How do medical professionals make sense (or not) of AI? A social-media-based computational grounded theory study and an online survey

To investigate opinions and attitudes of medical professionals towards adopting AI-enabled healthcare technologies in their daily business, we used a mixed-methods approach. Study 1 employed a qualitative computational grounded theory approach analyzing 181 Reddit threads in the several subreddits of r/medicine. By utilizing an unsupervised machine learning clustering method, we identified three key themes: (1) consequences of AI, (2) physician-AI relationship, and (3) a proposed way forward. In particular Reddit posts related to the first two themes indicated that the medical professionals' fear of being replaced by AI and skepticism toward AI played a major role in the argumentations. Moreover, the results suggest that this fear is driven by little or moderate knowledge about AI. Posts related to the third theme focused on factual discussions about how AI and medicine have to be designed to become broadly adopted in health care. Study 2 quantitatively examined the relationship between the fear of AI, knowledge about AI, and medical professionals' intention to use AI-enabled technologies in more detail. Results based on a sample of 223 medical professionals who participated in the online survey revealed that the intention to use AI technologies increases with increasing knowledge about AI and that this effect is moderated by the fear of being replaced by AI.

What constitutes victims of toxicity - identifying drivers of toxic victimhood in multiplayer online battle arena games

Introduction

Toxic behavior (i.e., toxicity) is a pervasive problem in online gaming communities such as League of Legends. This issue arises from factors such as frustrating and stressful in-game experiences and online disinhibition. Prior research on addressing toxicity has focused primarily on the perpetrators and how to mitigate their negative behavior and the consequences. The aim of this study was to approach toxicity from the perspective of the victims instead, and consequently, to investigate the factors that contribute to the experience of victimhood in multiplayer online battle arena games.

Methods

A global sample of League of Legends and Defense of the Ancients 2 players (n=313) was collected to test hypotheses based on three theoretical approaches drawn from previous work, namely, the online disinhibition effect, social cognitive theory and theory of planned behavior. Participants were asked to complete a survey that included variables related to the three theoretical approaches.

Results

The results of the study indicated that self-efficacy, and benign and toxic disinhibition, were the most relevant antecedents for the experience of being a victim of toxicity. Accordingly, the findings thus suggest that players with low self-efficacy and high online disinhibition may be more likely to experience victimhood in multiplayer online battle arena games. In general, insights based on our study demonstrate that individual characteristics partially explain why some players are more susceptible to toxic behavior than others.

Discussion

The study's results have practical implications for game developers and policymakers, particularly in the areas of community management and player education. For example, game developers may consider incorporating self-efficacy training and disinhibition reduction programs into their games. Overall, this study contributes to the growing body of literature on toxicity in online gaming communities and invites further research into toxicity from the perspective of the victims.

To be or not to be stressed: Designing autonomy to reduce stress at work

BACKGROUND

Many organizations are undertaking efforts to reduce the stress of (oftentimes overworked) employees. Information Technology (IT) (e.g., smartphones) has the potential to be a key instrument for reducing stress. One design-relevant factor considered to reduce stress is the concept of autonomy. Unfortunately, little research exists using autonomy as a characteristic of technology design.

OBJECTIVE

Against this background, this study aimed to investigate specific autonomy-related design options with the potential to prevent stress.

METHODS

In a factorial survey, this experimental study tested three design options in an overwork scenario: 1) autonomy (no intervention by design), 2) nudge ("nudging" by design), and 3) enforcement (hard stop by design). 51 participants (mean age 38 years, 50% women, mean work experience 18 years) from the Netherlands, United Kingdom, United States of America, and Germany participated in the experiment for 330 seconds on average. To test our hypothesis, we used a two-step approach. First, a multiple linear regression was applied. Second, we carried out a one-way ANCOVA comparing the effects of our design options.

RESULTS

Our results indicate that autonomy can be manipulated through technology design and is negatively correlated with stress. Additionally, the design options autonomy and nudge were associated with lower levels of perceived stress than was enforcement.

CONCLUSION

The study proposes a careful use of IT and policies that limit the perceived autonomy of employees. Overall, this study offers a set of design recommendations arguing that organizations should implement technology that helps employees prevent overwork and maintain their autonomy.

Competence transfer in virtual realities: Can virtual reality bring products and services together?

