Rodger Marion, Ph.D.
University of Texas Medical Branch
The Health Information System Simulation Project
ABSTRACT
The Health Information System Simulation (HISS) Project has
developed a unique training approach that combines training in
patient problem-solving with interprofessional communication and
the latest computer-technology. This approach focuses on simulated
patient cases presented in a computerized patient record. The
software can be used by students in medicine, nursing, and many
allied health professions.
PAPER
For the past three years the Health Information System Simulation (HISS) Project (Allied Health Project Grant 1 D37 AH00156) has developed, evaluated, and validated an approach to teaching allied health students to use the most up to date methods of computerized patient assessment and management in the delivery of health care services. This approach centers on simulated patient cases presented in a computerized patient record. Students interact with the simulated patients and with students in other disciplines through networked computers using our Windows based computer applications. In this environment they learn to collaborate while mastering skills in diagnosis and treatment planning.
The central HISS application, the Electronic Patient Record (EPR), accesses and displays a complete simulated patient record. It includes histories and physicals, laboratory results, photographs, and graphical representations of diagnostic tests such as X rays, EKGs, and CT scans. Four simulated patient cases have been developed for the EPR: geriatric stroke, pediatric leukemia, cardiac hip fracture, and HIV. Four new patient scenarios will be developed in the next grant period and include: lung cancer with work rehabilitation problems, tuberculosis/chronic back pain, systemic lupus erythematosus, premature birth/spina bifida.
Other HISS programs, MainBooks, run simultaneously with the EPR and provide the computerized links between students, faculty, and the simulated patients. MainBooks track student usage and record findings for assignments. Faculty members record their assessments of student performance which students can view later. The MainBook, Patient Consultation and Referral (PCR), allows students to consult with colleagues in other fields when developing care plans for their simulated patients. Other MainBook applications provide on line Help and other auxiliary services to users.
Beta test sites have been established at the Medical College of Georgia and the College of Health Sciences, Community Hospital of Roanoke Valley, Virginia. Several universities have received licenses for the Phase I Release (PIR) software. The PIR has been available since February 1995.
With the recent continuation of funding (2 D37 AH00156), the project aims at augmenting its initial activities to show students new uses for computers in health care. The EPR will expand to include on screen video and sound of patient evaluations and interviews. These enhancements will allow student users to reach community resource directories, records of home assessments, and other data from various sources all from a single computer workstation. In doing this, the EPR will be transformed from a merely computer based, Electronic Patient Record into a virtual patient record with access to all information available concerning a patient.
The evaluation design asks two questions of these additions to the HISS applications. First, by using computer applications that simulate consultations and referrals on local area networks (LANs) and through teleconferencing, can we show that innovative technology can encourage better communication and interaction between different health care professionals. Second, will these technological innovations positively influence graduates to consider rural or urban practices that focuses on underserved patients. This current development effort will result in the Phase II Release (PIIR)software which will be available in late 1996.
During the demonstration, symposium attenders will be able to view the use of the EPR and MainBooks. We will also discuss how to incorporate the HISS applications into health sciences curricula in medicine, nursing, and allied health professions.
