MMS Information Technology Award: Prevailing Award Subjects From Past Years

2016

Category: Resident
Summary: Automated SMS/Email Based Check-ins to Educate and Monitor Patients is an automated patient support and monitoring tool that delivers precisely timed text-message and/or email-based reminders to patients for a variety of indications (e.g. procedure prep, discharge). The patient instructions are either video based or written in a clear, succinct, manner. Moreover, the program delivers check-in questions related to patient progress and flags those at-risk of non-compliance for appropriate outreach. The program, and its content, is fully customizable to reflect any practice/institution, which enables patients to experience the program as a seamless extension of their providers care. The software removes significant technical barriers, as it does not require an app download or EHR integration.

Category: Student
Augmented reality (AR) combines real-world environments with computer-generated sounds, text, and graphics. Current applications focus on consumer products and video games, however, such navigation systems have potential for use in medical education. The game developer software Unity 3D engine (San Francisco, CA) was utilized to program 3D anatomic models into a “game environment’ which was then projected into augmented reality using Vuforia software development. Both computer-generated anatomic models and real patient anatomy derived from CT and MRI imaging can be displayed in this manner. Imaging in DICOM format was converted into 3D models using the software 3D slicer. Final data was uploaded onto a smartphone fitted into a Google Cardboard viewer; the user enters an AR environment and has the ability to zoom, rotate, and clip through layers of projected anatomic models. As this program is based on the optical inputs of a smartphone, the model is easily accessible and highly mobile. The application was field-tested in fifteen BU medical students, who completed a follow-up survey.

2015

Category: Resident
Summary: The Mindful Moods project aimed to go beyond the feasibility of collecting patient self report data in real time on a smartphone platform and instead investigate the clinical validity of that data. At this point in time, it is clear that technology can do many things in a scalable and low cost manner, but the real question for healthcare is can technology do such things in a manner that is valid, safe, and effective. The smartphone app created for this study assessed nine questions related to major depressive disorder on a daily basis and was piloted in 13 clinical subjects who used the app for one month, creating just over 3,500 data points. Results suggested that patients report symptoms of depression differently to a smartphone and that data collected from mobile platforms holds potential but requires further clinical validation before being deployed on a larger scale. The results have been published and are freely available to read at http://mental.jmir.org/2015/1/e8. Of note, the app was available on the iTunes and Android app stores during the study period and created with a budget of less than $1,000. It highlights the ease of creation and potential clinic use of real time data for major depressive disorder but also underscores the important role that clinicians must play in the development of technology for healthcare.

Category: Student
Summary: The best medical care is experience-driven, but no doctor has experience treating every disease. To bridge potential gaps in knowledge, Parallel Patients supplements a physician’s toolkit by identifying patients similar to their own in the electronic health record system. Using an anonymized EHR database from the Beth Israel Deaconess Medical Center with records from over 40,000 patients, we built a platform for clinicians to quickly find the top ten most similar ICU records for any given patient admission, allowing new doctors in particular to view the management of prior cases, learn from the perspectives of other clinicians, and ultimately improve their medical outcomes. We are currently developing a grading website ( https://parallel-patients-gavinovsak.c9.io) for our partnered physicians to evaluate search results from our platform, and with their feedback, we hope that our technology can empower doctors and add value to the future of medical care.

2014

Category: Resident
2-Minute Medicine (Web publication site) (Marc Succi – Mass General Hospital - Radiology)
Clinicians spend a significant portion of time exploring segmented content platforms for new medical research. 2 Minute Medicine was created to produce original, centralized, medical reports of current research.

The applicant’s web publication produced ~110 reports/month in 2014, serving 120,000+ monthly views in 120+ countries. In the past year, readership grew 214% (Q2 2014/Q2 2013). The bounce rate in Q2 2014 was 30%, a decrease of 3% from Q2 2013, indicating industry-leading reader engagement. A pool of 250 readers were randomly selected from our registered user list (users registered for at least one week). 42% responded. Prior to using the site, readers reported consuming a mean of 2.92 studies per week. After using the site for at least one week, readers reported consuming a mean of 6.99 studies weekly (p <.0001). 31%="" of="" visitors="" engaged="" the="" site="" daily,="" 22%="" every="" other="" day,="" and="" 29%="" once="" per="" week.="" 97%="" of="" readers="" agreed="" or="" strongly="" agreed="" that="" they="" were="" more="" up="" to="" date="" with="" medical="">
In conclusion, centralized, numerically-rated and concise medical reports from www.2minutemedicine.com is a useful medical education tool.

