Month: March 2019

Andddddddd…..

We’re back. Just like that, Spring Break has come and gone. Team 3 is returning to action with renewed vigor, suboptimal tan lines, and a new iteration of TUPAC.

Chief among our work over the last two weeks was thinning out an MVP based on feedback from our marathon day with SF operators during their Mountain Path training exercise. While medics were going through unpredictable prolonged field care exercises, we watched and reaffirmed that a primary need was time-efficiency. One untrained teammate who wasn’t a medic, for example, took nearly 15 minutes to execute a teleconference that should have taken a third of that time for two reasons: they didn’t have the right information in front of them and the support physician on the other end didn’t have their patient’s information readily available either. This is the situation our app will live in, but we also learned during Mountain Path that in order to do so, we had to be more user-friendly than it had previously been.

So, before conducting any beneficiary interviews over break, we set out to create TUPAC “V3”, the latest iteration of the telemedicine app with a central focus on building a “PACket” of information that will be compressible, comprehensive, and easy to create.

After building a new App, we ran a few key A/B tests around 1) messaging, 2) scroll capabilities, and 3) home screen layouts. The results of the latter two are not as consequential as the most former, so we’ll get right to it: We learned from multiple beneficiaries that our MVP is better off to first be deployed as a file-creator, where users can send concise scripts of patient information using a method of their choice, and not as an all-in-one app messenger like our previous versions had envisioned. This does not mean that we do not see that capability in the future, but along our theme of “thinning out” and gaining adoptability, we have decided to focus the experience around creating files that will be easily sendable through already mature communication habits like email.

We look forward to sharing more of our findings and work during the presentation, but also stay tuned for a new team name out of this group on the horizon – its time to make a business!

– Team 3

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Roger Dail: Former 18D;  CEO & Founder – Ragged Edge Solutions
– Determine a metric that demonstrates time saving between using TUPAC and “hand jamming” the information.
– “The enemy of good is perfect; anything better than what the guys use now is a win.”
– Ensure the PACket, once delivered to a physician, looks like telemedicine script they are used to using/ seeing.

Drew Hinnant: 18A; S3A, 3SFG
– Mountain Path AAR.
– Coordination for potential TUPAC demonstration for command-level leadership.
– Standardize “Medications” such that options reflect current issued drug and dosages.
– Scroll capability is nice; user preferences dictate; Build in flexibility for user.

RC (name withheld): 18D
– Add an ability to share profiles in the setting menu.
– Current debate on colloids and potential for the future; importance of ensuring app is up-to-date with current best practices in medicine.
– In Part 1 of app, merge fluids and bloods together; most medics consider them one and of the same.

Alex Wilson: Former 18D; current Fuqua student
– Importance of reflecting accurate resources available.
– Preferences for scrolling over page view.

Russell Dallas: 18D
– Relevant and up-to-date information on resources slide.
– Indicated preference for sliders and scrolling.
– Supported using other native apps (WhatsApp, Signal, etc.) as a means for sending PACket; in-app messenger not a necessity.

Sean Keenan: Former SF Battalion, Group, and Theater Surgeon;  pre-hospital care SME
– Importance of differentiating between “rank” and “position.”
– Importance of accurately recording certain vitals (i.e. blood pressure); get rid of sliders, or if kept, ensure they have a high level of sensitivity.
– Use the industry standard ADVISOR transcript as the framework for app, not the PFC workflow sheet; importance of ensuring the output mirrors what the ADVISOR docs are used to seeing.

Rich Salve: Former 18D; RN, DUHS;  Ragged Edge Solutions cadre
– PACket compression options.
– For patient history section, use S.A.M.P.L.E. format (industry standard).
– Drop-down option for medications would be easier and more efficient.

CM (name withheld): 18D
– Indicated preference for scrolling.
– Very receptive to using other native apps (WhatsApp, Signal, Wicker) to send PACket over.
– Z-out option is nice to have, not a necessity.

Beck Mitchell: TangoTango
– Discussion of PTToC options integrated w/ existing communication networks;
– Expansion of 5G LTE and high-level assessment of where TUPAC fits in.
– Potential resource for future development.

Mark Schultz: Orion Labs
– AI integration with existing PTToC, and use of bots to automate workflows like TUPAC.
– potential resource for future development.

 

This week, we got to experience the SF telemedicine use case first hand – by observing a live training exercise taking place across North Carolina known as “Mountain Path”.

Huddled in a dark wing of a fifth floor office renovation in Raleigh, we exchanged discussion points and collected key insight that will be shaping the next phase of our product development.

Of the major takeaways from this week, this “out-of-the-office” experience allowed us to realize, and then discuss, a point of iteration for our mobile telemedicine platform. In brief, we need to get deeper into the actual telemedicine needs and shift our focus around providing an all-out clinical care app. This epiphany is not yet considered a “pivot”, as our base ideas are still intact. However, we are walking away from this week of customer discovery with a sharpened problem scope and new design considerations for smoother SF telemedicine in remote conditions.

