Blogging the WIDE Conference (Day One)

Left straight after class and drove like a bat outta hell to make it to E. Lansing just in time for the opening session. This is the first WIDE conference done by the folks in the WIDE Center ( Jeff Grabill, Bill Hart-Davidson, and Jim Porter). Tonight's talk was done by Barbara Mirel and the title of her talk was "Rhetoricians Without Borders: An Ecological Tale from Healthcare" (my scattered notes below the fold).

I have seen several old friends and met some new folks whose work I know, but have never seen in person (and most exciting was the lovely Lily Hart-Davidson). Tomorrow the day starts at 7 a.m. (* SOB *) and we'll be done by 3 at which point I am definitely headed to the local yarn super store THREADBEAR (yes, it does deserve all caps because it is that damned good). More notes on tomorrow's talks after they happen :-)

Don't forget to look below the fold!

Barbara Mirel
U of M

Rhetoricians without borders: An ecological tale from healthcare

Looking at various systems that are being used in the evaluation, monitoring, and treating patients with depression. Doctors, care managers, nurses, and IT folks are all working together.

Examining 2 frameworks that bridge the distance
1. Interdisciplinary approach
2. Ecological systems approach

Differences that the choice of framework make
Where do we fit?
Where can we make a contribution

*Bridging Distances
1(Interdisciplinary). Specialists across disciplines
Order data and design by common grounds, x-borders
Elements, spread broadly
uses and flows of information
paths of coordinated texts
cases of use, patterns
user profiles
models of work, visualized
common ground

stability/continuity

(concepts, pattens, heuristics, dominant knowledge, information properties)

2 (Ecological). specialists across disciplines...

cross-cutting problems
experimentation/change

(selective problems, competing interests, persuasion, evidence, info prop.)

Interdisciplinary (patient care)
Goal: right intervention for the right patients
tasks for optimal, cost-effective interventions

1. *outcomes
communicate, summary, boundary obj

Ecological systems
selectively deals with other issues (best care)
Intuitiveness of care givers
Mismatch 10%

2. *outcomes
health team-org
health team- IT
"lab report"
most important info
missing 2 way communication

*Program Assessment

1. data reports (length of call, #, etc)
2. what data are missing
recurrent questions

redefined problem
care giving is monitoring and taking outcomes measures

outcomes show patients fall into certain groups in terms of needling the same seady outcomes questions asked to mark their progress

ecological systems
return to the original (unresolved) problems
-causes of improvement
-self management and improvement
-assess and evolve practice-do assumptions hold?

*Conclusion
1.
-stable
-legacy systems
-content and processes for delivering the innovation
-scale
-technological ways to launch the innovation

2.
-change
-open systems for required info
-success factors in the innovation stream
-learn
-fully defining the innovation

Interdisciplinary seems to have won at this point. Mirel wants us to go away with the thought that it might be best to work in middle. The notion of hybridity. Getting caregivers, IT folks, and others to work together on a system that works better.

Interdisciplinary (systems are set and you want to scale)

This project has moved from ethnography to action research. The researchers role has changed simmce the organization being studied has seen that they have something to offer in terms of what they are seeing in their observations.

Power differential is not as great between those at varying levels in the medical professionals than it is between them and the IT folks.