phase to minimize the interference with microscopy work. Therefore,

these instrument computers are solely set up to share their desktops to the shared

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workspace rather than being used to display the contents of the shared workspaces. Such

use would compromise the operation of these dedicated workstations. Also suitable

solutions to integrate audio-video communications between individuals or individual

and multiple scientists need to be addressed to support this scientific data discussion in

addition to the real-time image sharing.

At the time of the first stage of the development, scientists in PC3 were able to share

their microscope images to the shared workspace outside the containment area.

However an integrated audio-video solution was not ready and a normal telephone was

used to facilitate verbal communications between the scientists in the two areas.

6.7.3 Scenario Three: Collaborative PC4 Work

The ability to enable real-time sharing of various data types would greatly facilitate PC4

work. The higher level containment constraints have a practical impact on any potential

technology especially the selection and installation of appropriate hardware. A new PC4

facility was planned at AAHL when we implemented the shared workspace. The design

of the collaborative PC4 work has been part of the overall new PC4 design process. The

ultimate goal has been to allow data from PC4, such as live microscopy images, to be

shared to scientists working in PC3 or the general office area.

The construction of the new PC4 suite was completed eighteen months after the first

phase which was the installation of the shared workspace. I will use information shown

on the AAHL website (CSIRO) to briefly describe the collaborative PC4 work at the

time of writing this thesis. The PC4 suite provides state-of-art technology and

infrastructure, including the bioimaging facility and a specialist microscopy service, for

diagnostics and research of infectious diseases that require the highest level of

biosecurity. The control room next to the PC4 area is a PC3 area and has multiple large

glass windows to allow scientists in PC3 to see the PC4 working area (Figure 6.8). PC4

scientists wear headsets for communications with scientists in other areas. Multiple

room cameras capture the room views of PC4. Figure 6.8 shows that two expert

scientists in the control room sit in front of multiple computer screens which show the

microscope images and other data that the scientists in PC4 are working on.

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Figure 6.8. Collaboration between scientists in PC4 and scientists in the control room in PC3

6.8 Post-deployment User Study

The aim of the study was to understand the initial implementation of the shared

workspace and provide feedback to the design team for potential improvements. It was

conducted by me over one week. A questionnaire and semi-structured interview

methods were used. Twenty staff from diagnostics, research and microscopy groups

took part in the study. This was around 50% of the total number of regular or potential

platform users. These participants were identified as staff who had used the shared

workspace during the first two months of training sessions and at the beginning of the

implementation. Fifteen of them completed the questionnaire and another five

participants from three different work groups were interviewed.

The questionnaire focused on general usage of the platform and participants’

experiences with the platform. It consisted of ten questions including two open-ended

questions which asked about any problems they had and for any suggestions for

changes. Questionnaire results were analysed by using Excel software. Results of the

open-ended questions were categorized. The aim of the interviews was to explore the

questions in the questionnaires to have a deeper understanding of participants’

experience, particularly how they felt about the design of the platform. These interviews

were conducted in the meeting room outside the containment areas. Interviews were

transcribed and categorized according to the interview structure. The results of this

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study have helped to verify and reflect on some of the design considerations and have

led to a number of modifications of the platform. Some of the findings are presented

below.

The usage The analysis of the questionnaires revealed that usually during the meetings

there were 3 to 4 users at each side. The meetings lasted around 50 minutes. Half of the

meetings were planned regular group meetings, such as diagnostics group meetings, and

some were ad-hoc and for a special purpose, such as management meetings.

Distributed group meeting Since the shared workspace was designed to support group

meetings, we were interested to understand how the distributed group meetings

compared with the face-to-face group meetings before the use of the platform. The

ability to access, share and interact with multiple data resources and high quality audio

and video have been highlighted by the study participants. One research scientist

commented:

“Large space to work in and large presence of the people you are working with.

The ability to multi-session so that you can real-time access to all the data you

need to discuss. Often when running a standard video conference it is difficult to

see the data in PowerPoint and if you realise that a different set of graphs or

other image files etc would be valuable, they are not there. With this system they

are! This is a must for all groups that use videoconferencing on a regular basis.”

I asked about the usefulness and helpfulness of the platform compared to face-to-face

meetings on a five-point scale rating question (1: much worse, 3: the same, and 5: much

better). Interestingly, 6 out of 20 participants reported that the distributed meeting was

the same as the face-to-face meeting and 6 out of 20 participants felt that it was better

than the face-to-face meeting. The participants explained that this was because of the

availability of various data resources and shared interactions of the visual information. 8

out of 20 participants felt that the distributed meeting was worse than the face-to-face

meeting. From the explanations of these participants this could be interpreted as that

face-to-face was necessary for better engagement with people and some of them had

been used to getting in/out of the containment area. A complete understanding of the

benefits of this platform would require a longer period of time of implementation to

allow the platform to be integrated into the practices at AAHL.

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Flexible configuration The study findings showed that 8 out of 20 participants reported

that the choice of display mode depended on the situation during the meeting. It was

also interesting to see this difference across different work groups. Full screen mode

was more popular than the small mode in the diagnostics groups while this was the

opposite in the microscopy group. These findings supported the design consideration of

enabling different group and different type of interaction processes (e.g. conversational

meetings or data-centred meetings) and the provision of a flexible configuration of

display spaces.

Modifications There were technical issues reported when the participants answered the

question of “what do you not like about the collaboration platform, suggestions?” Some

of these issues were due to the limitation of the platform and some of them were related

to users’ familiarity with the platform. Based on the feedback received the design team

has added several features to the shared workspace. For example being able to work on

documents on a private workspace before sharing them on the displays was mentioned

as an area for improvement by some of the staff who used shared workspace from

outside the containment area. This was similar to the findings in the CCEAD study that

participants needed a private workspace for reading or editing documents at their own

paces or for multi-tasking during the meeting. As a result, an additional laptop linked to

the platform has been provided for this purpose in the room outside the containment

area. Participants were able to work on the data on the laptop before sharing it to the

common displays.

6.9 Discussion

The study identified physical constraints posed by the containment barriers that are very

similar to those faced by people who need, for example, to cross town or otherwise

expend extra effort in order to collaborate with people who were separated by physical

distance. The study also identified issues with information sharing that relied on

standard communication methods (e.g. email, telephone and face-to-face meetings) for

supporting the coordinative process. These were similar to those faced in settings where

collaboration involved developing shared understandings of various data. However,

while these issues might be partly common to other distributed groups, their particular

expression within the work in AAHL was also shaped by the specific biosecurity

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requirements of the setting - the actual work done by AAHL and the actual physical

containment that it entailed.