Below, we share some key takeaways from the people we met:

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Interviews conducted at 3SFG “Mountain Path” Exercise:

Ryan Maves: SOCOM instructor; Associate Professor USUHS
– Telemedicine best deployed after team has stabilized the patient, after 2nd survey.
– Sometimes it is best for physician to follow patient’s vitals to stay ahead of the complications even when the team hasn’t called the physician.
– Small complications in routine procedures can complicate the treatment, and having a physician to guide the team through would be great.

Doug Powell: Former 4BN 3SFG Surgeon; current Staff Intensivist, First Health Physicians Group
– App ideally can be downloaded in the US that can then be uploaded onto a burner phone bought locally.
– Need a way for physician to monitor each action that the team has performed.
– Simplicity and usability is key.

Jeremy Pamplin: Deputy Director, U.S. Army’s Telemedicine and Advanced Technology Research Center
– BATDOK will inevitably be successful; all other (working solutions) are a waste of time and resources.
– Focused on the “big Army,” enterprise level development, adoption, and integration of technologies.

William Vasios: Former command physician assistant, Special Operations Command – Africa
– Discussed his role in advancing the field of pre-hospital care/ critical care research.
– Discussed trends he has seen in previous PFC exercises, and areas of the exercise where our team might derive the most value.

Roger Dail: Former 18D;  CEO & Founder – Ragged Edge Solutions
– Teams usually have the phone attached to their chest in landscape that they can then flip down to type and read.
– Current methods of paper and pen are inefficient because paper gets torn, ink gets washed off.
– BATDOK works great when used by the techs demonstrating its usability, but few people can use it after they leave.

Rich Salve: Former 18D; RN, DUHS;  Ragged Edge Solutions cadre
-BATDOK is improving usability and can select different capabilities in settings to limit the amount of phone capacity needed for usage.
– Very few deltas receive the training that we observed at Mountain Path
– Fewer use it as a refresher course.

DW (name withheld): Former 18D; Ragged Edge Solutions cadre
– Batdok usually fails after a few clicks and often freeze when all options are selected in settings, especially voice recording and voice recognition
– It is necessary to remember the specific steps needed to get to a specific function.
– Ideal would be to have redundancy in the buttons so that there are more than one intuitive paths to reach the same function.

PL (name withheld): 18D; SOMA PFC Working Group member
– History behind the drive to standardize PFC training, protocols, and resources (ADVISOR Line).

CK (name witheld): 4-3SFG Signals Detachment
– Any solution must meet minimum requirements that ultimately protect a units digital/ electronic signature.

Brad Hayes: Founder & CEO, Aerial Inspection & Mapping Images, LLC
– Provided insight into current efforts to leverage drone technologies during PFC scenarios; talked through strategies his company has taken to overcome the limited communication environment.

David VanWyck: 4BN 3SFG Surgeon; “Mountain Path” OIC
– Need to have a Batdok-like app that works
– Physicians provide advise at around hour 4-5 after injury
– Batdok wanted to test out usability with the deployments, but haven’t been as responsive

JW (name withheld): 18D; “Mountain Path” NCOIC
– Provided candid discussion on why SOCOM and Army Special Forces has stumbled when working to adopt different technological solutions.

Stacey Shackelford: Director, Joint Trauma System (Defense Health Agency)
– Discussed JTS’s role in navigating Title 10 and establishing joint requirements for medical training.
– Discussed JTS’s current efforts to standardize PFC scenario training across the different services.

Sean Kennan: Former SF Battalion, Group, and Theater Surgeon;  pre-hospital care SME
– What do these guys (medics) really need? Focus development on that; teams need an easy way to digitize the tele consult transcript.
– Don’t try and replicate BATDOK

“Kat”(name withheld): PA; 4-3SFG “Mountain Path” team leader
– Provided insight into operational considerations, clinical decisions, and personal feelings around her teams first tele consult experience.

JW (name withheld): 18X, 4-3SFG “Mountain Path” assistant team leader
– Provided insight into operational considerations and personal feelings around his teams first PFC exercise/ teleconsult experience.

NP (name withheld): 18X, 4-3SFG “Mountain Path” team leader
– Provided opportunity to observe and listen to actual tele consult between his team and ADVISOR line.

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Other Interviews:

Michael Jelen: Director, Berkley Research Group; experience in software consulting
– Reviewed team progress on system architecture plan, advising new efficiency plan for communicating system needs during our final pitch

Matt McGuire: Software Architect & Developer, Protectwise, Inc.
– Provided technical advice on different ways of building a back-end system for TUPAC, and some of the current commercial solutions available in the market.

Drew Hinnant: 18A; S3A, 3SFG
– Reviewed high-level plan for remainder of semester, including Mountain Path exercise and how we could grow from it.
– His outsider perspective of the event, but insider knowledge of how training exercises occur was a major part of our preparation plan.
– Discussed next steps for reconnecting with 18E’s as we build our system requirements document.