UMedCT University Medical Clinical Tracking Eric Cox Thesis Project INFO-I 680/681 TCO IU School of Informatics

UMedCT – 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 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 rotation o 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 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 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 tablet o Available to any university’s medical program as a complete system or supplement to an existing mobile web-based application o 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 Tracking Project Timeline

UMedCT – University Medical Clinical Tracking Domain Expert Interviews  To properly devise a list of system requirements o Interviews were conducted with 3 clinical faculty within the IU School of Medicine  Questions for each clinical faculty member extracted information about school requirements o Broken apart into class year (1 st year med student, 2 nd year med student, etc.) o Majority of clinical experience Classroom Role-playing Clinical simulations Clinical rotations

UMedCT – University Medical Clinical Tracking Requirements  Functional o The system data and web services must be reliable o The system must be easy to use o The system must securely authenticate users o The system must format accessed content to the platform of origin  Usability o The system must be accessible at all times o The system interface will be easily learnable o The system will leverage the user’s domain knowledge by using appropriate language and icons

UMedCT – University Medical Clinical Tracking Brief Literature Review  Titled: The Role of Technology in Assisting Medical Schools to Track Student Learning During Clinical Experiences o 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 Tracking Conceptual Model

UMedCT – University Medical Clinical Tracking Low-Fidelity Prototype  Mockingbird o Online prototyping tool to quickly and efficiently mockup the application o Internal walkthrough was performed, revealing system enhancements

UMedCT – 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 Tracking Usability Test  A total of 6 users were recruited from the IU School of Medicine o 2 Undergraduate students with a Pre-Med focus o 1 – 1 st year medical student o 1 – 2 nd year medical student o 2 – 4 th 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 were o Asked to sign the informed consent form for testing purposes according to IRB o Provided a demographic questionnaire to gauge familiarity with general technology o Provided a mobile device and PC to perform the test o Provided a set of task scenarios to complete during testing

UMedCT – University Medical Clinical Tracking Usability Test cont.  The test consisted of o 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 Camtasia o 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 completion o 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 Tracking Evaluation Results  100% task completion rate based on the task scenarios as described in the handout Emergency Medicine Clerkship FormICM – 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 Tracking Evaluation Results cont.  Error rates during usability testing revealed a slight increase among users, while using the mobile online system o 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 Tracking QUESTIONS ?