The use of collaboration technology within AAHL was proposed as a way to reduce the

complexity of coordinating distributed activities in collaborative diagnostics and

research work and to improve the sharing of various data including real-time data from

instruments. Different local practices and arrangements need to be considered in the

overall design solution to support the complex scientific collaboration that defines the

work of AAHL. Similar to the MDTM study and CCEAD study, this case study

contributes to my overall exploration in supporting collaboration across different local

settings. It allows me to further investigate the major issues of interest in my thesis,

including the needs for supporting coordinative practices (e.g. Schmidt & Simons 1996,

information sharing (e.g. Banon & Bodker 1997) and different local practices (e.g.

Schmidt et al. 2007).

6.9.1 Supporting Coordinative Practices

The findings of the field study demonstrated the importance of collaboration in this

environment and how collaboration within AAHL was affected not only by the physical

containment barriers but also the challenges of sharing information between different

groups. The collaboration was within the same organization where standard guidelines

and procedures were shared across the barriers. However, the partly distributed nature

of the collaboration was a requirement for the work groups involved given their specific

local practices in each work area. The work groups inside and outside of the

containment barrier were closely interlinked in the processes required to accomplish

their work. The diagnostics and research work requires multiple groups to perform a

range of tests and investigations and to communicate about complex data sources before

providing an evidence-based diagnostics report for external clients or for making

decisions about research directions. The completion of the task was more than a

workflow-type of process. It was coordinative practice of data analysis with a mutually-

shared goal and took place in the particular socio-technical context within AAHL.

Scientists involved needed to understand each others’ work and how their own work

related to the overall diagnostics or research data context, such as, applications,

experiments and reports.

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The aim of the collaboration platform is to support the inter-communication between

scientists so scientists from different groups could build a common understanding,

articulate their work and perform cooperative work. It requires the technology to

enhance existing coordination practices and not to interrupt existing dynamics of

information exchange. The collaboration in AAHL involved different individuals and

groups who worked on different sides of the barriers and had different work

responsibilities and information requirements. Data in this situation supported a set of

interrelated diagnostics and research practices and coordinated the articulations of

distributed activities in different groups. The breakdowns of coordinative practices

found in this particular environment were not only caused by the containment barrier,

but also the lack of support for the process of sharing understanding between work

groups involved, which was the centre of the collaboration. The shared workspace

needed to be used across different work groups, to support their specific work practices

and comply with their existing data requirements, computer resources and data security

configurations.

6.9.2 Linking People with People, Information and Facilities

The priority of improving information sharing was not so much to support a shared data

repository but rather to develop technologies to support collaboration during the

analysis and interpretation process of data. These data were in various existing

repositories with different access requirements that were required by the work of

AAHL. This implies that there were two broad requirements for providing successful

technology support for collaboration in AAHL. One broad requirement was access to

“distributed” shared workspaces on each side of the containment barriers, so that staff

did not need to cross the barrier to communicate and collaborate with each other. The

second was support for the availability of data, including evolving experimental results,

for shared viewing and analysis between individuals and workgroups, irrespective of

where they were.

The two shared workspaces helped to meet the first requirement. The multiple-display

environment supported nearly life-size video-conferencing and the sharing of relevant

information to allow scientists to collaborate in real-time across the containment barrier

between the general office area and PC3. Synchronous interactive application sharing

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allowed flexible working patterns beyond just the sequential presentation of single

documents. However the shared workspace in itself will not solve all the information

sharing requirements. To address the second requirement, it would require real-time

access to a range of material objects and digital resources that are critical for the

accomplishment of particular activities in diagnostics and research. Linking people with

instruments and facilities is one of the core capabilities for technology to support the

collaboration in AAHL, particularly for the role it plays in sharing real-time information

results, such as “live” images directly from instrument workstations, and in supporting

PC4 work.

6.9.3 Designing for Different Local Requirements

The study has provided insights into the design of collaboration systems in a workplace

where various collaboration situations existed. Customizing the design to just one of

these situations was not enough. Flexible configurations for different interaction

requirements were made at the level of the shared workspace. The shared workspace

was built on our prior work of BISi which is a collaborative workspace prototype

paying particular attention to spatial arrangements to support small group discussion.

Different discussion meetings could vary in terms of factors such as group size, purpose

and pattern of interactions (e.g. verbal communication or interacting with data or

instrument computer). A collaborative workspace for distributed collaboration in the

AAHL needs to provide flexible support for various types of interactions, ranging from

conversations to data-centered activities, from interaction between individuals to group

meetings, from discussions of stored data to discussions of specimens currently under a

microscope. These different interactions have implications for the physical setting of the

collaborative workspace, the user interface design, the configuration of the view of

remote participants and the information spaces on the displays.

Importantly, the study has demonstrated that a generic collaboration platform can be

extended by capabilities developed in response to the specific requirements of the work

of the local setting. The shared workspace, appropriately configured, could be a

generalisable solution for distributed group meetings. Configuration was also needed to

support different types of collaborations in the design of the overall platform. As

reviewed in Chapter 2, Schmidt et al. (2007) identified two categorically different

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relationships between studies of work practice and the technology design these might

inform. The first are work practice studies of specific settings for the purpose of

developing specific technologies for that setting and the second are studies for the

purpose of building generic technologies that can be combined and re-combined in

different settings. The study was planned to be the first kind. However by including the

discussion of how the findings of the study actually informed the design process the

study showed how the actual technologies developed can be hybrids. While the first

phase of the design addressed the more generic requirements of information sharing and

collaboration ‘over distance’, the second and the third stages focused on the local

requirements that were caused by the very specific work at AAHL. The integrated

platform, including real-time scientific data discussion and real-time collaborative PC4

work, could support the variety of collaborative work at AAHL.

6.10 Conclusion

Through the work presented in this chapter I have been able to explore the collaborative

practices, particularly information sharing, in scientific collaborations between different

groups and over the “distance” of physical containment barriers in a biosecurity

laboratory. I have described how the findings from the field study informed the multi-

stage design and development approach, how this approach was organised and used. We

have seen that the local requirements of specific real-time scientific data discussion,

collaborative PC4 work and the appropriate integration of these design components

have been addressed to meet the challenges of collaborative scientific work in AAHL.

The results of the study contribute to the design of the collaboration platform which not

only could resolve common communication issues over distance but also support those

that arose out of the specific setting of AAHL.

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7 Issues and Design Guidelines

Through a series of case studies, this research provides insights into how to design

collaborative workspaces to support collaboration in complex work settings. Design

implications for supporting MDTMs across different hospital settings and implications

for supporting CCEAD’s distributed meetings have been discussed. The results of the

AAHL study have been used to inform the design of an integrated collaboration

platform implemented in the challenging work environment of AAHL. This research

has demonstrated that the design of a collaborative workspace needs to attend to the

careful arrangement of physical space, the appropriate integration of physical space and

information sharing functionalities, and the variations within local practices to support

distributed collaboration across different local settings.

