The Development of a Point of Care Clinical Guidelines Mobile Application Following a User-Centred Design Approach

This paper describes the development of a point of care clinical guidelines mobile application. A user-centred design approach was utilised to inform the design of a smartphone application, this included: Observations; a survey; focus groups and an analysis of popular apps utilised by clinicians in a UK NHS Trust. Usability testing was conducted to inform iterations of the application, which presents clinicians with a variety of integrated tools to aid in decision making and information retrieval. The study found that clinicians use a mixture of technology to retrieve information, which is often inefficient or has poor usability. It also shows that smartphone application development for use in UK hospitals needs to consider the variety of users and their clinical knowledge and work pattern. This study highlights the need for applying user-centred design methods in the design of information presented to clinicians and the need for clinical information delivery that is efficient and easy to use at the bedside

TELESPIRO: A LOW-COST MOBILE SPIROMETER FOR RESOURCE-LIMITED SETTINGS

Chronic obstructive pulmonary disease (COPD), a disabling combination of emphysema and chronic bronchitis, relies on spirometric lung function measurements for clinical diagnosis and treatment. Because spirometers are unavailable in most of the developing world, this project developed a low cost point of care spirometer prototype for the mobile phone called the "TeleSpiro." The key contributions of this work are the design of a novel repeat-use, sterilisable, low cost, phone-powered prototype meeting developing world user requirements. A differential pressure sensor, dual humidity/pressure sensor, microcontroller and USB hardware were mounted on a printed circuit board for measurement of air flow in a custom machine-lathed respiratory air flow tube. The embedded circuit electronics were programmed to transmit data to and receive power directly from either a computer or Android smartphone without the use of batteries. Software was written to filter and extract respiratory cycles from the digitised data. Differential pressure signals from Telespiro showed robust, reproducible responses to the delivery of physiologic lung volumes. The designed device satisfied the stringent design criteria of resource-limited settings and makes substantial inroads in providing evidence-based chronic respiratory disease management. © 2013 IEEE

Leveraging Food and Drug Administration Adverse Event Reports for the Automated Monitoring of Electronic Health Records in a Pediatric Hospital

The objective of this study was to determine whether the Food and Drug Administration’s Adverse Event Reporting System (FAERS) data set could serve as the basis of automated electronic health record (EHR) monitoring for the adverse drug reaction (ADR) subset of adverse drug events. We retrospectively collected EHR entries for 71 909 pediatric inpatient visits at Cincinnati Children’s Hospital Medical Center. Natural language processing (NLP) techniques were used to identify positive diseases/disorders and signs/symptoms (DDSSs) from the patients’ clinical narratives. We downloaded all FAERS reports submitted by medical providers and extracted the reported drug-DDSS pairs. For each patient, we aligned the drug-DDSS pairs extracted from their clinical notes with the corresponding drug-DDSS pairs from the FAERS data set to identify Drug-Reaction Pair Sentences (DRPSs). The DRPSs were processed by NLP techniques to identify ADR-related DRPSs. We used clinician annotated, real-world EHR data as reference standard to evaluate the proposed algorithm. During evaluation, the algorithm achieved promising performance and showed great potential in identifying ADRs accurately for pediatric patients