In this paper, we present the concept of a telematics system that not only opens an audiovisual communication channel to groundbased doctors, but also provides them with medical background information on the patient (e.g. contraindication of certain medicaments, affliction with haemophilia, diabetes). This information can be a vital supplement to the diagnostic data (e.g. electrocardiogram, oximetry) relayed to the specialist by the cabin crew, aiding the doctor in deciding on the right therapy, instructing the crew appropriately and monitoring the treatment.

In this paper, we present the concept of a telematics system that not only opens an audiovisual communication channel to ground-based doctors, but also provides them with medical background information on the patient (e.g. contraindication of certain medicaments, affliction with haemophilia, diabetes). This information can be a vital supplement to the diagnostic data (e.g. electrocardiogram, oximetry) relayed to the specialist by the cabin crew, aiding the doctor in deciding on the right therapy, instructing the crew appropriately and monitoring the treatment.

There is a current trend of constantly increasing emphasis on the cost-effective operation of vehicles in freight and passenger transportation. One of the efforts is to reduce the unproductive time of the driver and the vehicle which is spent on maintenance and repairs. The unproductive time can be significantly minimized by well-timed and faultless diagnostics that is, ideally, without need for a service visit. Real-time remote diagnostics, including an application that evaluates the current state of the vehicle, is a modern tool for efficient use of the vehicle.

With the ubiquity of digitalization, digital convergence of applications, devices, networks and artifacts presents both challenges and opportunities for individuals, organizations and society. Physical artifacts that were not digital in the recent past are now increasingly becoming intertwined with digital components, providing them with digital capabilities. As a consequence, vast amounts of information that used to be invisible can now be captured, digitized and used in new places and novel ways. Organizations thus seek to innovate IT-enabled services based upon the flows of information across both internal and external organizational boundaries. Because IT-enabled services support organizational actors in communicating and collaborating both inside and outside the organizations’ boundaries, they can also assimilate and diffuse knowledge across these boundaries. The thesis is a collection of five papers and a cover paper reporting an exploration of the role of digitalized equipment in boundary-spanning practices as a contribution to the design and implementation of IT-enabled services. Three embedded case studies of Swedish industrial organizations provide an opportunity to address the research question. The findings are based on studies of remote diagnostics services for industrial equipment enabled by remote diagnostics systems, an application family within ubiquitous computing. The thesis illustrates that remote diagnostics systems have a profound impact on how organizational boundaries that were drawn as ‘cross-overs’ are becoming less limited by constraints of time, space and the type of data shared. These systems permit workers at remote sites to gain access to information about external dispersed equipment and production processes. They also create new boundaries between entities that were not previously connected and across existing boundaries with new information and knowledge. This thesis gives insight into how such information sharing across boundaries may leverage multicontextual practices. This thesis contributes to the existing literature with the development of a conceptual apparatus for understanding how embedded technology transforms boundary-spanning practices from a pure social activity to a boundary-spanning assemblage. Boundary spanning is an increasingly complex sociomaterial practice that fundamentally rests on technology as well as human competencies. The technology is deeply intertwined in the boundary-spanning activity as the sensors installed in the monitored equipment serve as the remote technicians’ eyes and ears. Together, the technology and the technicians form a boundary-spanning assemblage. While information systems research has called for attention to the ‘IT artifact’, this thesis underscores the importance of the characteristics of the specific technology and the profound effects it has had on its surroundings. In contrast to predominant ubiquitous computing research that mainly explores mobile applications, this thesis also shows how the increased embeddedness of IT makes technology an invisible but ever-present part of everyday work practices. Digitalized equipment with embedded technology thus raises not only novel opportunities but also novel challenges for both users and researchers. We can design IT solutions today where people close to the technology have no access to or awareness of it. People can be monitored without visual cues revealing the monitoring. Furthermore, developing or using an IT-enabled service is not merely about developing/using a technology or a system; it also involves issues about the technology’s value creation, its ownership, competencies and customer relationships. IT and services should thus not be considered as separate and subsequent processes: they are deeply intertwined and mutual. This thesis thus suggests that digitalized equipment with embedded technology deserves critical scrutiny.