Category: Student
RapiDose: A medication-dosing app (Ben Arevalo, Brad Segal – Harvard Medical School)
Over six weeks, six Guatemalan medical interns (‘externos’) were given a smartphone containing an application (“app”) to reduce medication-dosing errors in a step-wedge study design. Dosing was monitored in real time to ensure the app suggested safe doses. Pharmacy records were analyzed, externos were timed during brief clinical encounters, patients were asked quality improvement survey questions, and externos answered quantitative and qualitative questions about their user experience.

After introducing the app, the entire patient encounter was completed 27% faster (n=275, p <0.000001). without="" the="" app,="" medications="" were="" dosed="" incorrectly="" 34%="" (n="142)" of="" the="" time.="" there="" was="" a="" net="" 43%=""> <0.0001) improvement="" in="" dosing="" accuracy="" when="" medications="" were="" dosed="" using="" the="" app,="" raising="" total="" dosing="" accuracy="" to="" 94%="" (n="216)." all="" of="" the="" clinicians="" testing="" the="" app="" reported="" that="" the="" app="" was="" ‘easy’="" or="" ‘very="" easy’="" to="">

Overall, the app was demonstrated to be safe and efficient. Making this app available to junior physicians can improve patient safety by greatly enhancing dosing accuracy and permitting more clinical time to be devoted to non-dosing activities—adding value to patients and providers alike.

2013

Category: Resident
Summary: Twiage is a secure mobile app-to-web platform that allows medics to send real-time data in the field to doctors in the ED. The communication between EMS and ED is currently carried about by a one-time radio communication. This often leaves ED physicians in a black box until the patient arrives and delays mobilization of resources, which can have devastating consequences in an acute MI, stroke, or major trauma. By sending real-time information available on a web dashboard in the ED, Twiage saves time, improves provider communication, allows the early mobilization of resources, and improves EMS and ED workflow to help deliver better patient care. 

Category: Student
Summary: Morbidity and mortality are still significant problems in general anesthesia (GA) and are addressed frequently both clinically and in the popular media. In very young patients evidence suggests that neurotoxicity causes adverse neuro-cognitive effects and also poses a major health concern following GA. However there is limited understanding of the fundamental brain mechanisms underlying anesthetic drugs. While it is known that general anesthetics primarily target the central nervous system (CNS), standards of clinical care for brain monitoring have yet to be established. This highlights an urgent need for improved understanding of brain physiology under GA, especially in the vulnerable pediatric population. Studies have shown the potential for electroencephalography (EEG)-based brain monitors to reduce over-exposure to anesthetics. Unfortunately though, for unknown reasons these existing index-based clinical EEG monitors (which provide a single proprietary number indicating depth of patient unconsciousness) do not work in children. 

We found a constant spectral anesthetic signature that emerged from these signals, regardless of age. This forms the basis of a novel technology for brain monitoring that could be applied to pediatric populations to replace current inaccurate methods. Continued analysis on >70 additional patients is currently underway, and similar results will contribute to the enormous impact that this new technology and appropriate monitoring paradigm will have on daily clinical practice with similar ease of use and far more cost effectiveness due to decreased patient morbidity and mortality resulting from neurotoxicity. 

2012

Category: Resident
Summary: The proliferation of electronic medical record systems (EMRs) has led to new challenges in the practice of clinical medicine. Physicians are now responsible for aggregating information from hundreds – sometimes thousands – of clinical records which are still organized in traditional, ineffective silos (notes, imaging, labs, etc.). In many cases, this leads to suboptimal care delivery; records are often incompletely reviewed (AMIA Annu Symp Proc. 2003:269-73), information frequently remains buried (Am J Med. 2009 Jun;122(6):495-6), and studies are repeated unnecessarily (Genet Med. 2008 Feb;10(2):114-6). We have built an automated chart biopsy interface that processes and presents a patient’s entire record at the time of admission using validated natural language processing (NLP) searches. This information is automatically curated, organized, and displayed in a custom, optimized interface designed to mimic clinical workflow. This novel EMR interface will save time, improve quality of care, reduce errors due to missed data, and prevent re-ordering of redundant tests.