This chapter reflects on the insights from the three case studies guided by the two

groups of research questions. This reflection leads to the following synthesized results

and contributions of this thesis:

A set of interrelated socio-technical factors that shape distributed collaborations

across complex work settings

A generalized set of guidelines for designing a collaborative workspace to

support collaboration across different local settings

7.1 Understanding Distributed Collaboration in Context

The first group of research questions is:

What special characteristics of interaction do collaborative workspaces need to support

in complex work settings? What are the socio-technical factors that shape the dynamics

of the distributed collaborations across different local settings?

By examining collaboration in MDTMs, the CCEAD meetings and the AAHL, I have

developed an understanding of distributed collaboration in these particular work

settings. I have incorporated the social, spatial and communicative dimensions of

interaction in media space (e.g. Bly et al. 1993, Harrison 2009) into the analysis of the

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fundamental requirements of collaborative workspace. Particular attention has been

given to social interaction, focusing on shared awareness and context, negotiation and

coordination (e.g. Aoki & Tang 2009), and communicative interaction, focusing on real-

time access to information and interaction with information (e.g. Luff et al. 2009). I

have investigated the collaboration issues in three work domains, including distributed

medical discussions of complicated patient cases (e.g. Kane & Luz 2006, 2008, 2013,

Kane & Groth 2014), large-scale team meetings to coordinate emergency responses to

animal disease (e.g. Kristensen & Kyng 2009, Pipek et al. 2014) and real-time scientific

collaboration in a complex and challenging work environment (e.g. Finholt & Olson

1997, Jirotka et al. 2013). The case studies presented in this thesis extend related work

in these domains by exploring a range of issues related to variations in local practices

and the effects of asymmetrical distributed settings on collaboration.

7.1.1 Summary of Findings

The findings relating to socio-technical issues in each study are summarized below.

MDTM study. The MDTM study shows how factors such as room size, team size,

seating arrangement and display configuration impact on participants’ engagement in

conversation and information sharing. Importantly, it highlights that the distributed

MDTM is embedded within and shaped by local settings which have not only different

physical settings for the meetings but also different practices for the preparation and

sharing of medical information. The study shows that the different social, organizational

and technology aspects of each local meeting have their own local histories, processes

and practices that have been developed to address the local context. These local

variations contributed to the particular challenges of the distributed MDTM as

experienced by the participants.

CCEAD study. The study of CCEAD meetings identifies factors such as the time

pressure of the task, the diversity of the participants and asymmetries between local

settings and how these influence information sharing and consensus building in

distributed meetings. It shows that technical solutions across multiple locations and

institutions need to consider the asymmetries between these settings, including the

different size and structure of individual teams; the differences in the roles and

engagement of participants and local constraints on the potential introduction of

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collaboration technologies. In particular, collaborations across large-scale settings can

involve a set of concerns that impact not just the technology design but broader inter-

organizational coordination. The study shows that that while technology can play a role

in facilitating consensus building, solutions to supporting distributed collaboration are

not simply technical. The introduction of agreement plans helped to mitigate some of

the concerns underlying vested interests of the members.

AAHL study. The AAHL study reveals that the “distributed” nature of the interactions

not only relate to the challenges caused by the physical setting, characterised by the

containment barriers, but also to the need for collaboration support between the

scientists and their work groups. Coordinating distributed activities in collaborative

diagnostics and research work in AAHL is complex. Different local practices are

characterized by the particular discipline of a work group, the effects of the containment

barriers on the work environment and what particular form of scientific data and

instruments the scientists work with. While the general principles of supporting

scientific collaboration are to link people with people, link people with information and

link people with facilities (Finholt & Olson 1997), the local requirements of specific

real-time scientific data discussion and collaborative work across the physical

containment barriers need to be addressed to meet the challenges of scientific

collaboration in AAHL.

7.1.2 Common Issues

Each study uncovers a tangle of social, procedural and organizational factors that shape

distributed collaborations in particular complex settings. These factors affect individual

and team interaction in video-mediated communication, social cohesion and decision-

making and analysis practices during the distributed meetings. A significant finding is

how variations in local practices and arrangements of local resources impact on

interaction in distributed collaboration. Local practices within organizational and

environment settings are often developed to suit particular local conditions.

The key issues that are common to the three studies include:

how information is prepared in different teams before the collaboration meetings

and issues of sharing information during meetings

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the physical setup of the meeting room and environment, and how the

constraints imposed by different local physical settings impact on the

collaboration

the size and structure of teams and the organizational contexts, and the

coordination work required for different teams and organizations to work

together

These issues are complex and interrelated. They form a matrix to influence the

interactions in the collaborations across different local settings. I broadly structure these

issues into three categories: physical space, information space, and practices and

organization. Figure 7.1 illustrates how these issues relate to each other in two local

settings and also across the two settings in distributed collaboration.

Figure 7.1. Complex and interrelated issues in distributed collaboration across two different local settings

The two local settings have their own versions of “physical space”, “information space”

and “practice and organization”. I use the term “physical space” to refer to the issues

related to physical settings and the term information space to refer to the issues in

information sharing. The issues of physical space relate to how the spatiality of the

setting is configured and how it shapes people’s social experience and interactivity. The

issues of “information space” here relate to the ways in which particular artefacts

become entangled in the practice of people’s work, physical settings and the

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mechanisms people develop to address constraints to achieve the sharing of the

artefacts. The “practice and organization” issues relate to the organizational context, the

nature of the work practices, the environment, individuals’ and teams’ particular

approaches to work, their working relationships and existing technology uses.

As illustrated in Figure 7.1, information sharing is the centre of collaboration.

Information space sits in the middle of the interactions across the boundary of different

settings. The information sharing in the three case studies is a process of constructing

common information spaces. The process includes analysing information and

interacting with other team members before the meetings, preparing the presentation of

information before the meetings and the discussions of various information resources

during the meetings (Bannon & Bødker 1997). Collaboration technology enables a

shared understanding of information to be achieved when distributed individuals or

teams are connected and join together (Bossen 2002). Difficulties in information space

can be caused by the complexity of the information itself but also the context of

different teams and different organizations. While collaboration technologies can

support real-time information sharing during the meetings, coordination work also plays

a role in supporting the collaboration across different organization, work areas and

teams (Schmidt & Simon 1996, Abraham & Reddy 2013).

An “information space” is closely interrelated to local “physical space” and

“organization and practices” as illustrated in 7.1. Factors relating to local physical

settings and organizational context shape the particular local information practices as

we have seen in the case studies. The case studies have found that different teams

working at different organizations and work areas have different information

requirements and divisions of work.

Importantly, Figure 7.1 illustrates how distributed collaboration is embedded within and

shaped by two (or more) local settings. The work practices, physical setup and

information sharing practices of each local setting are originally developed to suit

particular local conditions. Interaction problems emerge when the two (or more)

different settings are joined together by collaboration technologies. Differences in local

practices and procedures as well as local arrangement of physical spaces and

information spaces can join together to impact on the effectiveness of distributed

collaboration across the settings. The two local settings cannot simply be treated as two

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isolated settings for technology intervention (Ellingson & Monteiro 2006). Standardized

collaboration technology that fits one site may not suit the other site (Monteiro et al.

