Quantifying medical student clinical experiences via an ICD Code Logging App.

OBJECTIVES: The logging of ICD Diagnostic, Procedure and Drug codes is one means of tracking the experience of medical students' clinical rotations. The goal is to create a web-based computer and mobile application to track the progress of trainees, monitor the effectiveness of their training locations and be a means of sampling public health status. MATERIALS AND METHODS: We have developed a web-based app in which medical trainees make entries via a simple and quick interface optimized for both mobile devices and personal computers. For each patient interaction, users enter ICD diagnostic, procedure, and drug codes via a hierarchical or search entry interface, as well as patient demographics (age range and gender, but no personal identifiers), and free-text notes. Users and administrators can review and edit input via a series of output interfaces. The user interface and back-end database are provided via dual redundant failover Linux servers. RESULTS AND DISCUSSION: Students master the interface in ten minutes, and thereafter complete entries in less than one minute. Five hundred-forty 3rd year VCOM students each averaged 100 entries in the first four week clinical rotation. Data accumulated in various Appalachian clinics and Central American medical mission trips has demonstrated the public health surveillance utility of the application. CONCLUSION: PC and mobile apps can be used to collect medical trainee experience in real time or near real-time, quickly, and efficiently. This system has collected 75,596 entries to date, less than 2% of trainees have needed assistance to become proficient, and medical school administrators are using the various summaries to evaluate students and compare different rotation sites.

Telesonography: foundations and future directions.

The practice of telesonography has yielded promising results in several domestic and international projects aimed at providing basic sonography services. Common themes that recur within telesonography-based research include the quality of transmitted images, clinical applications, and technical and nontechnical barriers to implementation. The research base continues to grow in concert with expanding telecommunications capabilities and refinement of small portable sonographic devices. Persistent barriers to the deployment of telesonography systems include a lack of telecommunications access, a lack of standard training and operational protocols, and a paucity of research regarding the long-term health impact of telesonography within target communities. Telesonography may be used directly to improve the standard of care within a given community; however, limited resources and interest may prevent sustained operations. Future projects may use telesonography to supplement the training of health care providers in remote locations in an effort to establish permanent sonography services for their respective communities.