Medical Simulations in Emergency Medicine : Study

Using virtual reality or simulations in medical training can be a wonderful tool. Especially in medical situations which are difficult to replicate with possibilities of making errors during training. A recent prospective observational study on use of virtual simulation technology in emergency medicine is revealing of the open acceptance of such tools by young medical professionals.

Twenty seven EM residents of the Ohio State University completed mock oral examinations in a traditional format, conducted face to face with a faculty examiner. All residents were invited to participate in a similar case scenario conducted via Second Life for this study. The examinee managed the case while acting as the physician avatar and communicated via headset and microphone from a remote computer with a faculty examiner who acted as the patient avatar. Participants were surveyed regarding their experience with the traditional and virtual formats using a Likert scale.

None of the examinees had used SL previously. SL proved easy for examinees to log into (92.6%) and navigate (96.3%). All felt comfortable communicating with the examiner via remote computer. Most examinees thought the SL encounter was realistic (92.6%), and many found it more realistic than the traditional format (70.3%). All examinees felt that the virtual examination was fair, objective, and conducted efficiently. A majority preferred to take oral examinations via SL over the traditional format and expressed interest in using SL for other educational experiences (66.6 and 92.6%, respectively).

View Full Article with Supporting Information (HTML) ACADEMIC EMERGENCY MEDICINE 2011; 18:559–562 © 2011 by the Society for Academic Emergency Medicine

Do check out eMedsimulations , an innovative medical eLearning company from Rhode Island with development center in Mumbai, India.

Also See:

Learning in a Virtual World: Experience With Using Second Life for Medical Education

The results of this pilot suggest that virtual worlds offer the potential of a new medical education pedagogy to enhance learning outcomes beyond that provided by more traditional online or face-to-face postgraduate professional development activities.

Global Survey of mHealth Initiatives: W.H.O Report

The World Health Organizations (WHO) recently released the findings of a comprehensive survey on the state of mHealth usage in 112 member states. For the purposes of the survey, the Global Observatory for eHealth (GOe) defined mHealth or mobile health as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices.

The survey results highlight that the dominant form of mHealth today is characterized by small-scale pilot projects that address single issues in information sharing and access. A vast majority (83%) reported at least one mHealth initiative in their country. Of this 83%, most Member States reported implementing four or more types of mHealth initiatives.

The four most frequently reported mHealth initiatives were: health call centres (59%), emergency toll-free telephone services (55%), managing emergencies and disasters (54%), and mobile telemedicine (49%). The least frequently reported mHealth initiatives were health surveys (26%), surveillance (26%), awareness raising (23%), and decision support systems (19%).

The study identified 6 major types of mHealth initiatives:

1) Communication between individuals and health services

• Health call centres/Health care telephone help line

The African, Americas and Eastern Mediterranean Regions reported health call centres/ health care telephone help lines that address specific health issues such as HIV/AIDS, H1N1, reproductive health/family planning, pandemics, and drug abuse.

• Emergency toll-free telephone services

The South-East Asia Region reported the highest percentage of emergency toll-free telephone services (88%).

2) Communication between health services and individuals

• Treatment compliance

Approximately one third of responding Member States across all WHO regions reported conducting treatment compliance initiatives.

• Appointment reminders

Countries in the high-income group reported the largest proportion of appointment reminder initiatives (71%). The majority of these initiatives were established (42%) using various functionalities including voice, SMS, and the Internet.

• Community mobilization

SMS was the primary method of communication used in the initiatives. The Americas, Eastern Mediterranean, and South-East Asia Regions reported the highest adoption for community mobilization and health promotion.

• Awareness raising over health issues

Awareness raising initiatives showed relatively low levels of uptake across WHO regions, though the Eastern Mediterranean (28%), European (28%) and Americas (25%) Regions reported using this initiative the most. Main health topics for these initiatives were women’s health, drug and alcohol abuse, smoking cessation, and HIV/AIDS.

3) Consultation between health care professionals

• Mobile telemedicine

The Americas (75%), European (64%) and South-East Asia (62%) Regions reported high rates of adoption of mobile telemedicine initiatives, though a large proportion of these initiatives were informal or in the pilot phase.

4) Intersectoral communication in emergencies

• Emergencies

The use of mobile devices for emergency communications was one of the most frequently reported initiatives across all WHO regions. The African, South-East Asia, and Americas Regions, have the highest levels of adoption at 48%, 75%, and 67% respectively.

5) Health monitoring and surveillance

• Surveillance

mHealth surveillance activity is more prevalent in countries in the low-income (40%) and lower-middle income groups (27%) than those in the higher-income groups.

• Patient monitoring

Patient monitoring initiatives were most prevalent in the European Region (47%), followed by the Region of the Americas (33%). Countries in the high-income group reported the highest levels of activity in this area (58%).

6) Access to information for health care professionals at point of care

• Information and decision support systems

The South-East Asia (62%) and Americas (58%) Regions had the highest proportion of Member States with information initiatives. There is low global uptake of mobile decision support systems within WHO regions; no region reported adoption of over 25%.

• Patient records

The level of adoption of mobile patient records was moderate across all WHO regions and World Bank income groups.

