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Jeremy's Daily Blog

3 goals for summer internship
1.      Better understand roles and relationships among different members of the healthcare workforce and day-day functioning of a physician

2.      Understand the role of IT in healthcare and gain familiarity with technology tools by working with a project team

3.      Finding what role/s I would enjoy in the healthcare system 

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CATCH-UP

6/17/2013

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App Fun

This past week I have had some trouble logging into the weebly website and now have quite a bit of material to work with. I will try and limit myself to writing the highlights in an effort to keep this post at a reasonable size. 
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I started the week exploring three existing apps created for IBD patients. The apps were "GI Buddy," "GI MONITOR" and "myIBD." Though designed differently, all three of the apps serve a similar purpose. These apps are platforms for IBD patients to record their daily symptoms and provide tools for patients to analyze what they have recorded. Playing around with these apps, I began developing an understanding of how the design of an app ties into the functionality of the app. I compiled conclusions in an excel chart and will highlight some ideas here.

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The Home Screen
It is crucial for a "home screen" to exist that can lead to all other capabilities of the app. This one screen makes it simple for a user to find what they are looking for and minimizes the amount of time wasted on searching for different functions. I found myself using features of an app that were not displayed on the home screen much less often.

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Pictures Worth 1,000 Words
Following the concepts mentioned earlier for web design, it is important to  include only information that is vital, so a screen does not become cluttered. All of these apps used different diagram and icons to portray information instead of lengthy instructions. Besides for making the screen more aesthetically pleasing, I realized that I would not have read the instructions had they been provided and therefore prefer the use of icons. Some of these icons, however, seemed to hold an ambiguous function and in building our app we will have to be careful about relying to heavily on their use. 

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Make It More Fun Than Just Writing In An Answer
Everyone can write in an answer. It's boring. We do it all the time. You put little thought into the response and you may just be too lazy to respond at all. It is so important for the app designer to realize this and to think of innovative ways for users to respond to questions. The use of color coded sliding scales as seen on the right is a prime example. Instead of typing in your weight, you can simply slide your finger to the proper number. If you do need a typed answer, then the use of a search function from a compiled database of potential answers. In some of the apps explored above, when inputting what you had for a meal, you simply had to search through the USDA database of food options. 


Playing with these apps has made me more comfortable with the future task of designing one. I have learned how a user approaches these apps (or at least a user like myself) and what can set an app apart. GI Monitor, for example, has a social networking aspect to their app and I found this to be a really interesting way to draw in users. Sure enough, when I looked at the amount of comments on the itunes store, GI Monitor was by far the most popular of the three apps I observed even though all three serve a relatively similar purpose. Insights such as these will prove to be vital when the designing of our app begins.

Learning The Medicine And Technology Connection

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The next few days I began reading articles from a publication titled Digital Infrastructure for the Learning Health System. The articles discussed how technology could, should and will be implemented into the healthcare system and what issues may come up as this process takes shape. Certain themes appeared repetitively throughout these articles and understanding them is important for the discussion of what potential technology holds for the healthcare system.


The background is well known. Presently, healthcare costs in the US are about 17% of GDP and these costs are growing at a rate faster than the country's GDP. Comparatively, healthcare costs make up a much larger portion of the United States economy but quality of care is arguably worse than that present in many other first world countries, We are just not getting the bang for our buck!

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We can find many reasons that attempt to explain this contradiction of cost and quality. The United States healthcare system is full of what economists term as market failures. There are situations of asymmetric information and risks of moral hazards that yield an imperfect market. The healthcare system is fragmented and communication between different members is severely lacking. With all of these inefficiencies, science is improving and the practice of medicine is becoming more complex everyday. There needs to be more evidenced based care, but with the dis-organization and medical data recorded on paper, much of the innovative tools for analysis are futile.

Technology has the ability to change the status quo. Electronic resources can make data accessible, transferable and usable in real-time. Patients can become more involved in their medical care and disclose "user-generated data" such as fatigue, pain, diet, exercise routine and adherence to their treatment plan. Tools for analyzing data can be used and give feedback in time for a clinician to benefit from their results. This process will cut the cost of implementing evidence based medicine and push for a more organized system in which doctors come together with other service providers to create a multidisciplinary approach to care. By incorporating technology into medicine, we are jumping onto the quick growth "tech bandwagon." We are putting our system in a position for rapid improvement.

Technology is a great tool to improve our healthcare system but there are challenges to overcome if we are to take advantage. We will have to build an infrastructure that can handle this new environment and will have to make the system simple and intuitive for it to be adopted. Standards will have to be set so everyone is "talking in the same language" when inputting information and or else collaboration cannot be achieved. There will need to be a culture shift, in which patients are both willing and welcomed to take an active role in the way their treatment progresses. Implementing technology is a difficult task but it is more than just a fix to our healthcare system. Completing these tasks begins a new era of high quality and personalized care for each patient.
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    Jeremy Rosh is a rising Junior studying finance and pursuing a pre-med track at the NYU Stern School of Business. Searching for ways to combine the disciplines of medicine and business, he is working this summer on project to simultaneously  improve the quality of care that patients receive while driving down costs. Embracing the summer atmosphere and as an energetic and curious twenty year old, Jeremy cannot wait to see what he will uncover during these next few months.

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Division of Gastroenterology, Icahn School of Medicine at Mount Sinai
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