Mobile Computing For Decision Support and Learning in Radiology

and Pediatrics!!

Michael P. D'Alessandro, M.D.!Department of Radiology!

University of Iowa College of Medicine / University of Iowa Children's Hospital!!

Donna M. D'Alessandro, M.D.!Department of Pediatrics!

University of Iowa College of Medicine / University of Iowa Children's Hospital!!

Slides at www.slideshare.net/michaeldalessandro!

Acknowledgements!

!Meeting Theme: Pediatric Radiology: Less Invasive, More Efficient!

Morning Seminar Theme!We will show you how to use a mobile device to increase efficiency in patient care by providing right information at the right time to right person who is making a decision!

!Long history of innovation in mobile technology + mobile apps by Asian corporations + researchers + entrepreneurs!

This morning seminar is sponsored by!

Objectives!

• On a mobile device learn how to: !• Perform decision support at the point-of-care

thus tying learning to practice !• Read educational apps and Ebooks!• Stay current with society news and radiology

journals!• Manage your library of journal articles!• View podcasts and vodcasts!• Maintain a learning portfolio / participate in a

community of practice!

Our Philosophy Learning is an Apprenticeship!

"In what may be called the natural method of teaching, the student begins with the patient, continues with the patient, and ends his studies with the patient using books and lectures as tools, as means to an end."!

- Sir William Osler!!•  Learning at the point-of-care!

•  Is best way to change physicians' knowledge, attitudes, and behaviors!

•  And thus improve patients' care, outcomes and lives!

To App or Not To AppThat Is The Question!

•  Apps - if < 30 years old!•  Pros !

•  Polished user interface!

•  Cons!•  Usually not free!•  Not interoperable!•  Small number of apps!

•  Web - if > 30 years old!•  Pros !

•  Usually free!•  Interoperable!•  Large number of Web sites!

•  Cons!•  Unpolished user interface!

- Owen Williams, Smartphones: The Silent Killer of the Web As You Know It, The Next Web, May 5, 2014!

Decision Support - Web Browser The Killer App!

Safari (iOS) Chrome (Android) Explorer (Win)!

•  Situating Learning in Practice!•  Use radiology-specific search engines to search

the best free Web resources!•  goldminer.arrs.org!

•  GoldMiner Global in 35 languages!•  www.searchingradiology.com !•  www.searchingpediatrics.com!

•  Microlearning!•  Small units of learning over a short time!

Clinical Question Searches Using Google vs. Evidence-Based Summary Resources!

"The authors found no significant differences in speed or accuracy between searches initiated using Google versus summary resources."!

! ! !- Acad Med. 2014;89:940-943.!

Check Your Institution First!!

•  For subscriptions to!•  Apps!•  eBooks (including PDFs)!•  Web-based decision

support tools!

•  For discounts on all of the above!

•  Your library should have the information!

Pediatric Decision Support - Apps Textbook-Like!

Epocrates Bugs+Drugs (iOS) Pediatric Hospitalist Guidebook (iOS) LactMed (Android+iOS) About Herbs (iOS) !

!

TravWell(Android+iOS) STD Tx Guide (Android+iOS) MMWR (iOS) Vaccine Schedule (Android+iOS) About Contraception (iOS) !

!

Pediatric Education - Apps!

Skyscape (Android + iOS) Pediatric Quiz (Android) Pediatric Question of the Day (iOS) PICU Question of the Day (iOS)!

!

!

Radiology Decision Support - Apps Textbook-Like!

Medscape (Android+iOS) Epocrates (Android+iOS) pedsMRI (Android+iOS) Contrast Protocols (iOS)! Radiology + Pediatrics Radiology + Pediatrics!

!!

!

Radiology Education - Apps Teaching Files!

Radiology 2.0 One Night In The ED (iOS) CTisus iQuiz (iOS) Essentials of Pediatric Radiology (iOS)!

!

!

Ebooks!

Kindle (Android+iOS+Win) Google Play Books (Android+iOS) iBooks (iOS) Freda (Win)! Kindle [.azw /.azw3] EPUB [.epub] EPUB [.epub]+iBooks2 [.ibooks] EPUB [.epub] !

!2,941 educational radiology Ebooks were found in the Kindle (2,466), iTunes (225) and Play (250) stores!4,548 educational pediatric Ebooks were found in the Kindle (3,866), iTunes (432) and Play (250) stores!!!!!!!!

Staying Current With Societies Social Media!

