timecat time capture tool improving people’s lives through innovations in personalized health care...
TRANSCRIPT
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TimeCaTTime Capture
Tool
Improving People’s Livesthrough innovations in personalized health care
Time Capture Tool (TimeCaT):Development of a Comprehensive Application to Support Data Capture for Time Motion Studies.
Marcelo A. Lopetegui, M.D.Postdoctoral Researcher
Department of Biomedical Informatics
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TimeCaTTime Capture
Tool
Clinical Workflow
HospitalManagement
ClinicalResearch
Understand Measure
Background
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TimeCaTTime Capture
Tool
Background
Patient Safety, detecting interruptions and medication errors
Productivity and efficiency
Clinicians workload and time allocation
Quality of care, assessing timeliness of treatments and procedures
Clinical Workflow
Understand Measure
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TimeCaTTime Capture
Tool
The observation and analysis of tasks within
an activity with an emphasis on the amount of
time required to perform the task.
Background
Time Motion Studies
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TimeCaTTime Capture
Tool
Self Reports External ObserverComputerized
Systems
Background
Time Motion StudiesA
ctiv
e T
rack
ing
Self W
ork
Sam
plin
g
Conti
nuous
Obse
rvati
on
Work
Sam
plin
g
Pass
ive T
rack
ing
Mult
imedia
Reco
rdin
g
Posi
tion T
rack
ing
Devic
e
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TimeCaTTime Capture
Tool
Observer Subject
Task one
Task two
Task three
Id task time
1 Begin 09:30:20
2 Task 1 09:30:22
3 Task 2 09:31:54
4 Task 3 09:35:01
5 End 09:36:35
Continuous Observation TMS
Background
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TimeCaTTime Capture
Tool
Task one
Task two
Task three
WORKFLOW 1
INTE
RV
EN
TIO
N
Task one
Task four
Task three
WORKFLOW 2
Task two Task four
Background
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TimeCaTTime Capture
Tool
Results
Results
Results
+
+
+
H1
H2
H3
Background
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TimeCaTTime Capture
Tool
Results
Results
Results
Background
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TimeCaTTime Capture
Tool
Background
Continuous observation time motion studies could enhance clinical workflow studies by providing rich quantitative data required for in-depth workflow analyses.
However, methodological inconsistencies have been reported in continuous observation TMS, potentially reducing the validity of TMS’ data and limiting their contribution to the general state of knowledge.
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TimeCaTTime Capture
Tool
Background
We aim to standardize clinical workflow time motion studies by developing methods and
tools that ensure their reproducibility.
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TimeCaTTime Capture
Tool
Background
Electronic40%
Stopwatch+paper42%
Both2%
n/r16%
Time Capture Tool
Electronic Stopwatch+paper Both n/e
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TimeCaTTime Capture
Tool
Methods
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TimeCaTTime Capture
Tool
Comprehensive
Accessible Scalable
Dynamic
Time Capture Tool
Background
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TimeCaTTime Capture
Tool
Background
THE TIMECAT ROADMAP
1
2
3
4
5
Task 1
Task 2Task
3
Aim: Identify critical areas requiring normalization and gain awareness of the state of the art in TMS.
Aim: Make a time capture tool available to TMS researchers, and use it as means of testing, distributing proposed methods, and collect user’s feedback.
Aim: Propose standards regarding human observers’ training, develop a realistic and appropriate inter-observer reliability assessment score, unify approaches for multitasking scenarios and capturing interruptions.
Aim: Facilitate results aggregation across sites, workflow comparisons and knowledge discovery by solving definitions inconsistencies.
Aim: To move forward in the analysis of TMS produced data: from a simple average time on tasks, to a comprehensive quantitative workflow analysis driven by TMS data.
