Pathology Consult - A Case Study
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Pathology Consult - A Case Study

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Case Study of Elsevier's Agile Product Development process

Case Study of Elsevier's Agile Product Development process

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  • I’d like to share this case study with you because it has certainly taught us a great deal about repurposing an existing product, in this case it was a about making an online version of a book for pathologists

Pathology Consult - A Case Study Pathology Consult - A Case Study Presentation Transcript

  • PathConsult: a case study Presented By: Jonathan Clark Date: May 15 th 2006
  • PathConsult
    • user understanding is critical
    • iterative development keeps the focus on the user
    • think outside the book
    But was it rapid? I’ll let you be the judge of that!
  • Development starts & ends with the user Understand the user, their tasks and their goals Evaluate the UI, not the user Design for the user, make sure they can efficiently and easily complete their tasks user-centred design
  • Example: Electronic Information Retrieval Librarian Morning Lunch Afternoon After Hours Researcher Student Practitioner Significant generalizations; Use of Elsevier electronic products is much smaller
  • It all started with a book..
    • 3000 pages
    • >8000 images
    • organized by organ system
    • 9 th edition
    • includes diagnostic pearls
  • Psychology of a Pathologist
    • Prototypes for Obsessive-Compulsive Disorder and Introversion
    • Most are fanatical about their hobbies (eg, cooking, wine-making)
    • Typical work week for a Pathologist: 50 hours
    • Pathologists HATE change more than most physicians
    • More like a surgeon than they care to admit
    • Most feel as if they are the Rodney Dangerfields of medicine
  • What does a pathologist do?
    • 90% of what a pathologist does is:
      • Look at microscope slides & make a diagnosis
    • If they cannot make a diagnosis, they:
      • Look up information or ask a colleague or order additional stains or send out to an expert
    • Why do they look up information?
      • They’re not sure what they’re looking at
      • They can’t decide between 2 or more possible diagnoses
      • They know what the diagnosis is but need additional information
      • They need help on what to do to determine a diagnosis
  • Pathologists at work
    • Life Goals
      • Be good at my job
    • Experience goals
      • Don’t waste my time
      • Don’t be condescending
    • End goals
      • Answer a specific question about a possible diagnosis
      • Find a picture
      • Find a specific piece of information for a case
      • Be more efficient
    • Perry, Private Practice, 42
    • Has been in private practice for 8 years
    • Comfortable using computers, but currently doesn’t use them as much as his books for pathology-related questions
    • Often has very specific questions related to thresholds, margins, staging, grading; just wants the important bits, not all the background or foundation information
    • Driving need : Needs something that can help him work more quickly, more efficiently, and more effectively.
    • Perry works in a private practice located in a medium-size hospital in the western suburbs of Chicago, Illinois. There are 6 pathologists in the office, plus a pathology assistant who handles gross. Perry is the “go to” person in the office for gastrointestinal cases, but everyone handles a bit of everything. His day is incredibly busy, with sometimes as many as 60 cases to review. The majority of the cases are fairly straightforward, though sometimes he will have a rare diagnosis. Perry usually eats lunch at his desk around noon, but often won’t it finish until a few hours later because of the number of cases he has to finish in a day. Perry has a large library of books and refers to them often. Usually he looks for a specific picture to match a case, trying to pinpoint a diagnosis. He gets frustrated having to read through lots of text to just find the one piece of information he’s looking for, and wishes he could just jump past all of the basic information right to the things he needs. Sometimes his work is interrupted, as colleagues ask for opinions on other cases. While this can be frustrating, he doesn’t mind, as Perry often asks them for help with areas about which they are more knowledgeable. He tries to keep up with new developments in the field, but it’s not as important as when he was an attending, since he mainly sees the same types of cases. Still, it’s good to know about new immunostains and emerging areas like genetics, even if they’re not always useful in his day-to-day work. Perry works hard, and tries his best to leave on time to get home and spend time with his wife Jeanne and his three kids.
