Taller Internacional de Software Educativo


Trabajo :

Multimedia and Health Care: An infoway for Target Population


Federal University of Juiz de Fora
* Department of Computer Science
*** Deptartment of Nephrology
Campus Universitário - CEP 36100 300
Juiz de Fora - MG - Brasil

Federal University of Rio de Janeiro
**Department of Computer Science
P.O. Box Postal 68 511 - CEP 21 945 270
Rio de Janeiro - RJ - Brasil

 Autores :

Fernanda Campos*
Marcus Bastos***
Gláucia Sá Fortes*

Neide Santos **
Rogério Baumgratz ***
Marcos Quinet*


In this paper, we report the development of interactive multimedia for target people, under a multidisciplinary approach. The work aims to test new technologies efficiency as a communication channel to inform target population and to display information and orientation in kiosks at Brazilian public hospitals. Interface issues are presented as well as the related future works.

1. Introduction 

The nineties are seeing the consolidation of hypermedia systems second-generation, due to the increasing computer capacity in large-scale information management and the graphical user interface improvement. In addition, hypermedia applications spectrum have become largest, and one of their most encouraging and updated use is in distance learning, continuing education and education for target people.

New technologies should help individuals to have a better way of living. People in the information society use different kinds of technologies to communicate and to gather useful information. Medicine has been using the computing resources for examine, diagnosis and diseases care, as well as the new networking technologies for medical collaboration and consultation. Therefore, it is lacking intensive use of these advances as way of communicating with target people.

Narrowing this point of view, updated health information for target population seems to be an interesting field to join self-learning approach with user-friendly computing systems, such as multimedia. Multimedia can display images, sound, video in an interactive and motivate way with great possibilities of bringing benefits for not medical specialists.

In this paper, we report the development of an interactive multimedia prototype - High Pressure. We aim to achieve two goals: test this technology efficiency as a communication channel to inform target population and display information and orientation about health care in an inspiring and entertaining way.

2. High Pressure: an Interactive Multimedia for Target People

High Pressure is a common and silent disease that many times is non-symptomatic, presenting in about 20% of the Brazilian population. So, we are developing an interactive multimedia, which answers the most usual questions, such as what is high pressure? which are the main risk factors? which are the kind of food we must avoid? what kind of sports we must practice? which is the impact of high pressure in the whole body? The multimedia also emphasizes the importance of a regular visit to the medical doctor. To reach this goal, we joined a multidisciplinary team, which had the following tasks:

2.1 Development Phases

Developing interactive multimedia for target population, we have faced many questions:

The first questions can be minimized through the use of a strong modeling support. The last question needs the support of a powerful software development environment.

2.1.1 Multimedia Modeling

The multimedia development core seems to be a clear and well built contents modeling. Our multidisciplinary team - medical doctors, computing and education specialists and computer science specialists must have a shared understanding about interactive multimedia essence - content divided in little pieces of information connected by referential links, displayed in an user-friendly interface. We used an easy method for modeling High Pressure - Hiper-Author [Sequerra-Breitman, Rocha & Santos, 1994].

Hiper Autor helps a work team to organize and discipline both their thought and their work, providing specific tools and supporting techniques for each phase of the authoring process. The method is composed of a graphical language and documentation forms. The Hiper Autor development process follows the spiral life cycle model, in an evolutionary approach. It involves successive versions of the multimedia application during the specification and project phases. The main phases of the method are initial requirements elicitation, elaboration of the global network scheme, elaboration of the nodes and links network and detailed design specification.

The purpose of the requirements elicitation phase is to determine the application scope and the educational goals. The topics that will be covered in the application must be chosen, and the depth to which they will be covered has to be determined. Elicitation consists of collecting, validating and specifying the requirements of the multimedia application to be built. During modeling, context are defined. In Hiper Autor, contexts are partitionings of the whole content into large groups of related topics. The products of this phase is the context diagram form, consisting of the diagram itself in a graphical notation and a natural language statement of the application objectives.

The next step is the elaboration of the global context scheme. The result of this phase is a simplified form, consisting of the name of the node, a brief description of the topics to be discussed, the determination of the links from this nodes to other nodes and information about the node format, i.e., text, sound, images.

