UMedCT
University Medical Clinical Tracking
Eric Cox
Thesis Project
INFO-I 680/681 TCO
IU School of Informatics
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
•
o
Limited technology
•
o
Many universities still use paper & pen to track and validate student experiences
while on clinical rotation
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
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 (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 Tracking
Requirements
 Functional
o
o
o
o
The system data and web services must be reliable
The system must be easy to use
The system must securely authenticate users
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
o
o
o
2 Undergraduate students with a Pre-Med focus
1 – 1st year medical student
1 – 2nd year medical student
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 were
o
o
o
o
Asked to sign the informed consent form for testing purposes according to IRB
Provided a demographic questionnaire to gauge familiarity with general technology
Provided a mobile device and PC to perform the test
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 Form
ICM – II Clerkship Form
80
100
60
80
40
20
60
Online app
Offline app
0
40
20
Online app
Offline app
0
 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
?
UMedCT – University Medical Clinical Tracking