Notes on Observations

• Baseline data collection in Ultrasound and in Chest (In-Patient and ICU) has been completed. This data which focuses on radiological practice and consultations with primary care physicians and clinicians from the radiological side. During the baseline data collection process we actually gained access to and made observations in four different radiological services: ultrasound, in-patient bone, out-patient bone, and chest. Additionally, we have made some limited observations in magnetic resonance imaging and computed tomography. The ultrasound and chest data, in particular, is rich in consultation instances between clinicians/primary care physicians and radiologists.
• Data analysis has also begun. This process includes: indexing the data (using C-Video software), extracting significant scenes, and writing up important elements for consideration in designing the first prototypes of the new system. All of the baseline videotape of the radiological services has been reviewed and an initial index has been completed. Beginning in January, a masters' student at the University of Michigan will investigate ways of better accessing and indexing our videotapes.
• The data that we have collected is in the form of written notes and videotapes which document a variety of routine activities as well as exception handling in these areas. The data results from over 100 hours of observation which resulted in 45 hours of videotaped information.
• A detailed codebook has been completed in order to better extract and analyze significant variables from the videotapes. Coding of the initial radiological data will be ready for statistical analysis in January.
• Negotiations have been initiated with clinicians and primary care physicians in order to observe how this group interacts with radiological images and reports and to analyze their consultation patterns with radiologists.
• Several interviews with clinicians have been done and we have completed 35 hours of observations of primary care physicians. At that point, we are beginning to analyze radiological usage and patterns of use by clinicians and primary care physicians. This is giving us a better understanding of each of the major user groups who will utilize the new system.

• In November 1995, an hour long documentary of radiological practice was produced. This combined excerpts from our videotaped data and combined with a narrated script which identified important elements for the engineers to consider in their system design.
• A similar documentary of practice in the clinics is being developed from over 35 hours of video and observations of the primary care physicians.
• Team members Finholt, Cote, and Yakel also attended the Radiological Society of North America convention in Chicago, IL to see view new systems for the interpretation and dissemination of radiological images and to assess the degree of user input into these systems.
• An exhaustive literature search has been completed and over 200 books and articles on radiological practice (including interpretation of images), radiologist-clinician consultation, sociological studies of radiologists is now analyzed and has been entered into a database.