Remote Cooperation:
CSCW Issues for Mobile and Tele-Workers
Alan Dix and Russell Beale (eds.)

There are a number of health care and allied professionals who can be described as mobile workers. These include such staff groups as District Nurses, District Midwives, Health Visitors and Social Workers. The generic term to describe these categories of staff is 'Community Care Workers'.

The first generation of computerized information systems designed to support Community Health activities were developed in the late 1980s, and were essentially retrospective management information systems. One such system (hereafter referred to as "System A") was developed in East Dyfed Health Authority during the late 1980s. This system used a hand-held 'organizer'-type computer to collect data for a management information system which ran on a super-microcomputer using a proprietary operating system, located at the District Health Authority headquarters. There have been a number of problems with this type of system, particularly in regard to issues of staff acceptability.

The knowledge and experience gained during this development was utilized in the design and production of the first of the second generation of Community Health Information systems ("System B"), designed to provide operational support for community health activities. In addition to management information, System B offers support for team working in community care and a knowledge base to support individuals in their work.

In early 1993, the Institute for Health Informatics completed a field trial of System B where Community Health staff and Social Services staff used portable laptop PCs in the field, linking to desktop PCs at their base and thence to a central UNIX machine. This chapter describes the recent experience of System B and compares it with experience of System A.