Made available in DSpace on 2014-12-17T14:55:04Z (GMT). No. of bitstreams: 1 GlauciaRMAS_TESE.pdf: 2163942 bytes, checksum: 5778dd8818ffc286b87137c2a56b9fc0 (MD5) Previous issue date: 2012-05-14 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Breast cancer, despite being one of the leading causes of death among women worldwide is a disease that can be cured if diagnosed early. One of the main techniques used in the detection of breast cancer is the Fine Needle Aspirate FNA (aspiration puncture by thin needle) which, depending on the clinical case, requires the analysis of several medical specialists for the diagnosis development. However, such diagnosis and second opinions have been hampered by geographical dispersion of physicians and/or the difficulty in reconciling time to undertake work together. Within this reality, this PhD thesis uses computational intelligence in medical decision-making support for remote diagnosis. For that purpose, it presents a fuzzy method to assist the diagnosis of breast cancer, able to process and sort data extracted from breast tissue obtained by FNA. This method is integrated into a virtual environment for collaborative remote diagnosis, whose model was developed providing for the incorporation of prerequisite Modules for Pre Diagnosis to support medical decision. On the fuzzy Method Development, the process of knowledge acquisition was carried out by extraction and analysis of numerical data in gold standard data base and by interviews and discussions with medical experts. The method has been tested and validated with real cases and, according to the sensitivity and specificity achieved (correct diagnosis of tumors, malignant and benign respectively), the results obtained were satisfactory, considering the opinions of doctors and the quality standards for diagnosis of breast cancer and comparing them with other studies involving breast cancer diagnosis by FNA. / O c?ncer de mama, apesar de ser uma das principais causas de morte entre as mulheres em todo o mundo, ? uma doen?a que pode ser curada se for diagnosticada precocemente. Uma das principais t?cnicas utilizadas na detec??o de c?ncer de mama ? a Fine Needle Aspirate FNA (ou Pun??o Aspirativa por Agulha Fina) que, dependendo do caso cl?nico, necessita da an?lise de v?rios m?dicos especialistas para a efetiva??o do diagn?stico. Entretanto, a realiza??o de tais diagn?sticos e a emiss?o de segundos pareceres t?m sido prejudicadas pela dispers?o geogr?fica dos m?dicos e/ou a dificuldade na concilia??o de tempo para realizar trabalhos em conjunto. Inserindo-se nessa realidade, esta tese de doutorado utiliza intelig?ncia computacional no apoio ? tomada de decis?o m?dica para a realiza??o de telediagn?sticos. Para tanto apresenta um m?todo fuzzy destinado a auxiliar o diagn?stico de c?ncer de mama, capaz de processar e classificar dados extra?dos de esfrega?os de tecidos mam?rios obtidos por FNA. Este m?todo est? integrado a um ambiente virtual para realiza??o de telediagn?stico colaborativo, cujo modelo foi desenvolvido prevendo a incorpora??o de M?dulos de Pr?-Diagn?stico para apoio ? tomada de decis?o m?dica. No desenvolvimento do m?todo fuzzy, o processo de aquisi??o do conhecimento foi realizado pela extra??o e an?lise dos dados num?ricos em base de dados padr?o ouro e por entrevistas e discuss?es com m?dicos especialistas. O m?todo foi testado e validado com casos reais e, em fun??o da sensibilidade e da especificidade alcan?adas (diagn?stico correto de tumores, respectivamente, malignos e benignos), os resultados obtidos foram satisfat?rios, considerando tanto os pareceres de m?dicos e os padr?es de qualidade para diagn?stico de c?ncer de mama quanto a compara??o com outros estudos realizados envolvendo diagn?stico de c?ncer de mama por FNA.