2013). Understanding the variations needs to recognize where they have come from and

why they are there (Balka et al. 2008). This research considers distributed collaboration

as a setting that builds on existing local settings and is shaped by various embedded

processes, practices and information technologies of the local settings. This poses

particular challenges for the design of collaborative workspace that can work across

different local settings.

7.2 Guidelines for Designing Collaborative Workspace

The second group of questions is:

What principles and guidelines might support the design of collaborative workspaces

for complex work settings? How can collaborative workspaces be configured to support

distributed collaborations across different local settings?

Each case study identifies issues of collaboration and articulates their implications for

technology design to support distributed collaborations between different individuals

and teams in their particular information sharing practices. Reflections on these

implications and the complex and interrelated issues discussed in 7.1.2 suggest the value

of a set of design guidelines that can orient designers to these issues within specific

design situation. These guidelines are:

1. Focusing on supporting information sharing which is the centre of the

collaborations in complex work practices

2. Constructing physical space to support social and communicative interactions

3. Configuring physical space and information space to support integrated

communication and information sharing

4. Configuring collaborative workspace to enable local practices

5. Configuring collaborative workspace in the broader organizational and

procedural arenas

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The first two guidelines address the fundamental elements of constructing collaborative

workspace and will be described in sections 7.2.1 and 7.2.2. Guideline 1 relates to

supporting information sharing and guideline 2 relates to constructing physical setup of

audio-video devices and physical layout. Although these guidelines confirm the generic

design requirements for most of the collaboration technologies (e.g. Luff et al. 2009,

2013, Buxton 2009), they are discussed from the context of complex work practices and

the context of designing collaborative workspace.

The other three guidelines relate to the configuration of collaborative workspaces and

work practices and will be described in sections 7.2.3, 7.2.4 and 7.2.5. They can be

considered as three levels of configuration work that is required to achieve the optimal

assembly of information sharing, physical space and work practices in the design and

development of collaborative workspaces that can be used across different local

settings. Guideline 3, the first level of configuration, addresses the design requirement

of appropriate integration of physical space and information space to support the

coordination, awareness and collaborative sense-making process. Guideline 4, the

second level of configuration, focuses on how the design can enable rather than

constrain a local context. It is concerned with the strategy of providing flexible solutions

to adapt to different environments and practices. Guideline 5, the third level of

configuration, acknowledges the context of different teams and different organizations

as well as the coordination required to achieve coherent collaboration when used in a

collaborative workspace. As reviewed in Chapter 2, some conceptual tools, such as

social arena (Gartner & Wagner 1996), configurability (Binder et al. 2004) and

configuration categories (Balka & Wagner 2006, Balka et al. 2008), have been

introduced to support discussions about technology solutions and their impacts in

different local practices. This research leverages on these concepts and draws on three

levels of configuration work as a mechanism to address the challenges of designing

collaborative workspace across different local settings.

Figure 7.2 shows how these guidelines map to and reflect the interrelated issues

presented in Section 7.1.2. A note here is that these guidelines are not strict rules, but

rather high level guidelines. They are not totally separated steps. Figure 7.2 shows how

each element is interlinked with the others: constructing physical space needs to

consider the need of integration of information space; the integration of physical space

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and information space aims to fit the design into particular local settings; and the design

at local practice level needs to consider the design of the other site in order to allow

smooth collaboration across the different settings.

Figure 7.2. Mapping the five guidelines to the factors that shape distributed collaboration in particular local settings

(Guidelines: 1. Focusing on supporting information sharing; 2. Constructing physical space; 3. Configuring

physical space and information space; 4. Configuring collaborative workspace to enable local practices; 5.

Configuring collaborative workspace in the broader organizational and procedural arenas)

7.2.1 Guideline 1: Focusing on Supporting Information Sharing

As described in section 7.1, the information space sits in the middle of the collaboration.

I have discussed the design requirements that need to be taken into consideration in

supporting information sharing and interaction with information in the three case studies.

Two key requirements are presented here. One is to support the functionality of access

and visualization of a range of complex information. The other is to support the

interaction with information, concerning different activities, roles and reference needs.

Supporting real-time access and visualization of complex information

A collaborative workspace needs to support real-time access to a wide variety of

information sources involved in the collaboration. The case studies in complex work

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settings have found the following forms of information sharing requirements that

contribute to the complexity of collaboration practice:

Shared visualization of scientific images, medical images and maps that may

require high resolution and high definition systems to show details on these

images

Real-time access to data that is being processed in scientific instruments and

facilities so a better understanding of the data can be supported when data is

contextualized with background information of experiment setup and conditions

Integration of data resources from personal computing devices, such as laptops,

as shown in the CCEAD study and implemented in the collaboration platform in

AAHL.

Collaborative workspaces also need to support the simultaneous display of multiple

information resources. Given the complexity of the information involved in

collaboration, it is important to support the concurrent visualization of different

information at the same time. One of the advantages of multi-display environments is

that they allow simultaneous visualization of multiple information resources so

transitions between information being discussed can be reduced and efficiency can be

improved.

Supporting the needs of interacting with information

Real-time shared interactions across different sites need to be supported, especially

when discussing medical images, maps and graphic information. As shown in the three

case studies, participants can come from different disciplines and play different roles in

the collaboration. They perform different activities and have different interaction needs

during the distributed meetings. Some key participants need to interact with the

information directly, while non-key participants, who often act as observers, generally

do not have formal requirements to interact with the information. For example, in

MDTMs that I have studied, the radiologists and pathologists are the key participants

interacting with images during the meeting. Similarly, in the CCEAD meeting,

participants presenting information need to control the mouse and keyboard while the

chair of the meeting, who is active in the discussions, and the secretary, who takes

notes, may not need to interact directly with the information being displayed.

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The case studies also support the recognition that participants need to synchronize their

interactions with information across the distributed sites, particularly through their

referencing gestures (Robertson 1997, Luff et al. 2003). For a small group meeting

supported by the shared workspace installed at AAHL, shared interaction, by all the

participants sitting in front of the appropriate geometrically configured table and

displays, can be easily facilitated by using the keyboard and mouse on the table.

Interacting with information in a large meeting room setting is challenging for

peripheral participants, as we have seen in the distributed meetings in the MDTM study

and CCEAD study. Pointing issues are also relevant to the physical space requirements

for different participants. This will be further discussed in the following section.

7.2.2 Guideline 2: Constructing Physical Space to Support Social and Communicative Interactions

As reviewed in Chapter 2, researchers have identified design principles for constructing

a physical space to support spatiality and interactivity and to transform people’s

experience in the collaboration (e.g. Luff et al. 2003, Buxton et al. 2009, Henderson

2009, Paay et al. 2011, Stevenson 2011). My findings are consistent with the best

practice design principles in the literature. In the MDTM study and CCEAD study, I

examined the issues relating to the physical setting, the arrangement of system devices

and seating, and how these influence the social and communicative interactions. The

purpose of the investigations in these studies is not to simply reiterate well established

findings but to present them as part of the guidelines for the design of a collaborative

workspace.