BACKGROUND: The virtual and real worlds of work are increasingly merging through digital transformation. This also applies to products and services. Virtual Reality (VR) with all its learning opportunities is a promising technology to improve workflows and enable transparency between different departments and organizations. This transparency is particularly important when it comes to preventing potentially dangerous work situations. OBJECTIVE: We investigate weaknesses in competence transfer processes between computer-aided designers and service employees connected in a hybrid value chain. On the one hand, designers receive only little feedback, hence are missing necessary evaluation to adjust their designs to empirical specifications. On the other hand, service employees, therefore, work with sometimes impractical machine designs which makes their work on-site unergonomic, dangerous, and more difficult. METHODS: We present a design science-driven, empirical approach to provide enhanced competence transfer with the help of VR. Thereby, we evaluate a self-developed VR demonstrator with an iterative approach consisting of 60 qualitative interviews. RESULTS: The developed VR demonstrator supports interorganizational sharing of (tacit) knowledge by enabling designers to take the service perspective and ensuring collaboration across organizational boundaries. By intentionally using VR technology as an interruption to the work, the design can be viewed from a service perspective and evaluated for occupational safety and health issues. CONCLUSIONS: The work process improvements achieved by the VR demonstrator enable early consideration of design issues that are particularly relevant to safety, thus ensuring greater occupational safety and health protection in the processes for service employees.

Invite everyone to the table, but not to every course: How Design-Thinking collaboration can be implemented in smart cities to design digital services

Innovative collaboration strategies are a promising tool for fostering the governance of smart cities while acknowledging citizen centricity. During implementation, however, determining the number and background of the involved actors is challenging. The Design-Thinking (DT) approach appears suitable for addressing this issue as it offers a concrete and adaptable course of action. The present contribution involves a study on implementing DT principles in a German health resort and identifies three critical components: (1) team, (2) process, and (3) workspace. Our use case is an adaptable project- and workshop plan that encourages the implementation of DT collaboration in smart cities when designing digital services. Our results provide initial guidelines on how to involve diverse actors, when to integrate trained DT coaches, and how to design collaborative innovation in a digital way. The practice-oriented insights gained in the study can be applied, adapted, and discussed in other smart cities and citizen-centered projects.

Investigating the Use of Telemedicine for Digitally Mediated Delegation in Team-Based Primary Care: Mixed Methods Study

Background

Owing to the shortage of medical professionals, as well as demographic and structural challenges, new care models have emerged to find innovative solutions to counter medical undersupply. Team-based primary care using medical delegation appears to be a promising approach to address these challenges; however, it demands efficient communication structures and mechanisms to reinsure patients and caregivers receive a delegated, treatment-related task. Digital health care technologies hold the potential to render these novel processes effective and demand driven.

Objective

The goal of this study is to recreate the daily work routines of general practitioners (GPs) and medical assistants (MAs) to explore promising approaches for the digital moderation of delegation processes and to deepen the understanding of subjective and perceptual factors that influence their technology assessment and use.

Methods

We conducted a combination of 19 individual and group interviews with 12 GPs and 14 MAs, seeking to identify relevant technologies for delegation purposes as well as stakeholders’ perceptions of their effectiveness. Furthermore, a web-based survey was conducted asking the interviewees to order identified technologies based on their assessed applicability in multi-actor patient care. Interview data were analyzed using a three-fold inductive coding procedure. Multidimensional scaling was applied to analyze and visualize the survey data, leading to a triangulation of the results.

Results

Our results suggest that digital mediation of delegation underlies complex, reciprocal processes and biases that need to be identified and analyzed to improve the development and distribution of innovative technologies and to improve our understanding of technology use in team-based primary care. Nevertheless, medical delegation enhanced by digital technologies, such as video consultations, portable electrocardiograms, or telemedical stethoscopes, can counteract current challenges in primary care because of its unique ability to ensure both personal, patient-centered care for patients and create efficient and needs-based treatment processes.

Conclusions

Technology-mediated delegation appears to be a promising approach to implement innovative, case-sensitive, and cost-effective ways to treat patients within the paradigm of primary care. The relevance of such innovative approaches increases with the tremendous need for differentiated and effective care, such as during the ongoing COVID-19 pandemic. For the successful and sustainable adoption of innovative technologies, MAs represent essential team members. In their role as mediators between GPs and patients, MAs are potentially able to counteract patients’ resistance toward using innovative technology and compensate for patients’ limited access to technology and care facilities.

