Tondo Interactive Table

Goals & My Role Tondo was a multi-touch table project I worked on for my thesis project at IUAV University of Venice, which was supervised by Gillian Crampton Smith. Every year in the United States alone an estimates 98.000 patients deaths can be attributed to medical errors thus making clinical audits that accurately identify and help to rectify the root causes of these mystakes was more essential than ever. The goal of the Tondo table was to increase medical safety and to improve the quality of patients lives during their hospitalization. Get to the root of medical errors so they don't happen again. This project was mentioned in many medical blogs, including Inspine and Medgadget for its impact on the medical processes at the Clinical Risk Center of Tuscany.

The Challenge Identifying the causes of medical errors, both human and systemic, requires opennes and collaboration as well as the efficient sourcing, retrieval and analysis of the clinical data. In reality defensiveness and inefficiency often block the path to clarity and understanding. Increase collaboration between people and staff during the clinical audit was the main challenge of this project. One of the persistent problems during the audit is the reciprocal blame among participants who are worried to be legally accused and they adopt a very defensive and non collaborative behaviour that makes difficult to investigate the causes of the incident. Sharing numerous exams, clinical records and diagnostic images among participants was another big challenge of the audit that I solved with Tondo interaction model.

The Challenge Identifying the causes of medical errors, both human and systemic, requires opennes and collaboration as well as the efficient sourcing, retrieval and analysis of the clinical data. In reality defensiveness and inefficiency often block the path to clarity and understanding. Increase collaboration between people and staff during the clinical audit was the main challenge of this project. One of the persistent problems during the audit is the reciprocal blame among participants who are worried to be legally accused and they adopt a very defensive and non collaborative behaviour that makes difficult to investigate the causes of the incident. Sharing numerous exams, clinical records and diagnostic images among participants was another big challenge of the audit that I solved with Tondo interaction model.

The Outcome With Tondo, I worked to make patients/staff less defensive during clinical audits in order to understand the root cause(s) of medical errors. To start, I built interactions that helped people collaborate and encouraged all participants to share what they knew about the errors without fear by creating a circular visual treatment on the device. The table’s surface had a diameter large enough account for 8 to 16 participants (the average number of audit users) and the UI components were crafted to create a sense of sharing among people. During all audits, a facilitator controls the meeting, deciding who speaks and which documents should be reviewed. As the lead, he/she sits at the head of the table, which on Tondo translated into specialized controls on one end of the device. With Tondo the clinical staff could review the history of a patient during his/her hospitalization including all x-rays, ECG, blood tests and other clinical exams to trace how an error occurred. Within the Tondo system, the facilitator could mark both active and latent errors via an intuitive touch screen interface. By reviewing and coming together with the Tondo table, the staff could built concreate plans to avoid future errors. Initial user tests with several doctors and nurses confirmed that the end to end flows were intuitive and accessible.

Medical Errors The graph below shows the percentage and the type of medical errors that occurred in the Italian hospitals during 2009.

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Interaction Model The UI included a timeline of the patient's hospitalization divided by days. Tapping on one day opened the UI section located in front of the facilitator seat. At its opening all the reports were loaded and divided by type of exam. The medical records done during the selected day were retrievable through the icons. The facilitator's controls introduced a level of order necessary for a productive meeting. When one of the participants noticed something relevant to the investigation she could request the activation of the touch interaction in her quarter of the screen and share her findings with the others by highlightining them with her finger. This function restricted the presence of multiple touch points in different UI sections at the same time to avoid confusion. The user could open one document at a time while the remaining documents remained open and visible but on a semitraparent layer of the UI.

UI Design Rounded shapes are intuitive and easy to understand by the broad audience that my project targets. Through the interface users come into contact with medical information, I aimed to facilitate their understanding without forgetting the human aspect of the investigation.
Typography My goal was to make the text visible to everyone sitting in the external circle of chairs and for this reason I needed to use a large body with high legibility.
Colors I chose light tones to help people concentrate during the investigation. I decided to avoid red as much as possible to not alarm people. The use of red is limited to very critical part of the UI. The background of the table is cyan with added transparency. I chose this color to give brightness to the entire interface and make reports easier to read. Green and white icons bring vibrancy to the UI.

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