    Primary Persona
  • Elsevier Agile Development Process
  • developers developer developers pathologist pathologist pathologist consultant product mgr the boss UCD
  • High-level features & benefits list
    • A website for pathologists should contain:
      • Lots of high-quality pictures, with descriptions
      • Clear, concise, and current diagnosis info
      • Ability to compare differential diagnoses
      • Immunohistochemical stain information
    • For each diagnosis, pathologists want
      • Clinical information
      • Gross and microscopic description
      • Prognosis
      • Pictures
      • Differential diagnoses, including pitfalls and tips on what to look for
    • Content has to be:
      • Concise, bulleted style
      • Differential diagnosis information
      • Diagnostic pearls
  • High-level features & benefits list
    • A website for pathologists should contain:
      • Lots of high-quality pictures, with descriptions
      • Clear, concise, and current diagnosis info
      • Ability to compare differential diagnoses
      • Immunohistochemical stain information
    • For each diagnosis , pathologists want
      • Clinical information
      • Gross and microscopic description
      • Prognosis
      • Pictures
      • Differential diagnoses , including pitfalls and tips on what to look for
    • Content has to be:
      • Concise, bulleted style
      • Differential diagnosis information
      • Diagnostic pearls
  • Differential Diagnosis: low-fi prototype Amyloidosis Clear cell tumors Hürthle cell (oncocytic) tumors Hyalinizing trabecular adenoma and related lesions LYMPHOID TUMORS AND TUMORLIKE CONDITIONS Malakoplakia Medullary carcinoma MESENCHYMAL TUMORS METASTATIC TUMORS Other neuroendocrine tumors Parathyroid tumors Poorly differentiated carcinoma Home > Differential Diagnoses Then, select up to 5 diagnoses to compare Add   Remove Follicular carcinoma Follicular adenoma Papillary carcinoma First, select a body system Thyroid Select a different body system View Differential
  • Differential Diagnosis: low-fi prototype Home > Differential Diagnoses > Comparison Image caption (stain, magnification) Image caption (stain, magnification) Image caption (stain, magnification)
    • Diagnostic Pearl
    • Diagnostic Pearl
    • Diagnostic Pearl
    • 25 additional images available
    • View complete diagnostic information for Follicular carcinoma
    • Diagnostic Pearl
    • Diagnostic Pearl
    • Diagnostic Pearl
    • 15 additional images available
    • View complete diagnostic information for Follicular adenoma
    • Diagnostic Pearl
    • Diagnostic Pearl
    • Diagnostic Pearl
    • 18 additional images available
    • View complete diagnostic information for Follicular carcinoma
    Papillary carcinoma Remove from comparison Follicular adenoma Remove from comparison Follicular carcinoma Remove from comparison
  • As a Persona C I want to be able to view diagnostic information on a group of conditions so that I can decide between possible diagnoses. Story 7
  • Differential Diagnosis: as deployed
  • Differential Diagnosis: as deployed
  • From Pathology Book….
    • 3000 pages
    • >8000 images
    • organised by organ system
    • 9 th edition
    • includes diagnostic pearls
    • Online diagnostic clinical decision support covering general pathology.
    • Designed to be used at the point of work.
    • Image based.
    • Core is differential diagnosis tool to compare conditions.
    • At launch will includes 500 most useful conditions based on feedback from Pathologists
    .....to Diagnostic Tool
  • Timeline
    • Field study April 2005
    • Kick-off workshop July 5-7 th , 2005
    • Lo-fi prototype July 13 th , 2005
    • First customer demo September 7 th 2005
    • Second customer demo November 10 th 2005
    • Third customer demo February 17 th 2006
    • Launch May 17 th , 2006
  • PathConsult
    • Our lessons learned:
      • that user understanding is critical
      • that iterative development keeps the focus on the user
      • and to think outside the book
  • Thank you [email_address]