VillageMED

Creating a mobile platform to enable seamless support of the existing clinical workflow for a missionary healthcare in a challenging environment like Haiti

TEAM
Myself — UX Design & Front-end Programming
Dr. Sunyoung Kim — Research Advisor
Theresa Allen — Data Collection
Damini Bhatt — Prototyping
Stephen Thomas — Back-end Programming

PLACE
Rutgers University's Human-Computer Interaction Lab for Health & Sustainability with VillageMED

Mobile technology can enhance postoperative care and patient handoffs between providers, as well as harnessing the power of information sharing to improve patient engagement and communication. This project is to develop a novel mobile platform to enable standardizing data acquisition, organizing information storage, and facilitating communication in the delivery of missionary healthcare. 

The Challenge 🤔

How do you design an Emergency Medical Record system for mobile clinics in a challenging environment?

Background

There are several organizations today that engage in volunteer medical missions to under developed organizations. Many of these missions take on the form of a mobile health clinics, which are essentially like a traveling clinic that goes to communities to provide health aessesments, education, and services to people. In these clinics, the most common form of keeping records is with pen and paper. Although these missions successfully help people, there is a lack of effective patient management due to the paper system being inefficient. For instance, the members who go on each medical mission might change, leaving a lack of systematic means for patient data management.

There are many patient management systems available today, but many of these systems cannot be deployed effectively in the environments where medical missions occur due to technical, cultural, and/or environmental obstacles.

Therefore, we worked with VillageMED a US-based nonprofit organization that provides periodic medical services to Haiti communities, to create an affordable, easily deployable, and culturally relevant system that supports patient documentation in a challenging environment. Our goal was to create an Electronic Medical Record (EMR) suitable for this kind of clinic in such an under-developed region.

The Solution 💡

Introducing an affordable, easily deployable, and culturally relevant Emergency Medical Record system to support patient documentation in a challenging environment

On-Site Observation

This study used a mixed-method approach with Theresa conducting semi-structured interviews with all stakeholders of a mobile clinic team and attending mobile clinics for on-site observation to understand the current practices and needs. There was also testing and recieving feedback on the low-fidelity prototype on-site.

The atmosphere where an EMR will be held will be busy, noisy, and often unorganized. Therefore, an EMR should effectively support all steps of the current workflow but needs to be flexible enough to accomodate various situations at the same time.

Photos by Theresa Allen from her on-site visit to Haiti with VillageMED

Low-Fidelity Prototypes

The findings from the interviews informed the direction of our
prototype design. Through these investigations, we found valuable insights for the design of an EMR specific to the needs of a mobile clinc. Key design considerations include:

• Simplicity and easy of use
• Seamless support of the existing clinical workflow through feature segmentation
• Flexibility to accomodate organizational and operational variability through chunking features

With all things considered, we came up with a system that was made easy to use by first-time users and in busy situations. We decided on designing for tablets since they are the perfect size for portability from site to site and mobility on-site. 

First version drafts of application made by Damini Bhatt and Theresa Allen

Features

To serve these needs, we have the following main features:

• Main dashboard that visualizes the queued patients and their current status at different stations, allowing volunteers to easily identify which stations are congested and need help
• Translated original paper records into four seperate web pages corresponding to the steps in workflow (i.e. Vitals, Exam, Prescription, and Dispense)
• Ticketing management system to support the current operating practice for clinical process management 

Final Interface Design

I was especially involved in bringing the prototype to life from the lo-fi designs. Besides coding the front-end side with HTML and CSS, I also made some significant design changes and features from the original wireframes.

Overall, we decided to go for a different color branding for VillageMED from the original design. Instead of a bright turoquise with white, we decided on choosing red and orange since it is still bold and energetic yet more sophisticated.

In addition, I felt it was better for our application to head in the direction of flat design. VillageMED is meant to be simple, so we wanted to keep it minimal. Flat design ensures that responsive designs work well and load fast, which is especially important because this would already be in a technologically challenging environment.

Final system screens after two design iterations: a home-screen dashboard, check-in, and patient records

Prototype Feedback

The low-fidelity prototype was brought on the Haiti trip to collect feedback from volunteers, and the volunteers were excited about having an electronic system to manage patient records.

We also implemented the following feedback to the final design:

Total Patients Seen

Volunteers asked to display the number of completed patients on the home screen to give volunteers a feeling of achievement through the day.

Check-in Patient Photo

Volunteers pointed out that it would be extremely useful to take a picture of a patient during check-in so that people can easily be facially recognized.

Language Support

We found that Haitian nurses used English to read and write on a patient chart but were more comfortable with using Haitian Creole, one of the official languages of Haiti.

Hardware Implentation

Because this is a non-profit organization, we had to come up with an affordable way to make the tablets connect to each other with minimal equipment. Therefore, we came up with a way to use a Rasberry Pi and a router to create a local network for the tablets. 

In essence, the Rasberry Pi and router acts as a local wi-fi network that an unlimited amount of tablets can connect to. The microSD card inside the Rasberry Pi stores the VillageMED application.

All that's needed: Rasberry Pi, router, and tablet with VillageMED application

Conclusion

All in all, we found that it is certainly important to support the current clinical workflow, while at the same time affording flexibility to accomodate various conditions for scalability. By indentifying design features for successful adoption, we hope to further advance research prace in the domain of healthcare technology for resource-limited settings.

Personally, this was an eye-opening experience for me and challenged myself to think outside of the box with such limited constraints. Not only did this project provide the platform for creativity in exploring solutions, it also gave way to my exploration of how to simplify the visuals and functionality of this project.

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