Although the spatial layout can help to shape interaction and awareness of what other

people are doing, the construction of physical space is intended to provide the

infrastructure and mechanism to enable a meaningful place for collaboration (Harrison

& Dourish 1996, Dourish 2006b). In my case studies this construction of physical space

aims to support information sharing in a complex environment, particularly the mutual

interpretation of complex information to achieve shared understandings and agreements.

Implications for the design of physical space in particular work domains have been

discussed in Chapter 4, 5 and 6. This section will focus on two related considerations

for the design of collaborative workspace. One is the appropriate physical arrangement

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of devices and furniture, and the other is the attention to different roles and function-

space relationship.

Appropriate spatial arrangement of devices and furniture

The devices and furniture in a collaborative workspace, such as displays, cameras and

tables, are in a complex relationship with a wide range of other artefacts within specific

physical settings, such as a meeting room. The devices, furniture and the room together

form a physical setting that need to support the coordination and awareness and

collaborative sense-making processes (e.g. Streiz et al. 1999, O’Hara et al. 2011).

A collaborative workspace incorporates sophisticated video conferencing devices which

can present real-time, life-sized images of remote participants and a coherent

environment for interaction. An optimal arrangement, with appropriately sized and

positioned displays and cameras can support participants’ feelings of co-presence,

including their perceptions of non-verbal cues like gesture, body language, gaze and

awareness of others’ reactions. The shared workspace installed at AAHL and its

prototype, the BISi, both attended to the geometrical configuration of cameras, displays

and furniture position to reduce asymmetries produced by camera orientation among

other factors (O’Hara et al. 2011). Related design guidelines suggested by Paay et al.

(2011) have provided a foundation for the design of the shared workspace at AAHL.

These include the consideration of optimal viewing distance and consideration of the

positioning of cameras and displays so that remote participants appear life size and

participants’ gaze directions are consistent in both sites. Factors that need to be

considered also include the physical layout of the room and the careful arrangement of

the shape and positioning of the table so as to present a space that is continuous between

two sites.

Supporting the relationship between space and function

Work environments can be organised into different spaces that support different tasks

and each area can have its particular collaboration context that can shape the

interactions supported within it (Fitzpatrick et al. 1996, Buxton 2009). The meeting

space arrangements in MDTM and CCEAD Canberra site are affected by the division of

roles and activities of the different participants. The MDTM study identifies the

importance of providing an interaction space for the radiologists and pathologists who

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need to position themselves to enable easy access to devices and materials at the

appropriate time. Their physical positions affect their interactions with other team

members both co-located and distributed during the process of interpreting the meaning

of information. The MDTM study and CCEAD studies show that the organisation of the

work environment is driven by the different social and communicative functions of the

roles and collaboration practices of the participants.

Supporting the relationship between space and function requires the adaption of the

collaborative workspace to support the diversity of activities and their arrangements by

appropriating a space for different roles. The design of the physical space needs to

maintain the existing mechanisms which structure the meeting space into different areas

where different actors are located, while enabling them to switch between activities. The

arrangement of the physical space also needs to support augmenting group awareness of

these activities. The concern is how space can be arranged to support these functions,

the interactions associated with them and people’s engagement in cooperative activities

(Nova 2005).

7.2.3 Guideline 3: Configuring Physical Space and Information Space to Support Integrated Communication and Information Sharing

This section describes the third guideline, as shown in Figure 7.2, dealing with the

configuration of physical space and information space. Careful integration of

information sharing practices within local physical space can improve the flow of

discussion, group awareness and the robustness of discussion around the information

(e.g. Binder et al. 2004). This has been considered as a design feature as well as a

challenge for a collaborative workspace, particularly when it is developed for complex

work practices (e.g. Ciolfi et al. 2008, O’Hara et al. 2011).

This level of configuration is built on the design of the two fundamental elements of a

collaborative workspace: supporting the construction of an information space and

constructing a physical space. It relates to the particular feature of a collaborative

workspace - the integration of sophisticated audio-video communication and

information sharing in multi-display environments. It is concerned with making the

right information available in the right place and having appropriate places for the

combination of information and communication at particular times. Drawing on design

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requirements described in 7.2.1 and 7.2.2, the following guidelines are highlighted at

this level of configuration:

The design of a collaborative workspace depends on the layout of the room and

participants, the design of the audio-video infrastructure and the design of the

information space that populates it; and

The configuration of information space within the physical space needs to take

account of the positions of the participants, the positions of information being

displayed and the function-space relationship.

I will illustrate these configuration guidelines by using the example of the large group

meeting setting at the CCEAD meeting room at the Canberra site (Figure 7.3).

Figure 7.3. Integrating physical space and information space in a large meeting room environment

This proposed design of the room layout and physical configuration of the collaborative

workspace is based on the results of the workshop described in Chapter 5. This design

can be considered as an extension of the “shared workspace” (Figure 6.8 and Figure 6.9

in Chapter 6) installed at AAHL to a large meeting room and for a large group. There

are four LCD displays mounted on the wall. Three to four key participants, including

the Commonwealth CVO, who chairs the meeting, the secretary, who takes notes, and

an assistant, who controls the mouse and keyboard, sit at the table close to these

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displays. They can easily see all the other peripheral participants who sit at the tables

positioned around the main table. The existing projector display close to the window

and a large LCD display positioned at a side wall can be used to synchronize with the

displays of the shared workspace, each showing part of the information contents in the

shared workspace. The co-located participants in different areas of the room can see

each other and can simultaneously see the same information being discussed in detail.

There are two cameras mounted in the gap between the two rows of the four LCD

displays. The two cameras are positioned to capture the room overview and all the

participants can be included within the field of vision. The design can also incorporate

hand-held tablet devices for participants, including peripheral participants, to be used as

personal information spaces for them to maintain their own readings of the information.

This is not shown in Figure 7.3 and it will be further described in Chapter 8 in the

“Future work” section.

7.2.4 Guideline 4: Configuring Collaborative Workspaces to Enable Local Practices

As described in 7.1, one important result of this research is the understanding of

variations of local practices and how these impact on distributed collaboration.

Technology designers need to pay attention to the balance between common core

elements within a particular practice (e.g. sharing medical information), while taking

into account the varied styles of the practice (Balka et al. 2008). A one size fits all

approach to technology support is not appropriate; instead flexible support for different

situations in a particular practice is required (Randell et al. 2011). Account needs to be

taken of the evolving nature of local practices, as we have seen with the potential

introduction of PACS into MDTMs, and the new PC4 infrastructure in AAHL. The

configuration of collaborative workspaces is not just about facilitating a customized

solution for a particular application but needs to also attend to configuring the

collaborative workspace to enable rather than constrain the activities within local

contexts (e.g. Ellingsen & Monteiro 2006, Schmidt et al. 2007, Monteiro et al. 2013).

