Our Expert

Our expert is Dr. Venktesh Ramnath, a doctor in the Intensive Care Unit (ICU) at Jacobs Medical Center. Our tool was designed for use in the ICU to target the documentation burden of documenting patient updates, which occurs often in an ICU setting.  

Our Interaction 

After introductions, we gave a brief overview of our tool and walked Dr. Ramnath through our prototype. Our prototype is a low-fidelity design-based prototype made in Figma, designed primarily to show the workflow of clinical documentation using our tool Adelaide. Since our prototype was low-fidelity and design-based as opposed to functionality-based, we thought it best to present and explain the functionalities, workflow, and subpages of our prototype, and have Dr. Ramnath give feedback afterward. After presenting our prototype, Dr. Ramnath engaged in a retrospective think-aloud, on which we took notes. Following the think-aloud, we conducted a semi-structured interview, in which we asked a set of prepared questions while also allowing the discussion to lend itself naturally to new topics. Some sample questions include: Is there a feasibility of this being included in a clinical workspace? Would you make any changes to this tool? 

Feedback Points and Takeways 

From our discussion with Dr. Ramnath, we organized our feedback into two distinct sections: potential drawbacks of our current model and future steps in the development of our prototype, as well as how both inform the design of our prototype.  

Potential Drawbacks of the Current Model  

The first potential issue with the tool is the external nature. For example, this tool may be hard to integrate into current EHRs since due to different levels of EHR restrictiveness, EHR access issues, and the tool must implement the same functionalities by customizing it to EHR-specific. In addition, clinical professionals may be hesitant or unwilling to adopt a new tool, especially when they already have many other applications they need to access throughout their workday, such as the electronic health record, scheduling software, etc. To address this concern, one potential solution to this is to integrate this tool directly into the existing EHR systems instead of having it be an external application that connects to the EHR.  

Another point of concern is the true value it provides to clinical professionals. Does our solution really solve an existing problem? Is documentation support enough of a task to justify development of this new tool? Does it provide enough increased functionality over other similar technologies? For example, there already exists technologies that transcribes audio from patient and healthcare professional interactions. Some suggestions for new functionalities include adding a speech-to-text transcription to the beginning of our notes pipeline to further ease the documentation burden, or providing clinical decision support. For example, after generating the notes, Adelaide can provide diagnostic support, suggesting medications and dosages or providing patient diagnosis. While clinical decision support can make the tool more meaningful, it also adds an element of difficult (more regulations on tool approval, more technological implementation, more risk in suggesting faulty recommendations, etc.) and must be handled with greater care. 

Next Steps in Prototype Development

In order to further finalize our proof-of-concept prototype, we must refine our end user (ie what type of nurse will be using our tool, rapid response, bedside, ICU, etc.). It can also be helpful to observe the clinical workflow of a nurse doing documentation and conduct empathy mapping during the charting workflow. Specifically, we would observe nurses: their behaviors and actions and the reasonings behind them, any frustrations/headaches or pain points during the process, etc. Additionally, it would be helpful to do market analysis. This includes research into similar technology existing in the market and what new functionalities our tool is providing, any governmental or regulatory policies regarding the launch of our tool, etc. From the business aspect, areas of further research include possible finance avenues for our tool, potential business models, and barriers to entry in the current market.