With collected information in these two phases, the elaboration of the nodes network is started. During the previous phase, the content was divided into nodes, that can be addressed by a link, constituting a set of simplified forms. Even with this set, it is difficult to visualize the whole content and the links among the nodes. The visualization is essential to permit evaluating whether the organization of the document will allow obtaining the goals established for the product. Hiper Autor models the content with the information contained in the forms, providing a graphical representation of the nodes contained in the document as well as the links among them.

Based on the previous forms and further interactions with the domain expert, the multimedia application expert prepares a node network in which all navigational options are explicit. Using the graphical notation, it is possible to represent all nodes and their links, providing a global view of the application. It works with visual representation of the nodes and links network and its successive refinements. Since the node diagram is complete, it is possible to evaluate the design, and the presence of mistakes, incompleteness and inconsistencies. Evaluated the node diagram, the final draft of nodes contents is beginning. The result of this phase is the detailed design specification. Hiper Autor provides a specific form to support the complete specification.

In the High Pressure modeling phase, the first step was to elicit the medical expert knowledge, through a top-down methodology. After this step, both computing and education and computer science specialists started to sketch the nodes and links network. Figure 1 shows the main topics about High Pressure, which were elicited in work sessions with medical doctors. The topics was organized in a Brief Explanation about High Pressure and in eight contexts: What is High Pressure?; Who has High Pressure?; High Pressure Types; Symptoms; Risk Factors; High Pressure and your Body; Involved Risks; and Treatment. It was our preliminary nodes and links network. Successive refinements to reach the final version were made together by the team.

All team involved in High Pressure multimedia development understood well how Hiper-Autor works, and it was a good approach, since each team member can propose changes in the earliest phases of the development. From the modeling-in-the-large (conceptual model) to the modeling-in-the-small (the nodes and likes network), medical doctors were able to visualize the multimedia graphical representation.

Figure 1 - First Modeling of High Pressure Document

Figure 2 represents a preliminary modeling of the context Involved Factors, which emerged from team successive refinements.


Figure 2 -Involved Factors

Following Hiper-Autor steps, we validated the multimedia scope, the nodes content, the links between nodes and a preliminary interface design. When the validated modeling of High Pressure interactive multimedia was concluded, we started the development phase.

2.1.2 Multimedia Implementation

Modeled the multimedia application, the next phase was to chose a software environment for implementing the prototype. In previous works, we used successfully Asymetriz ToolBook 3.0â , because it allows images, video, animation, sound in a conventional hardware platform.

The authoring tools available in ToolBook 3.0â gave the required support for an ease and user-friendly implementation. Next figures present some of High Pressure screens.





Figure 3 - Multimedia High Pressure screens

3. Interface Issues

High Pressure prototype interface incorporates a surveillance high level and some predetermined patters to avoid unfortunate side effects. From the perspective of the interface design to promote and support continuous education, the important problems that had to be addressed were:

Considering that people have different needs, goals and intentions, when they navigate through the hypermedia, a perfect interface design is quite difficult. In order to make the hypermedia interface as effective and efficient as possible, we followed some rules:

The benefits cited by the group experience included the envisioning of new interface design and patterns. We have observed that it is possible to build a family of standard interfaces, based on common elements typical of specific application domains. Our more recent prototype - Diabetes Mellitus - provides a interface very similar with High Pressure interface. This standardization of the interface is an interesting goal, since it can improve the software productivity and we can test the effective of the interface components with a biggest number of people.

4. Conclusion and Future Works

The global infoway is driving the rapid evolution of information infrastructure that enhance our abilities to access and interlink materials in remote places. A virtual community can illustrate the impact of the new forms of communication and learning. As the Internet grows cheaper and more powerful it is becoming feasible to design virtual environments for target population. Many factors contributed to the success of these programs:

At the moment, we are working to make High Pressure multimedia available as a Web site. The site will integrate other Internet technologies, such as, a discussion group about High Pressure, links to related sites, e-mail support for medical requesting and a FAQ (Frequently Answered Questions).


We would like to acknowledge the CNPq, FAPEMIG and UFJF for supporting the research.


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Santos, N.; Campos, F.; Bastos, M.; Balgratts, R.; Varoto A.; & Miana, R. "Medicine and Multimedia New Horizons for Target Population". Proceedings of ED-MEDIA 97, Calgary, June 1997.

Sequerra-Breitman, K.; Rocha, A. & Santos, N. "Authoring Considerations in the Imaginary Museum Project: The Sistine Chapel - A case study" Proceedings of the ED-MEDIA 94. Orlando, June 1994.