General

In the Beginning

By November 23, 2018 No Comments

I’m Rob and I’m a Junior Doctor, as well as the founder of MedApps.

MedApps has one main focus: To improve the working lives of clinicians. We do this through our app, Resident Guide.

What is Resident Guide?

Put as simply as possible, Resident Guide is a digital hospital handbook.

Resident Guide was built in response to the issue of doctors being required to change either to a new hospital, or move between one medical team to another, every 2-3 months. This change is like starting a new job and carries with it penalties in terms of the Doctor needing to adapt to their new role, learn all the local procedures, phone numbers and referral pathways.

When I started developing the application that become Resident Guide in 2014 I had no idea that it would grow into my full-time job. Back then I was 100% focused on a surgical career and it was simply a pleasant hobby to learn to code.

Problem Inspiration

Resident Guide was inspired by a problem I experienced during my first 2 weeks of internship. I had just completed my Hospital’s orientation week, and equipped with my 120 page orientation handbook had transitioned across to my medical team, ready to start work.

One of the first things that my consultant asked me to do was to order a CT scan for a patient. I logged onto the medical records system and made the imaging request, and then went about the rest of my duties.

The next day I arrived to find that my patient had still not had their scan. Digging into it, I discovered that I had not followed the ordering procedure correctly: the electronic imaging request was meant to be accompanied by a signed and faxed contrast consent form.

This one mistake I made delayed the patient’s journey by an entire day (the patient could not progress in their treatment until their scan results were known) and cost the health system $1400 (Audit Office of NSW Bed Day Costs – https://www.audit.nsw.gov.au/ArticleDocuments/358/10_Managing_Length_of_Stay_Hospital_Readmission_Appendix_Three.pdf.aspx?Embed=Y )

Of course somewhere in that 120 page orientation handbook was the correct procedure for how to request a CT Scan, but of course there are certain logistical issues with carrying ⅓ a ream of paper around with you on the wards!

How it all began

The initial sketches for what became Resident Guide were laid out in April 2014. However, an encounter with a fellow Junior Doctor Daniel Kirkpatrick led to the opportunity to get paid for my development work, by bundling in a set of content he and his hospital had produced to assist their Intern, Residents and Rotating Doctors in Training from other sites become acquainted with their site.

I set about completing the iOS version of the application, before venturing into the Android development environment and learning Java to the best of my ability. I translated the application from Objective C across to Java in about 2 weeks, taking advantage of the ‘Week on, Week off’ nature of the Intensive Care Rotation I was undertaking in February 2015.

That version of the application launched soon after. There was no backend, meaning that my content changes required an update of the application package.

Early expansion

It wasn’t long until we had interest from another medical colleague. Her health district was holding a ‘Shark Tank’-like pitch session. She pitched the idea, and with funding for the project confirmed, I set about building a backend for the platform, with a REST API to enable updates to the mobile applications whenever content changed. This also allowed the platform to be highly scalable should new Hospitals wish to join.The next challenge was to update the apps to connect to the API. Whilst I found it relatively easy to modify the iOS app, the challenges of becoming proficient enough in a third language (Java) combined with my commitments to my job and ongoing surgical education (I was sitting the surgical primary exam at this time) proved too much. I transitioned to outsourcing for Android development at this point which was very effective and also beneficial from the perspective of learning about project management.

MedApps Today

Today, MedApps is an 8- strong team focused on delivering tools that improve the working lives of clinicians.

Resident Guide, our main tool for achieving this, is currently live at 23 sites across NSW and QLD.

We have 2,500 Doctors in Training on the platform and have welcomed our first medical students. We hope to shortly begin providing services to the Nursing and Allied Health fields.

Resident Guide Today

Whereas the original Resident Guide platform was quite a simple content management system, the platform today has significantly more features. We now see it as having 3 core functions:

  1. Best practice orientation, onboarding and integration

Resident Guide doesn’t replace in-person orientation sessions, it complements them. In addition, it means there is never any reason for a clinician heading to a remote site, or who has had a start date that differs from the main cohort, or a locum Doctor or Agency Nurse, to not have the base set of information that means they will be functional from day 1.

This light touch digital orientation & onboarding can be done in seconds and provides the clinician with everything they need to be job-ready from the moment they hit the floor.

The aim of Resident Guide is to ultimately facilitate integration, which is “… a more aspirational goal—doing what it takes to make the new person a fully functioning member of the team as quickly and smoothly as possible.” [https://hbr.org/2017/05/onboarding-isnt-enough?referral=03759&cm_vc=rr_item_page.bottom]

  1. Wellbeing

We will be writing a lot more about this as time goes by, but essentially there are 3 components here.

  • Providing common materials at different sites
  • Providing resources in consultation with our partners
  • Participating in research where appropriate and with appropriate ethical guidelines and consents
  1. Engagement & change management

Resident Guide has excellent demonstrated engagement with its user base. Later this year we will be kicking off a study looking at utilising several of the app’s documentation features to engage trainees in education, best practice and change management.

Ultimately, we believe the ability to present relevant content to Junior Doctors at appropriate times (for example, to Interns and Residents who have just started their Emergency Department Rotations) will assist their learning, reduce stress and improve patient care.

The Future??

Australia is currently experiencing a boom in Tech Health (That order is correct – Health Tech is something the established players try to do; Tech Health implies disruption, as we are first a technology company that specialises in health). Our team is excited to be working in this rapidly evolving space and looking forward to delivering on the quadruple aims of healthcare – that is:

  • Improving patient experience
  • Improving population health
  • Reducing per-capita costs
  • Improving clinician wellbeing

We’re looking forward to blogging about our social mission, the challenges we have faced, how we handle issues of privacy, technical articles and our beliefs about health and technology policy.

We would also like to acknowledge the hard work done by the other startups in this space who serve as an inspiration and excellent knowledge network: Dr Amandeep Hansara and the Creative Careers in Medicine team, Dr Andrew Yap at MedTasker, Dr Jonathan King at Lysn, the excellent team at CancerAid, Hugo and Scott at Perx Health, Dr Simon Menelaws who is trying to Humanise Culture.

I’d also like to personally thank my family, as well as all of my many clinical supervisors, mentors and colleagues for their support along the road so far and look forward to the many challenges ahead.