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
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
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
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.
