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managing patient care. Despite initially entering thedomain with a focuson the collaborative activities of theclinical staff, our fieldwork in the A&E department hasalso identified valuable opportunities for the exploitationof information technology by the patients themselves.Patients were frequently observed to show signs ofannoyance, stress and exasperation. Our field studieand previous research [e.g. 9] suggest that a major contributingfactor is long waiting times with no explanationor information. In addition to causing stress for the
patients, continual requests for information causedstress to the staff. The frequent need to respond to theserequests was often distracting, interrupting their ongoingwork. Such interruptions at times had the unfortunateeffect of increasing the patients’ waiting times still
further. Previous work has shown that urgent care patients
who were told the expected waiting time fortreatment and were kept busy while waiting, had highersatisfaction perceptions of their treatment [9]. Maister
[10] suggested that customers who were given informationabout how long they would have to wait are lesslikely to be anxious about the wait. Dansky and Miles
[11] found that telling patients in an urgent caredepartment how long they would have to wait waspositively related to their satisfaction with the treatment.This research suggests that the provision of information
of this type might be a useful tool not only forreducing stress, but also in influencing patients’ perceptionsof satisfaction with their visit. In the A&E waitingarea under study, some information was on display,though nothing that related to likely waiting times.
There was clearly a requirement for this informationsince staff were continually asked by patients both forgeneral information about the average waiting timesthat day and for specific information about their personalwait. This kind of information would enable patients
to make transport arrangements, and to letanxious family members know roughly how long theywould be at the hospital. It would also help to reassurethem that they had not been forgotten.
Our prototype design for such a system included arange of services we identified as potentially useful to thepatients in this setting. The combination of the patients’requirements and the requirements of the physical settingin the hospital suggested a system that offered a mixture
of ubiquitous and mobile functionality using a variety ofmodalities and devices. Hence, it provided a usefulexample domain for our experimental evaluation of theeffect ofthepresence or absence of a GUI on participants’use of our combined gesture and speech interactiontechniques.
3 Input and output techniques for mobile and ubiquitous
systemsGiven the inadequacies of traditional desktop input
techniques in a ubiquitous computing environment andeven more so with mobile and wearable computing,there has been considerable research investigatingalternative techniques [e.g. 12, 13]. Prominent amongst
these is gesture or stroke based input [14]. Furthermore,speech outpuhas been considered as an alternative tovisual output, and advances in text-to-speech technologyhave made the use of speech output more realistic [15].
3.1 An input technique for mobile, wearable and ubiquitous
systemsGesture input has formed the basis for many of theinputtechniques used with PDAs, whether in the form oftouchscreen strokes to perform commands