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TimeCaTTime Capture
Tool
Background
ValidationMethods
Incorporation
DisseminationPush New Version
EvaluationCollect Feedback and Analyze Data
DevelopmentMethods
Development
Tool
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
v3.9 [BETA]
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TimeCaTTime Capture
Tool
Tool
notebook5%
PDA47%
tablet pc21%
Ultra Mobile PC26%
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TimeCaTTime Capture
Tool
Cross-Platform(Device and Operative System agnostic)
Tool
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TimeCaTTime Capture
Tool
Responsiveand touch-enabled
Tool
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TimeCaTTime Capture
Tool
FoundationThe most advanced front-end framework in the world
Tool
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
Tool
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TimeCaTTime Capture
Tool
23
TimeCaTTime Capture Tool
Data Capture
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TimeCaTTime Capture
Tool
Observer Subject
Task A
Task B
Task C
Methods
Task A
Task B
Task C
Start Time
End Time
Obse
rvati
on
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TimeCaTTime Capture
Tool
Methods
Task A
Task B
Task C
08:15:22 -Task A08:16:05 -Task C08:16:13 -Task B
Notes:
DELETE RENAME FIX TIME
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TimeCaTTime Capture
Tool
Methods
Task A
Task B
Task C
08:15:22 -Task A
08:16:05 -Task C
08:16:13 -Task B
Notes:
STOP 08:17:25 -Other
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TimeCaTTime Capture
Tool
Methods
Task A
Task B
Task C
08:15:22 -Task A
08:16:05 -Task C
08:16:13 -Task B
Notes:Interruption
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TimeCaTTime Capture
Tool
Methods
Task A
Task B
Task C
08:15:22 -Task A
08:16:05 -Task C
08:16:13 -Task B
Notes:
08:17:01 -Task C
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TimeCaTTime Capture
Tool
Methods
Task A
Task B
Task C
08:15:22 -Task A
08:16:05 -Task C
08:16:13 -Task B
Notes: 08:17:01 -Task C
Notes:
Notes:
Notes:
Notes:
Current time Duration of Observation
Duration
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TimeCaTTime Capture
Tool
30
TimeCaTTime Capture Tool
Data Schemas
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TimeCaTTime Capture
Tool
Observer Subject
Task A
Task B
Task C
Methods
Task A
Task B
Task C
Start Time
End Time
Obse
rvati
on
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TimeCaTTime Capture
Tool
Task 1
Task 2
Task 5
Task 3
Task 4
Observer Subject
Methods
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TimeCaTTime Capture
ToolStart Time
End Time
Obse
rvati
on
Task A
Task B
Task C
Task D
Task ETask F
Task G
Task H
Task I
Task J
Methods
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TimeCaTTime Capture
Tool
Travel Nurse station Phone in/outLog in systemSocial ChatPrepare medication
ChartPatient roomAdmin
medicationExplains
procedureHallway
TMS1 TMS2 TMS3 TMS4 TMS5 TMS6 TMS… TMSn
Po-Yin Yen, RN, PhDResearch Assistant ProfessorDepartment of Biomedical Informatics
COAUTHOR
Methods
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TimeCaTTime Capture
Tool
Log in system
Prepare medication
Chart
Admin medication
Phone in/out
Social ChatExplains procedure
TravelNurse station
Patient roomHallway
TASK (hands on) LOCATIONSCOMMUNICATION
Methods
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TimeCaTTime Capture
Tool
Notes:Current time Duration of Observation
Com
munic
ati
on
Task
Loca
tion
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TimeCaTTime Capture
ToolStart Time
End Time
Obse
rvati
on
Social
Phone-in
Explain Procedure
Prepares Medication
Admin Medication
Chart
Nurse Station
Communication Task Location
Hallway
Patient Room
Hallway
Hallway
Nurse Station
Patient Room
Chart
Admin Med.
Prepare Med.
Prepare Med.
Social
Phone-in
Social
Explain Procedure
Social
Methods
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TimeCaTTime Capture
Tool
38
TimeCaTTime Capture Tool
Study Types
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TimeCaTTime Capture
Tool
39
TimeCaTTime Capture Tool
One dimension
Linear (sequential) time
Study Types
Multitasking
Three dimensions
Multi-Actor
“n” dimensions
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TimeCaTTime Capture
Tool
40
TimeCaTTime Capture Tool
Tasks Taxonomy
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TimeCaTTime Capture
Tool
Open flexible task list
Dimension 1
Task A Task B Task C
Dimension 2
Task A Task D
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TimeCaTTime Capture
Tool
Open flexible task list
Task A
Name:
Definition:
Start milestone:
End milestone:
TRAINING PUBLISHING
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
4
Aim: Facilitate results aggregation across sites, workflow comparisons and knowledge discovery by solving definitions inconsistencies.
