Teaching future physicians: technology, academics and patient care join forces in a mobile world - Wireless

Health Management Technology, Feb, 2002 by Holly Whitaker

Jeff is a third year medical student. He spends his days rotating through multiple hospitals and external clinics in a healthcare system that covers a 20-mile radius.

How do medical schools provide timely, pertinent information to students who are part of an increasingly mobile environment? Many institutions are turning to handheld mobile and wireless technologies with access to information anywhere, anytime.

When students enter new rotations, figuring out where to go and whom to meet with can be a challenge since medical students are always on the go, and faculty may find it difficult to relay the most up-to-date data. Using a synchronized connection, information from driving directions and contact data to course content and rotation requirements can be downloaded to mobile devices, allowing faculty to send updates to students through a frequently accessed and reliable channel. This information is often integrated from the school's existing website or an academic portal, such as Blackboard's eEducation Suite, increasing the value of these systems by providing a mobile extension to pertinent data.

In addition to content, traditional paper-based processes such as faculty/student evaluations can be improved with the interactive nature of mobile technology. Custom surveys and evaluations created by faculty can be pushed to and completed on students' handhelds. On the next synchronization, the evaluation is uploaded to a central database and collated, streamlining a once inefficient and often ineffective process. Faculty members can use this more timely data to tailor their curriculum according to student feedback and performance.

Mobile Patient Assessment

In the third and fourth years of medical school, students collect information on their patients, learn about their diagnoses and procedures, and report their findings and assessments to their superiors. To track this data, students often use the first generation of the medical handheld--the index card. But there is limited value in data that has no easy way of being archived or retrieved.

Medical schools, such as Florida State University, are distributing handheld devices that allow the same information to be collected anonymously and uploaded to a central database. This database provides a historical reference to past patient encounters, and can be used by faculty to review the type, quantity and quality of encounters their students see during rotations. This is the first time many faculty have had a method to track such student-patient encounters, and they use the information to adapt their rotations and ensure clinical proficiency.

Mobile applications also allow students to access reference materials at the point of care, enhancing their learning experience. Although a large number of reference materials are available for download on the Internet, many schools choose to provide downloads to materials through their own portals. This method allows faculty to review the materials and generate an approved list of resources. General references are made available to all students, while rotation-specific materials and tools are often bundled for download at the start of a clerkship. Students can use the references to perform research while still with a patient, instead of having to wait for access at a nursing station or in the medical library.

Technology Challenges

Providing information via mobile devices is not without technical challenges. Here are three facing medical schools today:

1) Healthcare systems have an increasing number of remote clinics and patient care sites that often have only a few systems with Internet access.

2) Although some schools provide or mandate a particular device, most remain device agnostic, allowing students to choose the device that suits their needs.

3) Some students synchronize their devices using their personal computers, but many rely on a central student-computing center.

Unlike a traditional enterprise, a university must develop applications with a more consumer-based mentality. If a university writes applications for a multi-device population, how will users synchronize their data? The handheld world does not have many defined standards. Cradles differ not only among brands, but also within them. Having every potential cradle available in a shared computing environment, not to mention in remote locations, is obviously not feasible. Yet, wireless LANs are not pervasive enough and require the additional expense of wireless cards for each device.

A Mobile Solution

To address these limitations, schools such as Harvard Medical School have their students synchronize via infrared (IR) technology. This is accomplished by deploying either small IR pods that can be easily installed on a computer with existing Internet access, or multi-port IR access points that can be plugged directly into an Ethernet connection, ideal for high traffic student areas that may not have existing systems.

Student adoption also can be hindered by lack of existing infrastructure. If content and curriculum management systems contain sporadic, untimely information, the usefulness of the application greatly diminishes and often leads students back to traditional resources. The key to adoption is to provide faculty with an application that makes it easy to organize and create course content, and then educate the faculty on the importance of keeping this content up to date.