Tuesday, August 2, 2011

VisualDx Success

Using VisualDx Mobile with some pediatric residents in derm clinic
One of the projects I picked up while in Botswana is introducing a computer program called VisualDx (I wrote about it in an earlier post). It’s a super-impressive program with a very user-friendly interface that helps generate a differential diagnosis (list of possible diseases) for dermatology cases. It’s pretty amazing and we don’t even have it at PennMed yet (hint hint) but the creators donated a copy to Princess Marina Hospital.

Getting anything done at Princess Marina Hospital is a huge to-do and VisualDx was no exception. Finding the library, finding a working computer and getting the permission to install a program on a computer all involved numerous phone calls, text messages and visits to far-flung corners of the hospital. But anyone who knows me knows that I don't shy away from a challenge and I was determined to get this off the ground.

That gauntlet was nothing, however, compared to introducing it to the Department of Medicine. The original idea was to identify motivated residents, train them, and have them “spread the love.” I identified a few but they seemed reluctant and I was unsure if they would spread the knowledge. One of the head doctors told me to talk about it at morning report and then require all the doctors to have a training session.

Quick background- morning report is brutal. BRUTAL. Half the room is asleep and participation is literally unheard of. They once had a session assigning doctors to update certain protocols (each doctor was required to work on one section). They would read out a category and ask for volunteers and would be met with stony silence until the resident in charge assigned someone that section. This request-silence cycle went on for 20 different categories. It was painful.

Needless to say, the possibility of requiring these folks to do anything was less than desirable. Therefore, we decided instead to bring VisualDx to morning report. Kari was presenting a case (she nicely bumped the date of her presentation up to this week so I could present as well) and we incorporated VisualDx into her presentation. She talked about an ulcer that we saw on the wards and when she was done I showed how you could use VisualDx to create a differential that included the disease.

Given the apathy that characterizes morning repot, I was basically expecting crickets. I was shocked when people actually seemed to be paying attention and even seemed interested in VisualDx! Not only that but they actually signed up for an optional tutorial session! I was flabbergasted!

VisualDx tutorial
The tutorial session went really well and next step is to work on installing the program on computers in the wards (which will involve approximately 14058434 visits to the wards, the IT department, the department of medicine etc…I get a headache just thinking about it).

I have really loved being a part of this project and the wheels in my head are already turning…maybe they could use VisualDx in outreach clinics in Botswana….or maybe Uganda where my mother is helping set up an ENT residency. Maybe they need a med student to travel and install it! OK, OK, I’ll slow down and get some sleep. 

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