Twitter (Android+iOS+Win) Facebook (Android+iOS+Win)!

!•  Subscribe to the accounts (Twitter) and pages (Facebook) of the

AOSPR, ESPR, SPR, WFPI + general radiology and pediatric societies!•  Receive stream of society news!•  Filter with lists (on Facebook)!

MicrolearningSocial Media!

Follow @pedsimaging for a curated stream of pediatric imaging educational information!•  Small units of learning over a short time!

Staying Current With the Literature Really Simple Syndication (RSS)!

RSS Feedly (Android+iOS) Phonly (Win)!!•  Is a newsfeed generated by a Web site when it is updated!•  Lets you subscribe to Web site + be notified when it is updated!•  Think of it as distributed version of Facebook + Twitter!•  Subscribe to RSS feeds of journal Web sites!•  Receive stream of journal articles !•  The Old Reader Web browser-based feed reader is an alternative to apps!!

Managing a Library of Journal Articles !Medical Literature Database!

Dedicated App ! ! Cloud-based file system! !Papers (iOS+MacOS+Win8) Mendeley (iOS) Storage: Drive / Dropbox / iCloud / OneDrive (Android+iOS+Win) ! "iTunes for PDFs" ! Viewer: Adobe Reader (Win) / ezPDF (Android) / GoodReader (iOS)!

Listening to Podcasts + Vodcasts!

iTunes (iOS) Podcasts (iOS) Podcast Republic (Android) Podcasts (Win)!

!•  Examples - CTisUS, LearningRadiology, Radiology, AJNR!•  Simple on iOS!

•  All podcasts indexed in iTunes Store or Podcasts app!•  Difficult on Android + Windows!

•  Find XML file containing RSS feed of podcast + type it into podcast aggregator (feed:// )!•  Podcast Republic integrates with iTunes!

How You Learn!

•  Diagnosis!•  Clinical skills related to experience!•  When seeing a new case you encapsulate it

in an "illness script" which you pattern match to previous "illness scripts" to help diagnose!•  Case-based reasoning!

•  Expert is the person who can best capture, organize, and retrieve their experience (cases)!

•  Treatment!•  Work-up driven by medical knowledge!

- Schmidt HG, Norman GR, Boshuizen HPA. A Cognitive Perspective on Medical Expertise: Theory and Implications. Acad Med 1990 Oct;65(10):611-21.!

Capturing + Organizing + Retrieving Your Experience / Cases Your Personal Learning Portfolio

!

Evernote (Android+iOS+Win) OneNote (Android+iOS+Win)!

•  For each case!•  Image annotated with: !

•  Question ~ Story ~ Answer ~ Impact on Practice ~ Resources Used!•  Result is your teaching file!

•  Is a knowledge management system!•  Why?!

•  For achieving + maintaining mastery in medicine!•  Shokunin - relentless pursuit of perfection in your profession to

achieve expertise, mastery, wisdom!

Learning From Your Experience / Cases Your Personal Learning Environment!

! ! ! ! Apps / Web sites!!!!!•  Is all Apps / Web sites you use!•  System that helps you take control of and manage your own learning!

•  Set your own learning goals!•  Manage your own learning - both content and process !

•  Your questions are starting point for further learning!

Sharing Your Experience / Wisdom / Cases Your Community of Practice!

! Blog Twitter / Instagram Figure1! www.pediatriceducation.org #FOAMRad #FOAMPed #PedRad www.figure1.com!!

!"Communities of practice are groups of people who share a concern, a

set of problems, or a passion about a topic, and who deepen their understanding of this area by interacting on an ongoing basis." - Wenger E. et. al. Cultivating Communities of Practice: A Guide to Managing Knowledge!

!!

The Future Wearable Computing / Augmented Reality!

•  Mobile computing is but a step towards wearable computing!

•  Your Internet connection follows you everywhere you go through wearable computing!•  Minimalist, elegant, mobile solution!

•  You will be presented with an augmented version of reality!•  The Internet overlaid upon what you

are seeing!•  Google Glass, Magic Leap!

Conclusion!•  Radiology + pediatric decision support can be done easily and quickly for free using

Internet search engines that search authoritative free Internet resources!

•  This talk is a start. Review these slides at: !•  www.slideshare.net/michaeldalessandro!

•  Web sites to start with:!

!•  Follow us on Twitter @pedsimaging and @pedseducation!

•  Questions and Comments?!