Competing health system priorities was consistently rated as the greatest barrier to mHealth adoption by responding countries

One Indian mHealth initiative merits special mention. mDhil is a health promotion organization launched in India with a for-profit business model. For 1 rupee a day, consumers receive to their mobile phone three health messages created by registered nurses and physicians on topics such as weight management, sexual health, and H1N1. At the end of 2009, mDhil had 150 000 paid subscribers, and closed a ‘series A financing round’ with a venture capital firm. mDhil sent out 1 million public health SMS messages by the end of 2010

You can Download the report here:

http://www.who.int/entity/goe/publications/goe_mhealth_web.pdf

Doctors' Use of Email and Social Media : Guidelines

Tens of Thousands of Indian doctors are using the internet, efficiently and otherwise. From search rankings to blogs and community building to branding, the internet has brought up new ways to communicating and researching. Here are the links to a few helpful guidelines to help doctors navigate the online world.

Doctor-Patient Email Communications is a growing trend and hard to underestimate. Very often, physicians are unsure of the limits and liabilities of conducting medical communication via email. Luckily the American Medical association has long back issued a set of practical guidelines to follow

Social Media is now being widely used by doctors as well as patients. All doctors even remotely on social media face many ethical and moral questions regarding online physician-patient relationships. Recently, the AMA posted some guidelines for Doctors use of social media tools in a professional capacity. Even the Australian and New Zealand Medical Associations have come out with their combined effort on this dilemma. Here’s the link to the Physician Social Media Guidebook (a 14 page pdf you can download/ view online). It is one of the most practical and useful guide of its kind online.

Related articles

• How doctors should professionally behave on Twitter (kevinmd.com)
• Using Web 2.0 technologies and social media for the cardiologist's education and update (medicineandtechnology.com)
• Physician reputation management in the age of social media (kevinmd.com)

Doing More With EMRs: What Are The Top Reasons For Failure?

Electronic Medical Records hold a lot of promise. When used well, EMRs decrease drug errors, streamline work flow, assist in clinical decisions and allow efficient accounting. At the same time, EMRs chosen without proper thought and assessment can cause long term pains. The really restrictive EMRs won't even let you shift medical data elsewhere and healthcare providers maybe stuck with outdated EMRs soon after buying them.

EMR failures are most often a cause of one or more of the following four reasons

• Technical EMR implementation failures, because of issues with hardware/ software combination or wireless connectivity issues;
• Financial failures, where the expected EMR ROI wasn’t realized, or the costs were significantly more than expected;
• Software incompatibility issues, where the EMR system didn’t interface with an existing medical practice management system; and
• People-related issues, where some physicians or staff members avoid training or simply refuse to use the EMR system. 

Making an EMR work for a healthcare provider needs work before, during and after installation of an EMR system. When choosing an EMR system, Ignore the bells and whistles and Look at the nuts and bolts.

The 10 Most Innovative Companies in Healthcare '2011

Here's a list of 10 most innovative companies in health care ( as per Fast Company), working to provide simple but effective technology solutions in healthcare.

1) Epocrates

For creating software that gives doctors and nurses instant information on drug-to-drug interactions, treatment recommendations, and more on their mobile devices or laptops.

2) SynCardia Systems

For giving mobility to artificial-heart recipients. Syncardia makes the world's only FDA-approved completely artificial heart. During a ten-year study for the FDA, 79 percent of patients successfully lived on the man-made heart until receiving a human heart transplant.

3) Voxiva

For developing mobile apps that coach users through everything from smoking cessation to diabetes management. The company recently worked with the U.S. government to launch Text4Baby, a mobile education program for pregnant women, and its work in poor countries like Rwanda has been a lifeline.

4) Cleveland Clinic

For rethinking the entire hospital experience, from the buildings to the hospital gown, with an eye to delivering a better patient experience. Ombudsman complaints dropped over 40% last year (versus 2009), patient satisfaction scores have gone up, and medical outcomes have been better across the board.

5) SafePoint

For providing a solution for one of the most intractable global health care issues: reused syringes, which render most injections in India, Pakistan, and Africa--and a growing number in the U.S.--unsafe and sometimes fatal. Inventor Marc Koska's low-cost syringe can't be reused--one use, it locks in place. Now, after eight years in the marketplace, Koska has licensing agreements with 14 countries and SafePoint's global awareness campaigns have reached over 500 million people.

6) Envoy Medical

For creating the first FDA-approved surgically implanted hearing system to address hearing loss caused by aging, noise and viral infections. Placed under the skin behind the ear, the Envoy device comprises a sound processor, sensor, and driver that convert vibrations in the ear into electrical signals that are processed so they're perceived as sound.

7) GE

For promising to revolutionize diagnosis with the Vscan, a mobile, pocket-size ultrasound machine the size of an iPod, connected to short wand. It works just like the bulky conventional ultrasound machine, providing an instant visual image (in color or black and white) inside the body, beyond a patient's vital signs.

8) PharmaSecure

For coming up with cost-effective protection against counterfeit drugs, which are especially prevalent in developing nations. Each individual drug package is stamped with a unique code and phone number. Consumers submit the code via text message, and PharmaSecure confirms the drug's authenticity. The service launched last year and is currently being used in India, where the government has moved to mandate the technology.

9) Neurovigil

For building a database of brainwave activity to help researchers recognize disease patterns in people affected by neural or nervous system maladies. The company's iBrain headband, worn at night, uses wireless electrodes to capture brainwaves. NeuroVigil's software interprets the data to produce a map of activity during sleep that's richer than anything previously available.

10) Second Sight Medical Products

For its ground-breaking retinal-implant technology, which recently hit the European market. FDA approval is pending.

You can also see the last year's list:

• Top 10 Innovative Companies in Healthcare 2010