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TimeCaTTime Capture
Tool
44
TimeCaTTime Capture Tool
Time Engine
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TimeCaTTime Capture
Tool
45
TimeCaTTime Capture Tool
Task Name -> Duration
Task Name -> Start Timestamp
Task Name -> Duration
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TimeCaTTime Capture
Tool
1 2 3 4
OnlineServer
UniqueTime Stamp Synchronized
5
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TimeCaTTime Capture
Tool
1329497834 2012-02-17T16:57:14Z ISO8601
Friday, 17th February 2012 11:57am
1329497834
1329793983
793983
02 hours 14 min 02 sec
11:57:10am
02:12:04pm
UNIX TimestampUNIX Epoch [00:00:00 UTC on 1 January 1970].
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TimeCaTTime Capture
Tool
Main Hospital in L.A.=> Pacific Time
Small Clinic in L.A.=> Pacific Time
Main Hospital in Boston=> Eastern Time
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
Task A
Client Server
Observation
task_id
observation_id
UNIX Timestamp
task_id
Timestamp
observation_id=>site_id=>Timezone
Task A at 08:20:15 am local time in L.A.
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
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TimeCaTTime Capture
Tool
51
TimeCaTTime Capture Tool
Training & Reliability
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
Real Observation
Training Session
Inter-Observer Reliability Assessment (I.O.R.A.)
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TimeCaTTime Capture
Tool
Observer A
Subject One
Data X
Observer B
Data Y
Time
Intervention
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TimeCaTTime Capture
Tool
Kappa
Intra-Class Correlation Coefficient
Bland and Altman limits of agreement
Pearson product-moment correlation
Standardization Efforts: Inter-observer reliability
Results
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TimeCaTTime Capture
Tool
Standardization Efforts: Inter-observer reliability
Results
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TimeCaTTime Capture
Tool
56
TimeCaTTime Capture Tool
Study Management
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
Representativeness across the day and the week
Healthcare describes a circadian and seasonal activity pattern
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
Number of patients per day during March 2009 and March 2010
Consuls per day
Consuls per day
March 2009
March 2010
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TimeCaTTime Capture
Tool
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TimeCaTTime Capture Tool
Data Visualization
& Reports
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TimeCaTTime Capture
Tool
Principal Investigator
TimeCaT
Observer
Subject
Site 1
Observer
Subject
Site 2
Observer
Subject
Results
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
Free task name
Tag1, Tag 2 Testing ScheduleTag 2, Tag 3 Tag 2, Tag 4
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
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TimeCaTTime Capture
Tool
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TimeCaTTime Capture
Tool
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TimeCaTTime Capture Tool
Roles and Privileges
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
Administrator
Observer
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TimeCaTTime Capture
Tool
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TimeCaTTime Capture Tool
Live Demo
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TimeCaTTime Capture
Tool
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TimeCaTTime Capture Tool
Future Work
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
Inter Observer Reliability Assessment
In-depth quantitative workflow analyses
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TimeCaTTime Capture
Toolhttp://www.timecat.org
Results
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TimeCaTTime Capture
Tool
Po-Yin Yen, RN, PhDResearch Assistant ProfessorDepartment of Biomedical Informatics
CO-INVESTIGATOR
Albert M. Lai, PhDAssistant ProfessorDepartment of Biomedical Informatics
CO-INVESTIGATOR
Peter J. Embi, MD, MSAssociate ProfessorVice-ChairDepartment of Biomedical Informatics
CO-INVESTIGATOR
Philip R. O. Payne, PhDAssociate ProfessorChairDepartment of Biomedical Informatics
PRINCIPAL INVESTIGATOR
Funding: Department of Biomedical Informatics
Acknowledgements
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TimeCaTTime Capture
Tool
TimeCaTTime Capture Tool
v3.9 [BETA]
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TimeCaTTime Capture
Tool
Methods
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TimeCaTTime Capture
Tool