A key design strategy, presented in the AAHL study, is to provide more or less generic

or standardized technical building blocks that can form the basis of systems across a

range of settings (Schmidt et al. 2007). The BISi prototype is a generic collaborative

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workspace in which communication and information sharing functionalities have been

carefully integrated. Although this type of generic solution may help to support some

elements of distributed collaboration, it may not fit well into local work settings without

appropriate adaption. The level of configuration discussed in this section focuses on

how to adapt a generic collaborative workspace to flexibly support local practices,

taking into account the constraints of local physical settings and different practices of

information sharing. In other words, it is not about an optimum setup that can better

support particular demands of a distributed collaboration but instead about what

constitutes an optimum setup within a particular situation. Technology designers need to

understand local practices as part of the design process.

To illustrate the configuration work at this level, I will draw on three design examples in

the three case studies. In each of the examples, I will start with a brief description of the

local constraints and particular features of practices which need to be considered.

Configurable communication and information spaces for small group collaboration

People usually configure space functions and tools and organize their activities around

these functions and spaces according to the situation (Binder et al. 2004). As shown in

the three case studies, the collaboration in a meeting environment involves sharing

information, interacting with information and exchanging opinions through

conversations among meeting participants (Kane & Luz 2009b). During the discussion,

participants switch between these activities and the focus of discussion can be either

verbal communication or data-centred interaction.

The design of the shared workspace installed at AAHL provides an example of

configurable display arrangements and functionality for small group discussion and for

different interaction and communication patterns. As presented in Chapter 6, as the

extension of the BISi to real-world work environments, the physical setting of the

shared workspace, the size and position of the displays and the position of the cameras

have been carefully re-designed. Additional consideration has particularly focused on

the configurable arrangement of the video-conferencing communication space and

information space. The four displays allow different configurations of information

sharing requirements, ranging from using all the display space for multiple data

visualization to using two displays to show data and two displays for life-size video

conferencing communication.

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Large group, large meeting room and different ways of sharing information

Physical settings and information sharing practices can be constrained by their

organizational context. The MDTM study and CCEAD study have shown that common

meeting rooms do not provide ideal environments for a particular collaboration but it is

a local condition that design solutions have to adapt to. There are also factors that need

to be considered related to the size of the team as well as the seating arrangement of

participants. Furthermore, different approaches to information preparation and sharing

are well-established local practices that participants may want to maintain.

Figure 7.3 shows the spatial arrangement for the large group and large meeting room

scenario. Based on this, the design can be extended in response to specific information

practices. For example, in the MDTM study, some pathologists prefer showing the

material directly from the original glass slides; this only requires linking a digital

microscope to the collaborative workspace system. In the same way, new healthcare

information systems, such as PACS and electronic patient records, can also be

integrated into MDTMs (Kane & Luz 2013). In the CCEAD study, the use of paper

documents as personal resources during the meeting is important and personal

computing resources can be used as a solution. In the AAHL study, a laptop was added

to the platform as a personal information space. What needs to be noted here is that the

potential integration of new devices and local systems needs to be carefully assessed. It

requires a harmonization effort to combine the technology usage and work process

(Kane & Luz 2008).

Real-time scientific collaboration in a challenging work environment

The development of the integrated collaboration platform in AAHL demonstrates the

approach of flexible configuration to support different types of scientific collaboration.

In particular, supporting collaborative PC4 work is an example of configuring

technology in an extremely challenging work environment which poses specific

physical setting and information sharing requirements. Collaborative PC4 work needs to

maintain the communications between scientists inside PC4 and outside PC4, allow the

sharing of real-time information from instruments inside PC4 to the scientists outside

PC4, and minimize the interference with the normal practices of the scientists in PC4.

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As shown in Figure 6.10 in Chapter 6, collaborative PC4 work has been incorporated

into the facility and physical space design of the new PC4 suite. Large glass windows

and audio communications allow scientists in the PC3 area to have an overview of the

PC4 area and communicate with the PC4 scientists wearing headsets. Multiple displays

outside in the PC3 area allow scientists to interact with the scientific data resources

from instruments in PC4 in real-time while facing the glass windows to see the

scientists in PC4 working on the instruments.

7.2.5 Guideline 5: Configuring Collaborative Workspace in the Broader Organizational and Procedural Arenas

There is a level of configuration work required when a collaborative workspace is

integrated into in the work flow and the organizational context. The three case studies

have identified the need for coordination work to support smooth collaboration. The

main purpose of a collaborative workspace is to support real-time collaborative

interpretation and analysis which is a component in the process of constructing common

information space between different teams. In other words, the collaboration supported

by the collaborative workspace takes place in a larger socio-technical context of

coordinative practice. While a collaborative workspace can play a role in supporting

inter-departmental or inter-organizational communication and information sharing, it

will not solve all the coordination issues and these issues can impact on the efficiency of

the distributed collaboration in using the collaborative workspace. In the three case

studies we have noted the complex processes of preparing information before the

meetings, the distributed activities in data analysis between different teams before the

meetings and different information requirements that need to be articulated and

coordinated in order to have a smooth collaboration.

As shown in the CCEAD study, pre-negotiated routines and agreements can help to

coordinate the decision-making process in the meetings. As shown in the AAHL study,

standard procedures, set up by AAHL for handling diagnostics work, coordinate a set of

interrelated practices between different teams so as to have a mutually-shared goal in

the collaboration. Although loosely coupled work settings like MDTM and CCEAD

have relatively high common ground and readiness for collaboration, the coordination

issues that are involved in distributed collaboration still need to be resolved in the policy

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and organizational arena (Balka et al. 2008). The CCEAD study showed that creating a

large-scale socio-technical system is a complex matter requiring the collaboration of

stakeholders at group and organizational levels and the establishment of policies (e.g.

the AUSVETPLAN), practices (e.g. data gathering practice) and even agreement on

introducing potential collaboration technologies. Such inter-organizational relationships

are challenging but need to be further explored as multi-organizational collaboration is

increasingly being seen.

The MDTM and CCEAD studies highlight the complexity of configuration at the

policy-making and organizational level. Issues related to organizational factors, such as

different mechanisms in public and private systems, may not be easily solved. This

configuration also depends on how willingly users participate in these changes and how

these changes will be supported in both the organizational and policy arenas (Balka et al.

2008). Fitzpatrick and Ellingsen (2013) recently reviewed 25 years of CSCW research

in healthcare and argue that there is a lack of CSCW work on the larger policy level.

The findings of this research confirm their concerns.