Human Factors and Technological Characteristics Influencing the Interaction with AI-enabled Clinical Decision Support Systems: A Literature Review (Preprint)

Background

The digitization and automation of diagnostics and treatments promise to alter the quality of health care and improve patient outcomes, whereas the undersupply of medical personnel, high workload on medical professionals, and medical case complexity increase. Clinical decision support systems (CDSSs) have been proven to help medical professionals in their everyday work through their ability to process vast amounts of patient information. However, comprehensive adoption is partially disrupted by specific technological and personal characteristics. With the rise of artificial intelligence (AI), CDSSs have become an adaptive technology with human-like capabilities and are able to learn and change their characteristics over time. However, research has not reflected on the characteristics and factors essential for effective collaboration between human actors and AI-enabled CDSSs.

Objective

Our study aims to summarize the factors influencing effective collaboration between medical professionals and AI-enabled CDSSs. These factors are essential for medical professionals, management, and technology designers to reflect on the adoption, implementation, and development of an AI-enabled CDSS.

Methods

We conducted a literature review including 3 different meta-databases, screening over 1000 articles and including 101 articles for full-text assessment. Of the 101 articles, 7 (6.9%) met our inclusion criteria and were analyzed for our synthesis.

Results

We identified the technological characteristics and human factors that appear to have an essential effect on the collaboration of medical professionals and AI-enabled CDSSs in accordance with our research objective, namely, training data quality, performance, explainability, adaptability, medical expertise, technological expertise, personality, cognitive biases, and trust. Comparing our results with those from research on non-AI CDSSs, some characteristics and factors retain their importance, whereas others gain or lose relevance owing to the uniqueness of human-AI interactions. However, only a few (1/7, 14%) studies have mentioned the theoretical foundations and patient outcomes related to AI-enabled CDSSs.

Conclusions

Our study provides a comprehensive overview of the relevant characteristics and factors that influence the interaction and collaboration between medical professionals and AI-enabled CDSSs. Rather limited theoretical foundations currently hinder the possibility of creating adequate concepts and models to explain and predict the interrelations between these characteristics and factors. For an appropriate evaluation of the human-AI collaboration, patient outcomes and the role of patients in the decision-making process should be considered.

Investigating the Acceptance of Video Consultation by Patients in Rural Primary Care: Empirical Comparison of Preusers and Actual Users

BACKGROUND

The ongoing digitalization in health care is enabling patients to receive treatment via telemedical technologies, such as video consultation (VC), which are increasingly being used by general practitioners. Rural areas in particular exhibit a rapidly aging population, with an increase in associated health issues, whereas the level of attraction for working in those regions is decreasing for young physicians. Integrating telemedical approaches in treating patients can help lessen the professional workload and counteract the trend toward the spatial undersupply in many countries. As a result, an increasing number of patients are being confronted with digital treatment and new forms of care delivery. These novel ways of care engender interactions with patients and their private lives in unprecedented ways, calling for studies that incorporate patient needs, expectations, and behavior into the design and application of telemedical technology within the field of primary care.

OBJECTIVE

This study aims to unveil and compare the acceptance-promoting factors of patients without (preusers) and with experiences (actual users) in using VC in a primary care setting and to provide implications for the design, theory, and use of VC.

METHODS

In total, 20 semistructured interviews were conducted with patients in 2 rural primary care practices to identify and analyze patient needs, perceptions, and experiences that facilitate the acceptance of VC technology and adoption behavior. Both preusers and actual users of VC were engaged, allowing for an empirical comparison. For data analysis, a procedure was followed based on open, axial, and selective coding.

RESULTS

The study delivers factors and respective subdimensions that foster the perceptions of patients toward VC in rural primary care. Factors cover attitudes and expectations toward the use of VC, the patient-physician relationship and its impact on technology assessment and use, patients' rights and obligations that emerge with the introduction of VC in primary care, and the influence of social norms on the use of VC and vice versa. With regard to these factors, the results indicate differences between preusers and actual users of VC, which imply ways of designing and implementing VC concerning the respective user group. Actual users attach higher importance to the perceived benefits of VC and their responsibility to use it appropriately, which might be rooted in the technological intervention they experienced. On the contrary, preusers valued the opinions and expectations of their peers.

CONCLUSIONS

The way the limitations and potential of VC are perceived varies across patients. When practicing VC in primary care, different aspects should be considered when dealing with preusers, such as maintaining a physical interaction with the physician or incorporating social cues. Once the digital intervention takes place, patients tend to value benefits such as flexibility and effectiveness over potential concerns.