Simulation in Health Sciences Education

Mobile health applications represent the next stage of patient empowerment. 30 years ago, patients received information and procedures from their physicians, often without instruction. Now, the smartphone physical empowers patients to identify, understand, and manage their own health on a completely new level. This offers critical implications for the future of medicine:

1. Patient Engagement: It’s probable that the physical act of regularly checking blood pressure or measuring blood sugar levels can make a patient more conscious about their health. It’s also hopeful that such self-tracking can inspire self-education and positive behavior change. This is difficult to measure experimentally (have you ever noticed that the most avid quantified self-ers are the fittest and healthiest people?) but it offers reason to be optimistic about mHealth.

2. Remote Care: A critical challenge of hospital readmissions is that, once the patient walks out the door, it’s no easy endeavor to reconnect with them. If physicians could remotely monitor patients, it’s possible they could identify early signs of a complication and intervene. As a readmissions researcher, I’ve spoken with patients who waited for three weeks of not being able to eat before returning to the hospital 30 pounds lighter. The smartphone physical could have flagged that—and someday, it will.

3. The Doctor’s Role: This is the big question, and it’s a loaded one. How will physicians interpret and process the information overload that follows such complete self-quantification? How will electronic health records and/or personal health records adapt to meaningfully consolidate, analyze, and present all this data? How does the patient’s ability to self-educate, self-diagnose, and (perhaps eventually) self-treat change the purpose and significance of the doctor-patient relationship? At Millennial Medicine, Dr. Eric Topol presented these mHealth innovations and said, “With this, why would you want to go to the hospital?” Good question — Will patients still want, or need, to interact with their doctors?

These are ambitious goals, but with the advances I’ve seen in this video as well as other seminal achievements made in mHealth and digital medicine recently, I’m optimistic that they are all entirely doable. I’m also conscious of how often I’ve used the word “possible” in this reflection and how scarcely I’ve said “proven.” It simply speaks to the fact that we’re faced with inspiring technical capabilities that offer tremendous hope; the challenge now falls to tomorrow’s physicians and scholars to innovate, research, and troubleshoot to bring these ambitions to realization.

Welcome to the Games and Simulation for Healthcare Library and Database.  This website aims to provide a portal and network to meet the needs of clinicians, researchers and educators in the healthcare community who want to integrate games and simulation into their scholarship and patient care strategy.  This resource also welcomes healthcare consumers, advocates, and others interested in patient and clinician education, and clinical research taking advantage of games and simulation-based learning.

Please visit frequently and feel free to contact our project team for details on how you can contribute to this project, or with any comments and suggestions.

1. The integration must take into account each user’s day-to-day life and workflow, including patients, providers, IT staff, and additional caregivers. Some users will need access to a greater depth of information, while for others design and usability will be paramount.

2. The design should be interoperable and support the integration of multiple MITs into a single EHR. In particular, developers should make sure to eliminate redundancies between the systems, where app users and EHR users might enter the same data into different fields.

3. Multiple environments have to be secure, but their security can’t keep them from interacting with each other. Stakeholders WellDoc interviewed reported problems with competing firewalls in implementing the integration.

4. Both halves of the integration, but especially the patient-facing app, should work natively on as many mobile devices as possible. Patients are most likely to use a system that allows them to continue using their device.

5. The mobile health offering is subject to a limitation already standard for EHR apps: it must be able to run even when network connectivity is sparse or intermittent, as is sometimes the case in large hospital complexes.

6. It’s crucial to have a support team in place familiar with the technology  to help acquaint users with it.

7. Make sure the two systems adhere to common standards. Not only data interchange standards like HL7, but also making sure that measurements in both systems use the same units. If lab-collected blood glucose data in the EHR and patient-collected blood glucose data have the same unit, but one is potentially more accurate, the integrated system should easily identify and distinguish the two.

8. The team working on an integration should be ready for a more complex process than anticipated. A clear vision, good communication, and a steering committee are important for anyone attempting to integrate a mobile heath offering and an EHR.