marcelo a. lopetegui, m.d. postdoctoral researcher department of biomedical informatics

TimeCaTTime Capture

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

TimeCaTTime Capture

Clinical Workflow

HospitalManagement

ClinicalResearch

Understand Measure

Background

TimeCaTTime Capture

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

TimeCaTTime Capture

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

TimeCaTTime Capture

Self Reports External ObserverComputerized

Systems

Background

Time Motion StudiesA

Self W

imedia

tion T

TimeCaTTime Capture

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

TimeCaTTime Capture

Task one

Task two

Task three

WORKFLOW 1

Task one

Task four

Task three

WORKFLOW 2

Task two Task four

Background

TimeCaTTime Capture

Results

Background

TimeCaTTime Capture

Results

Background

TimeCaTTime Capture

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.

TimeCaTTime Capture

Background

We aim to standardize clinical workflow time motion studies by developing methods and

tools that ensure their reproducibility.

TimeCaTTime Capture

Background

Electronic40%

Stopwatch+paper42%

Both2%

n/r16%

Time Capture Tool

Electronic Stopwatch+paper Both n/e

TimeCaTTime Capture

Methods

TimeCaTTime Capture

Comprehensive

Accessible Scalable

Dynamic

Time Capture Tool

Background

TimeCaTTime Capture

Background

THE TIMECAT ROADMAP

Task 1

Task 2Task

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.

TimeCaTTime Capture

Background

ValidationMethods

Incorporation

DisseminationPush New Version

EvaluationCollect Feedback and Analyze Data

DevelopmentMethods

Development

TimeCaTTime Capture

TimeCaTTime Capture Tool

v3.9 [BETA]

TimeCaTTime Capture

notebook5%

PDA47%

tablet pc21%

Ultra Mobile PC26%

TimeCaTTime Capture

Cross-Platform(Device and Operative System agnostic)

TimeCaTTime Capture

Responsiveand touch-enabled

TimeCaTTime Capture

FoundationThe most advanced front-end framework in the world

TimeCaTTime Capture

Data Capture

TimeCaTTime Capture

Observer Subject

Task A

Task B

Task C

Methods

Task A

Task B

Task C

Start Time

End Time

TimeCaTTime Capture

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

TimeCaTTime Capture

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

TimeCaTTime Capture

Methods

Task A

Task B

Task C

08:15:22 -Task A

08:16:05 -Task C

08:16:13 -Task B

Notes:Interruption

TimeCaTTime Capture

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

TimeCaTTime Capture

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:

Current time Duration of Observation

Duration

TimeCaTTime Capture

Data Schemas

TimeCaTTime Capture

Observer Subject

Task A

Task B

Task C

Methods

Task A

Task B

Task C

Start Time

End Time

TimeCaTTime Capture

Task 1

Task 2

Task 5

Task 3

Task 4

Observer Subject

Methods

TimeCaTTime Capture

ToolStart Time

End Time

Task A

Task B

Task C

Task D

Task ETask F

Task G

Task H

Task I

Task J

Methods

TimeCaTTime Capture

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

TimeCaTTime Capture

Log in system

Prepare medication

Admin medication

Phone in/out

Social ChatExplains procedure

TravelNurse station

Patient roomHallway

TASK (hands on) LOCATIONSCOMMUNICATION

Methods

TimeCaTTime Capture

Notes:Current time Duration of Observation

TimeCaTTime Capture

ToolStart Time

End Time

Social

Phone-in

Explain Procedure

Prepares Medication

Admin Medication

Nurse Station

Communication Task Location

Hallway

Patient Room

Hallway

Nurse Station

Patient Room

Admin Med.

Prepare Med.

Social

Phone-in

Social

Explain Procedure

Social

Methods

TimeCaTTime Capture

Study Types

TimeCaTTime Capture

One dimension

Linear (sequential) time

Study Types

Multitasking

Three dimensions

Multi-Actor

“n” dimensions

TimeCaTTime Capture

Tasks Taxonomy

TimeCaTTime Capture

Open flexible task list

Dimension 1

Task A Task B Task C

Dimension 2

Task A Task D

TimeCaTTime Capture

Open flexible task list

Task A

Definition:

Start milestone:

End milestone:

TRAINING PUBLISHING

TimeCaTTime Capture

Aim: Facilitate results aggregation across sites, workflow comparisons and knowledge discovery by solving definitions inconsistencies.

TimeCaTTime Capture

Time Engine

TimeCaTTime Capture

Task Name -> Duration

Task Name -> Start Timestamp

Task Name -> Duration

TimeCaTTime Capture

1 2 3 4

OnlineServer

UniqueTime Stamp Synchronized

TimeCaTTime Capture

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].

TimeCaTTime Capture

Main Hospital in L.A.=> Pacific Time

Small Clinic in L.A.=> Pacific Time

Main Hospital in Boston=> Eastern Time

TimeCaTTime Capture

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.

TimeCaTTime Capture

Training & Reliability

TimeCaTTime Capture

Real Observation

Training Session

Inter-Observer Reliability Assessment (I.O.R.A.)

TimeCaTTime Capture

Observer A

Subject One

Data X

Observer B

Data Y

Intervention

TimeCaTTime Capture

Intra-Class Correlation Coefficient

Bland and Altman limits of agreement

Pearson product-moment correlation

Standardization Efforts: Inter-observer reliability

Results

TimeCaTTime Capture

Standardization Efforts: Inter-observer reliability

Results

TimeCaTTime Capture

Study Management

TimeCaTTime Capture

Representativeness across the day and the week

Healthcare describes a circadian and seasonal activity pattern

TimeCaTTime Capture

Number of patients per day during March 2009 and March 2010

Consuls per day

March 2009

March 2010

TimeCaTTime Capture

Data Visualization

& Reports

TimeCaTTime Capture

Principal Investigator

TimeCaT

Observer

Subject

Site 1

Observer

Subject

Site 2

Observer

Subject

Results

TimeCaTTime Capture

Free task name

Tag1, Tag 2 Testing ScheduleTag 2, Tag 3 Tag 2, Tag 4

TimeCaTTime Capture

Roles and Privileges

TimeCaTTime Capture

Administrator

Observer

TimeCaTTime Capture

Live Demo

TimeCaTTime Capture

Future Work

TimeCaTTime Capture

Inter Observer Reliability Assessment

In-depth quantitative workflow analyses

TimeCaTTime Capture

Toolhttp://www.timecat.org

Results

TimeCaTTime Capture

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

TimeCaTTime Capture

v3.9 [BETA]

TimeCaTTime Capture

Methods

TimeCaTTime Capture

marcelo a. lopetegui, m.d. postdoctoral researcher department of biomedical informatics

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