Category: Student
Summary: In resource-poor countries, there is a lack of specialists in various areas including hematology-oncology, surgery, rheumatology, and infectious diseases. Rwanda has 1 oncologist for a country of 11 million people. In order to find a cost-effective solution to connect generalists in Rwanda to specialists in Boston, an online community was created where online consults can be submitted and discussed. There is a standardized consult template that physicians can use to submit consults, and there is also a function where photos can be uploaded. This function has been used to upload photos documenting rashes, pathology smears, as well as radiology. This community is composed of over 200 Boston-based specialists in various areas including hematology-oncology, rheumatology, general surgery, infectious diseases, dermatology, plastic surgery, and orthopedics, among other specialties. This community has been used to collaborate on over 200 complex cases. The community has over 300 discussions, 295 members, and 15 countries represented. After implementing a triaging system performed by the Clinical Exchange Coordinator, the time between the consult request and specialist response has decreased. The percentage of cases with responses has also increased. The Clinical Exchange Community is a cost-effective way to help facilitate collaboration among generalists in resource-poor nations and specialists to enhance patient care in resource-limited settings

2011

Category: Resident
Summary: The Testing Effect and Spaced Repetition are recognized by current research in medical education as vital to efficient and effective learning, yet modern education has few tools to enable students to benefit from these proven methodologies.  Succinctly put, periodic testing is superior to periodic study because it involves more effortful and active retrieval.  Furthermore, there is an ideal interval before further review to prevent time lost due to overly frequent review or knowledge lost due to too infrequent review.  Before computers, flashcards allowed self-testing of discrete knowledge, but it remained difficult and cumbersome to effectively implement a learning strategy using spaced repetition.  Modern computer programs have helped, but there is not an adequate software solution currently available for students wishing to employ these principles in their studies.  In response to this need, the candidate surveyed the entire medical school class for solutions.  Ideas and suggestions prompted the creation of Cube Knowledge, a learning platform for self testing and Spaced Repetition ideally suited to the study of medical knowledge.  The product today is a culmination of four years of continual iteration and improvement driven by input from my fellow medical students.   

Category: Student 
Summary: Interventional and diagnostic radiologists are presently limited by the computer mouse. We have developed software in conjunction with the Microsoft Xbox Kinect that enables radiologists to manipulate a PACS workstation using gestures.

We have observed that interventional radiologists infrequently review prior patient diagnostic radiology studies intraoperatively, as they are loath to extend the procedure by scrubbing out. We estimate that in 20-40% of cases, interventional radiologists would have reviewed patient studies intraoperative if they could have done so while remaining sterile. RADGET may decrease procedure time and enhance patient safety. In an ongoing BIDMC IRB approved study; we have setup two IR suites to use RADGET. We are quantifying the change in intraoperative PACS use. Preliminary qualitative feedback has been positive.

Diagnostic radiologists’ work habits make them particularly susceptible to repetitive stress injuries. We have observed that diagnostic radiologists spend 98% of the time interacting with a computer holding a mouse. (Normal computer users: 60% mouse/40% keyboard) We are evaluating the potential of RADGET to (1) improve PACS workstation ergonomics quantified with EMG and (2) increase clinical throughput as quantified by number of chest x-rays

2010

Category: Resident
Summary: Moca: a mobile tele-health platform for resource-poor settings: This open-source software project is aimed at using commonly available handheld mobile phones to exchange clinical information in developing nations where there is a significant urban-rural divide in Healthcare.

Category: Student
Summary: Hospital General El Buen Samaritano Teleradiology & PACS System: developed a low-cost, web-based solution allowing images to be stored, viewed and backed up over the internet. This system enabled the hospital to work more effectively with it's CT scanner.

2009

Category: Resident 
Summary: An Information Technology Website that Improves Communication for Volunteer Medical Missions: Communication between and within groups that travel on volunteer medical missions is notoriously inadequate. Resident developed an easy to use website facilitates communication - so all participants can communicate with past, present and future volunteers

Category:  Student 
Summary: Computerized organizational tools for health care programs in Zambia: While doing clinical work in Zambia this summer,  the student encountered two programs that required technological solutions to organizational problems. The first program was an outpatient pediatric malnutrition program at a clinic named Bwafwano. The paper-and-pencil record-keeping that the nurses were accustomed to was time-consuming and unhelpful for estimating the food supplement needed at 4 different sites, monthly ordering expectations, and enrollment tracking.  Student designed a simple spreadsheet that the nurses, despite poor computer literacy, could use. The second organization is called Ubuntu, which UMass Medical helped to establish, that assists the disabled with medical care and other support. They were set to receive a substantial grant while student was in the country, which would require them to report costs and service delivery on a semi-annual basis; they were not equipped to do this. He designed a user-friendly database tool that could keep records of clients, volunteer workers, service delivery, and program costs, and automatically generate reports on these latter two for the grant-providing agency.

