Better medical apps for healthcare practitioners through interdisciplinary collaboration: lessons from transfusion medicine
View/ Open
Date
28/11/2017Item status
Restricted AccessAuthor
Monsen, Karl Didrik
Metadata
Abstract
Mobile applications (“apps”) are increasingly used in medical education and practice.
However, many medical apps are of variable quality, lack supporting evidence
and fall outside the remit of regulators. In this thesis, I explore how the quality and
credibility of apps for healthcare practitioners could be improved. I argue that interdisciplinary
collaboration throughout the app life-cycle is critical and discuss how this
can be facilitated. My argument rests on prior work in eHealth and neighbouring disciplines,
and on original research in transfusion medicine.
Blood transfusion can be a life-saving medical treatment. However, it also carries
risks. Failures to provide irradiated and cytomegalovirus-negative blood components
according to guidelines are frequently reported in the UK. Such incidents put
patients at risk of serious complications. Haemovigilance data indicates that enhancing
practitioner knowledge may reduce mistakes. Thus, I worked with medical experts
to develop and evaluate the Special Blood Components (SBC) mobile learning app. To
facilitate this work, I created two tools: the Web App Editor (WAE) and the Web App
Trial (WAT). The former is a collaborative editor for building apps in a web browser
and the latter is a system for conducting online randomised controlled app trials.
The results are reported in five studies. Studies 1 and 2, based on interviews with
seven practitioners, revealed shortcomings in an existing transfusion app and the SBC
prototype. Study 3 demonstrated how students using theWAE were able to collaborate
on apps, including an app in stroke medicine. Study 4, an evaluation of the revised SBC
app with 54 medical students, established the ease of use as acceptable. In study 5, a
WAT pilot study with 61 practitioners, the SBC app doubled scores on a knowledge
test and was rated more favourably than existing hospital guidelines.
In conclusion, creating high quality medical apps that are supported by evidence is
a considerable undertaking and depends on a mix of knowledges and skills. It requires
that healthcare practitioners, software developers and otherswork together effectively.
Hence, the WAE and WAT are key research outcomes. They enabled participants to
contribute improvements and assess the usability and efficacy of the SBC app. The
results suggest that the SBC app is easy to use and can improve practitioner knowledge.
Further work remains to pilot and evaluate the SBC app in a hospital setting.