UMedCTUMedCTUniversity Medical Clinical TrackingUniversity Medical Clinical Tracking

Eric CoxThesis Project

INFO-I 680/681 TCOIU School of Informatics

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Problem Space

There is an immediate and critical need for a mobile clinical tracking system to be used at the medical university level, utilizing the availability of mini-pc technology to supplement an existing mobile application, that enables medical students to log clinical encounters, track progress within rotations and view statistical data, whether it be offline or online, all while in the clinical setting.

Medical students have a growing need to leverage advances in technology to more efficiently communicate with clinical faculty and professors, as well as the hospitals and clinics where they perform their clinical and residency education.

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Problem Space cont.

Medical University programs track student rotation experiences according to LCME standards:

o Paper-based• Many universities still use paper & pen to track and validate student experiences

while on clinical rotationo Limited technology

• The IU School of Medicine, like a few other medical universities use an electronic system for verifying student encounters, but these systems are designed by and for the parent university

o Medical schools require• Attending physicians, who are paired with students during rotations, to sign

(validate) encounters as soon as they are performed

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Idea – What is UMedCT?

A clinical encounters tracking tool, designed for and to be utilized by medical schools, that acts as a complete system or supplement to an existing mobile web-based electronic tracking tool

Loaded/installed on a mini-pc platform such as a Fujitsu tablet, leveraging an offline web platform for data storage and submission

Encounters data stored to local, offline database for future submission

Stored data synced and submitted via database connectivity to a centralized reports server

Encounters reports and statistics accessed via centralized web server and reports application

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Conceptualization

The concept is to provide a local, web-based application that is:o Installed and configured on a mini-PC platform such as a Fujitsu tableto Available to any university’s medical program as a complete system or supplement to an

existing mobile web-based applicationo Accessible anywhere at anytime

The application will:o Assist the student with

• Logging and storing required de-identified clinical encounters data • Applying attending physician validation prescribed by clerkship requirements• Uploading and submitting this data to a centralized reporting system• Accessing and applying real-time updates to off-line system files

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Project Timeline

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Domain Expert Interviews

To properly devise a list of system requirementso Interviews were conducted with 3 clinical faculty within the IU School of Medicine

Questions for each clinical faculty member extracted information about school requirementso Broken apart into class year (1st year med student, 2nd year med student, etc.)o Majority of clinical experience

• Classroom• Role-playing• Clinical simulations• Clinical rotations

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Requirements

Functionalo The system data and web services must be reliableo The system must be easy to useo The system must securely authenticate userso The system must format accessed content to the platform of origin

Usabilityo The system must be accessible at all timeso The system interface will be easily learnableo The system will leverage the user’s domain knowledge by using appropriate language

and icons

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Brief Literature Review

Titled: The Role of Technology in Assisting Medical Schools to Track Student Learning During Clinical Experienceso A total of 5 articles were reviewed and summarized to

• Evaluate familiarity with technology among students in medical school• Gauge the importance of technology use among medical schools• Extract how technology is currently being used among some schools• Define the importance of electronic vs. paper-based clinical tracking as medical

schools face ever-increasing and changing LCME accreditation standards for required medical student clinical interactions

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Conceptual Model

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Low-Fidelity Prototype

Mockingbirdo Online prototyping tool to quickly and efficiently mockup the applicationo Internal walkthrough was performed, revealing system enhancements

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Hi-Fidelity Prototype

Utilizing Open-Source software to limit the production cost of the application as well as enable access to upgrade and modify as needed

o System was designed using:• PHP scripting• Javascript• MySQL database

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Usability Test

A total of 6 users were recruited from the IU School of Medicineo 2 Undergraduate students with a Pre-Med focuso 1 – 1st year medical studento 1 – 2nd year medical studento 2 – 4th year medical students

o All students were recruited based on a recruitment script and informed that the test would take approximately 1 hour in its entirety

On testing day, students wereo Asked to sign the informed consent form for testing purposes according to IRBo Provided a demographic questionnaire to gauge familiarity with general technologyo Provided a mobile device and PC to perform the testo Provided a set of task scenarios to complete during testing

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Usability Test cont.

The test consisted ofo Asking users to utilize a think aloud protocol o Recording the screen to capture user interaction with the application, as well as errors by using screen capturing software called Camtasiao Capturing time-on-task for both the mockup of current system in use and the prototype

• Provided data for a comparative analysis of both systems

Upon test completiono Users were asked to complete a brief post test questionnaire to evaluate any thoughts of

• comfort with the application • labeling confusion • functionality issues • overall feedback of the application experience

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Evaluation Results

100% task completion rate based on the task scenarios as described in the handout

Emergency Medicine Clerkship Form ICM – II Clerkship Form

Results reveal an increase in efficiency with the offline system of an average of 49% T-test was performed on the data to reveal:

o T-value of 4.9 is ‘statistically significant’

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

Evaluation Results cont.

Error rates during usability testing revealed a slight increase among users, while using the mobile online systemo Cannot rule out the cause of this increase being due to a smaller, touch-screen

QWERTY keyboard

Based on Usability test results:o We can conclude that the off-line system (assuming any other extraneous factors were

well-controlled)• Provides quick and easy access to clerkship required forms data• Provides secure storage and submission of logged data• Is a more efficient system to log clinical encounters where Internet connectivity

signals are poor

UMedCT – University Medical Clinical TrackingUMedCT – University Medical Clinical Tracking

QUESTIONS

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