2008

Category: Resident 
Summary: Underdiagnosis of Hypertension in Children and Adolescents: Using electronic health records showed that approximately 75 percent of children with hypertension have not had their hypertension detected. Extrapolated to the national level, of the estimated 2.0 million children with hypertension,1.5 million have undiagnosed hypertension.

Category: Student
Summary: Disease Cluster Detection: Theory, Experiments and Software: developed a new graph-theoretical method to detect arbitrarily shaped clusters. The method draws from several disciplines, including cartography, graph theory, and statistics.  To make this method available to the epidemiology research community and to public health practitioners, they created an open source cluster detection software package

2007

Category: Resident
Summary: Improving Housestaff Efficiency with a Comprehensive Patient Data Manager

Category: Student
Summary: MyCourses and eCommons Web Portals: A web project to provide a variety of course information to medical students

2006

Category: Resident 
Summary: Creating a 'Virtual Patient' using CT, with Emphasis on Ultrasound Education: created 3D patient models to develop a tool to improve the understanding of the anatomic relationship of internal organs and internal structures to surface landmarks. The primary application for this project includes creation of dynamic 3D models suitable for integration into lectures spanning neurological, musculoskeletal, and ultrasound anatomy.

Category: Student
Summary: Teaching Surgical Decision Making: An Interactive, Web-Based Approach: Medical students and residents often lack the clinical exposure necessary to become competent in surgical decision-making. Because of this, the student and his team designed Web-based teaching modules to provide students additional case exposure.

2005

Category: Resident
Summary:  MRI Physics: The Movie(s): attempts to overcome a growing deficit in medical education by producing 18 interactive computer generated animations, emphasizing the time complexity of the MRI process. The animations start with the basics and gradually build on the fundamentals to facilitate a comprehensive understanding of this complex technology.

Category: Student 
Summary: Argus - Software for Efficiently and Effectively Turning Microarray Data into Biological Insights: Measuring the expression of one gene, or even a handful of genes, is like looking at the complexity of cellular activity through a keyhole. In designing Argus, the overriding goals were to create software that (1) can be used by a non-specialist, (2) is broadly accessible to the community, and (3) presents data in a fashion most useful to the end user. To these ends, Argus produces a Web-browsable database that can be searched locally or over the internet by anyone with a Web browser.

2002

Category: Resident
Summary: Design and Implementation of a Comprehensive Electronic Tool for Outpatient Test Results Management at Partners Health Care: we have developed an electronic tool called the Results Manager (RM), a browser based, comprehensive, provider-centric tool to help clinicians manage patient test results in a reliable and efficient manner. Using the Results Manager, clinicians can manager all outpatient test results from one place, acknowledge their receipt, generate result letters with a few clicks and set reminders for follow-up plan in the future.

Category: Resident 
Summary: ResidentWeb: Developed a community website dedicated to the issues and communication among residents. (still exists see http://ResidentWeb.com)

2001

Category: Resident
Summary: BedsideEBM: a Palm application comprising collection of clinical decision rules that are designed for ease of use and speed of calculation to aid in decisions at the point of care.  Quality of data and caveats are also clearly represented.  Furthermore, BedsideEBM is designed to allow clinical research with integrated functionality for logging the actions of research subjects.

Category: Student
Summary: Child Abuse Internet Education Initiative: Created a comprehensive website that can be used by providers, families, teenagers, and younger children to gain appropriate practical information about child abuse and neglect and their specific role in addressing this problem, as well as step-by-step guidance on what to do if they are facing a situation of this nature. A  "one stop shop" - a site where  physicians can quickly access (or link to) any information they are likely to need, where parents or concerned adults can find objective facts and specific instructions on what to do if they suspect abuse (or what to expect if someone else has filed a  report), and where teenagers and younger children can get age-appropriate information and guidance on what to do if they are  in an abusive situation or if they are worried about a friend.

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