7.3 Summary

Offering ideal solutions for distributed collaborations in complex work settings is

challenging. A particular challenge this research addresses are the variations in local

practices across different settings for collaboration. This research has identified a

complex matrix of issues that impact on collaboration. These issues relate to

information preparation and information sharing, physical setup and environment and

structure of the teams and organizational context. This research has also suggested a set

of design guidelines to support the development of collaborative workspace

technologies to provide coherent collaboration environments across different settings

while respecting the interdependencies and variations within local practices.

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8 Contributions and Conclusion

This concluding chapter summarises the contributions of this research and discusses

possible future work.

8.1 Contributions

The contributions include an understanding of distributed collaboration, an approach to

the development of collaboration technology and a set of design guidelines.

This research provides a rich understanding of distributed collaborations in particular

complex work settings

This research investigates distributed collaborations in three complex domains. There

has been growing research attention, in CSCW and HCI, to the expanding contexts of

work practices characterized by large-scale, inter-organization and increasingly

complex collaboration (Fitzpatrick & Ellingsen 2013, Jirotka et al. 2013, Pipek et al.

2014). The three case studies contribute to this trend through detailed understandings of

collaboration in distributed care teams (the MDTM study), multi-site and multi-

organizational teams (the CCEAD study) and scientific work in a challenging

biosecurity environment (the AAHL study).

Importantly, the three case studies share a focus on exploring interaction and

collaboration across variable local settings. Differences in the local physical settings,

information sharing practices and organizational contexts have been identified and

traced to their various sources. The particular collaborative work presented in each case

study is shaped by the requirements of the particular work practices. The findings from

these studies provide insights into how distributed individuals and teams collaborate

across different local settings that can be applicable to other similarly complex work

environments.

In addition, this research has investigated collaboration in some novel settings. The

study of CCEAD addresses collaboration in emergency response for infectious animal

diseases – a context which has not been studied previously in CSCW and HCI.

Similarly the AAHL study contributes to the on-going research interest in scientific

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collaboration with a case study of understanding the effects of the containment barriers

on “distributed” collaboration within a single scientific laboratory and the experience of

designing and implementing an integrated collaboration platform in that laboratory.

Furthermore, these work domains are valuable settings to help understand the

relationships between people, information and technology and to explore CSCW themes

that have been active in the research on distributed collaboration. Observing the

collaborative work in the three case studies provides detailed understandings of

fundamental issues of social, spatial and communicative interactions relating to media

space research (e.g. Bly et al. 1993, Harrison 2009). The work presented in this thesis

concerns issues of space and place (Harrison & Dourish 1996), common information

space (Bannon & Bodker 1997) and coordination (Schmidt & Simon 1996), which are

all long term issues of interest in the CSCW community. The explorations are also

aligned with research in the variability of local work practice (Schmidt et al. 2007) and

the recent development of conceptual tools, such as configuration categories and

typologies of variations (Balka et al. 2008). These tools have been used to ground the

discussion of the local practices and support the analysis of the findings.

Finally, from a methodology perspective, this research addresses the particular

challenges of studying distributed collaborations in complex work environments. It uses

adapted approaches in studying these collaborations and in the design process. For

example, this research involves multi-site workplace study which has been increasingly

considered as an important strategy to understand larger-scale, integrated and

interconnected collaborations (Randell et al. 2011, Blomberg & Karasti 2013).

Comparative studies over different work sites and analyses provide understandings

about commonalities and variations in work practices. Another example is that to

address the challenge of observing real-time distributed collaboration, this research

incorporates methods of “rapid ethnography” (Millen 2000), such as using collaborative

observation involving multiple researchers to improve the efficiency of the field study

as well as the data analysis as shown in the MDTM study. A third example relates to

how the field findings can be used to guide a systematic design process. The findings of

the AAHL study shaped the design of the collaboration platform through a staged

approach to form a final integrated solution for the overall work of AAHL. This

approach starts with generic requirements in the first stage of the design process and

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Contributions and Conclusion

178

follows these by specific local work requirements developed in later stages of the design

process.

This research contributes to design approaches for the development of collaboration

technologies that consider well-established local practices and can be used across

highly variable local settings

A major aim of this research is to contribute to the work in CSCW in designing

technologies that can be used across highly variable local settings without

compromising the integrity of local practices. Related CSCW work includes the use of

artefacts to enable the coordination of cooperative activities (Schmidt & Wagner 2004,

Schmidt et al. 2007), constructing common information spaces (e.g. Reddy et al. 2001,

Bossen 2002), and the effect of technology standardisation across different local settings

(e.g. Ellingsen & Monteiro 2006, Monteiro et al. 2013). This thesis contributes to this

research area with two complementary design approaches that can both be applied to the

design of collaborative workspace for distributed collaboration across variable local

settings.

One is the approach of moving beyond the aim of a dedicated solution to a more general

and re-usable strategy as Schmidt et al. (2007) suggest, which is “developing more or

less generic or standardised building blocks that can be combined and recombined

endlessly” (p.9). The design work presented in the AAHL study shows the recognition

of both the generic and site specific requirements, and, importantly, the demonstration

of how a generic shared workspace can be extended by the other design components to

form an integrated platform to support various local requirements.

The other one is the configuration approach which extends the design consideration for

flexibility to a broader perspective of configuration (Binder et al. 2004, Balka &

Wagner 2006, Balka et al. 2005, 2008). The results of this thesis suggest a range of

elements that need to be configured when collaborative workspaces are appropriated

into specific local settings for collaboration. These configuration elements include

integrating physical space and information space at system design level; adapting the

design to specific local practices; and configuring as an organizational effort to

coordinate across team and organizational diversities.

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Contributions and Conclusion

179

The design guidelines, including the three levels of configuration, developed in this

research contribute to the ongoing development of collaborative workspace technology

and the larger research agenda of supporting distributed collaboration in complex real-

world settings

The design guidelines developed in this research extend related guidelines developed in

earlier video-mediated environments (e.g. Luff et al. 2003, 2009, Buxton 2009,

Henderson 2009) to the context of design in current complex work settings and to the

recent development of collaborative workspaces.

This research addresses the challenges identified in recent reflections on the research of

distributed collaboration technologies as stated in Chapter 2. These challenges include:

the spatial configuration of a collaborative workspace; enhancing user experience in

distributed interaction by providing shared interaction tools; flexible support for

different collaborative activities and organizational contexts; supporting collaborations

between asymmetrically configured groups; and extending the designs of generic

research prototypes to fit them into particular work settings.

Finally, this research argues that collaborative workspaces can be developed to support

collaboration in a complex work environment by using a structured design approach.

The five design guidelines suggested here recognise that the design of a collaborative

workspace depends on careful integration of physical space, information space and

work practices. Most importantly, this research considers design in a larger socio-

technical context and highlights multiple levels of configuration work into the design

guidelines. This set of guidelines, particularly its three levels of configuration work

offers practical solutions that may be useful for other researchers facing similar

challenges.

