Better medical apps for healthcare practitioners through interdisciplinary collaboration: lessons from transfusion medicine
Monsen, Karl Didrik
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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.