Hung Le*, University of Rochester Medical Center, Rochester, United States Terry Doll, University of Rochester Medical Center, Rochester, United States Monica Barbosu, University of Rochester Medical Center, Rochester, United States Tom Dellaporta, University of Rochester Medical Center, Rochester, United States Amneris Luque, University of Rochester Medical Center, Rochester, United States Dongwen Wang, University of Rochester Medical Center, Rochester, United States Track: Practice Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2012-09-12

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The HIV Clinical Education Initiative (CEI) is sponsored by the New York State Department of Health AIDS Institute to meet the clinical education needs of HIV healthcare providers. Motivated by CEI’s success of on-site training for two decades and the outreach of CEI’s online resources to 17,000+ audiences from 140+ countries in recent years, we have expanded the CEI online training program through development of mobile applications. Deployed as web-based systems and native applications on Android and iOS platforms, these mobile resources can be directly used by healthcare providers on their hand-held devices for: (1) finding the frequently used phone numbers for assistance with HIV post-exposure prophylaxis (PEP) emergency care, consultation on specific patient cases, and identification of HIV clinical education resources; (2) checking the latest news, events, and articles related to HIV training; (3) watching HIV clinical education learning modules; (4) reviewing the recommendations to specific clinical problems based on New York State HIV clinical practice guidelines, and (5) exploring clinical decision making on individual patient cases through interactive case-simulation tools.

Over the past three years, the CEI online education program has accumulated a significant number of online learning modules. To make them available for mobile applications, we have developed a repository to classify these modules into specific categories such as HIV testing, PEP, prevention, mental health, etc. To facilitate browsing and reviewing of these learning modules, we have collected additional information such as: (1) speaker name, credential, affiliation, and bio sketch; (2) learning objectives; and (3) related clinical practice guidelines. This information is stored in a Microsoft SQLServer database that drives a mobile website (http://www.ceitraining.org/m) and an Android app (CEI-nema). Currently, there are 70+ learning modules and lists of HIV training events, news, and articles that are continuously updated.

To customize the general recommendations to specific patient cases, we have developed an interactive tool to assist clinical decision making based on practice guidelines. Healthcare providers can use it to review the decision making process on pre-defined demonstration cases. They can also define their own patient cases to explore the different decision options and processes step by step. To facilitate knowledge management (i.e., updates of clinical guidelines), we selected to implement this tool in a model-driven approach. For this purpose, we leveraged our previous work on the GuideLine Interchange Format (GLIF) and the GLIF GuideLine Execution Engine (GLEE). Through an enhancement of the GLIF/GLEE infrastructure with a Universal Presentation Layer, we can present a clinical decision process step by step; we can also support user interactions such as checking a specific step, reviewing different decision options, and entering data for a particular patient case. We have piloted this concept in an application used by HIV primary care physicians for insomnia screening and treatment (http://www.ceitraining.org/insomnia). This concept can be easily generalized to other clinical problems, as the entire system is driven by GLIF and GLEE.

Future development on CEI mobile applications include: (1) additional case simulation tools for PEP and immunization; and (2) integration of learning modules and case simulations.