8.2 Future Work

The findings of the case studies indicate several directions worthy of further exploration

in the area of designing collaborative workspaces. These directions include

incorporating new interaction technologies, incorporating security technologies and

evaluating technology design and implementation in multi-site and multi-organizational

collaborations supported by collaborative workspaces.

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Contributions and Conclusion

180

Incorporating new interaction technologies. One of the recent trends in designing

collaborative workspace has been incorporating new interaction technologies, such as

remote pointing and annotation tools, to support shared interaction with information (e.g.

Frykholm et al. 2012, Norris et al. 2013, Maher et al. 2014). We have seen that Olwal

et al. (2011) and Frykholm et al. (2012) demonstrate the use of handheld tablet device

for individual participants in MDTMs. The tablet device can be used as a personal

navigation tool and as a gesturing tool to allow synchronization of annotations on the

tablet device and large displays. In the context of MDTMs this means supporting the

display of case-based information to all participants and offering specific interaction to

support the pointing activities that certain participants need to perform. This

development may help to solve the remote pointing issue as participants can annotate on

their tablets and these annotations are shared to other co-located participants and remote

participants. The research team at CSIRO has an on-going interest in the area of

integrating new interaction technologies into the design of collaborative workspaces. I

have been involved in two lab experiments which explored the use of the iPad to

interact with collaborative workspace. The design allowed individuals and groups

working in front of large displays to efficiently control and manage the views on the

displays. The iPad can also serve as a personal information space to maintain

participants own view of the shared information.

Incorporating security and access control technologies. A particular concern in the

CCEAD collaborations is the security issues involved in data sharing, as described in

Chapter 5. There is an increased adoption of cloud-based infrastructures and

collaborative delivery of services dealing with sensitive data. One related research area

is the investigation of secure, trustworthy collaboration infrastructure allowing real-time

information exchange and interaction, while preserving confidentiality and privacy. At

the time of writing, one of the research teams at CSIRO is exploring the integration of

eAuthentication and eAuthorisation technologies into the collaborative workspaces. The

feasibility of this approach is being investigated in the collaborations in the biosecurity

domain, such as the CCEAD collaboration. A challenge of introducing enhanced access

control into a collaborative workspace is the balance between the competing goals of

collaboration and security. This is because collaborative systems focus on making

information available to all who need it, whereas information security seeks to provide

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Contributions and Conclusion

181

it to those with proper authorisation. There is a need to offer adequate protection to

information sharing while allowing a reasonable way to manage the complexity added

to the information access and sharing process. It will be interesting to understand how

access control influences the CCEAD meeting practice, particularly the sharing of

information.

Evaluating technology design and long-term implementation in multi-site and multi-

organizational collaborations. The small scale evaluation of the shared workspace

installed at AAHL only focused on getting user feedback to improve the technology

design after initial installation. Evaluation after the system has been used for a longer

time is needed in order to understand the long-term issues which may require particular

intervention. It will be valuable to observe the implementation of the other two

important components of the overall AAHL collaboration platform, supporting real-time

scientific collaboration and collaborative PC4 work. Understanding how the platform is

integrated into work practices and its benefit and challenges will require a

comprehensive analysis of long-term implementation. The guidelines presented in

Chapter 7 can be used as dimensions for the analysis in the evaluation to reflect the

design and to better understand how well the design fitted its context of use.

The integrated collaboration platform at AAHL can be extended to support the research

and operational collaborations between AAHL and other organizations. At the time of

writing, a number of shared workspaces, linked to AAHL, have been installed at CSIRO

research laboratories in different states across Australia. The installations of

collaborative workspaces in CSIRO laboratories can provide a research setting to

explore the on-going challenges of multi-site large-scale collaboration and to evaluate

the use of these technologies over time.

8.3 In Conclusion

This research addresses the challenge of designing collaborative workspaces to support

distributed collaborative work in complex work settings. It develops deep

understandings of a range of issues that impact on distributed collaboration across

different local settings. It also develops a set of design guidelines that can be used to

guide the design and development of collaborative workspaces which provide coherent

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Contributions and Conclusion

182

collaboration environments across different already existing local settings while

respecting the variations within local practices.

Solutions relying only on the introduction of new technologies will always need to work

within local contexts and will not in themselves change the problems which cause the

constraints in the first place (Fitzpatrick et al. 1998). What can change though are the

solutions themselves which can be designed to enable and support the configuration of

available technologies and resources to support distributed collaboration without

compromising local contexts. The insights from this research will have broader

implications for distributed collaboration situations where technologies will always

need to fit into different local settings.

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Appendix A: Publications

183

Appendix A: Publications

The results from this thesis have appeared previously in the following two peer-

reviewed journals and six peer-reviewed conferences.

Journals

Li, J. & Robertson, T. 2011, 'Physical space and information space: studies of

collaboration in distributed multidisciplinary medical team meetings', Behaviour

and Information Technology, Taylor & Francis 2011, Vol. 30, No. 4, pp. 443-454.

Robertson, T., Li, J., Hansen, S. & O'Hara, K. 2010, 'Collaboration within different

settings: a study of co-located and distributed multidisciplinary medical team

meetings', Computer Supported Cooperative Work, Springer 2010, vol. 19, no. 5,

pp. 483-513.

Conferences

Li, J., Robertson, T. & Muller-Tomfelde, C. 2012, 'Distributed scientific group

collaboration across biocontainment barriers', Proceedings of the Conference on

Computer Supported Cooperative Work (CSCW’12), ACM, Seattle, Washington,

USA, pp. 1247-1256.

Li, J., Muller-Tomfelde, C. & Robertson, T. 2012, 'Designing for distributed

scientific collaboration: a case study in an animal health laboratory', Proceedings of

the Hawaii International Conference on System Sciences (HICSS’12), Computer

Society Press, Hawaii, USA, pp. 373-381.

Muller-Tomfelde, C., Li, J. & Hyatt, A. 2011, 'An Integrated Communication and

Collaboration Platform for Distributed Scientific Workgroups', Proceedings of the

13IFIP TC13 Conference on Human-Computer Interaction (Interact’11), Springer,

Lisbon, Portugal, pp. 248-258.

Li, J., Muller-Tomfelde, C. & Hyatt, A. 2010, 'Supporting Collaborations across a

Biocontainment Barrier'. Proceedings of the Australasian Conference on Computer-

Human Interaction (OzCHI’10), ACM, Brisbane, Australia, pp. 320-323.

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Appendix A: Publications

184

Li, J. & O'Hara, K. 2009, 'Understanding distributed collaboration in emergency

animal disease response', Proceedings of the Australasian Conference on Computer-

Human Interaction (OzCHI’09), ACM, Melbourne, Australia, pp. 65-72.

Li, J., Robertson T, Hansen S, Mansfield T & Kjeldskov J. 2008, 'Multidisciplinary

team meetings: a field study of collaboration in healthcare', Proceedings of the

Australasian Conference on Computer-Human Interaction (OzCHI’08), ACM,

Cairns, Australia, pp. 73-78.

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