14 articles found

Building the TacMed Chatbot to Support Medical Education in Low-Resource Settings: A Low-Code Platform Approach

Abstract

Building the TacMed Chatbot to Support Medical Education in Low-Resource Settings: A Low-Code Platform Approach

16 June 2025

Introduction As technology continues to advance, humans and technology have developed together to meet our needs, changing the way we live. This evolution forms the foundation of cyberpsychology [1]. Chatbots, which are virtual agents that communicate with users, play an important role in fields like customer service, healthcare, and e-commerce [2,3]. Chatbots can either follow simple rules (rule-based) or use AI technologies like Natural Language Processing (NLP) and Machine Learning to interact more intelligently. However, AI chatbots may present challenges, including the risk of delivering incorrect information, especially in high-stakes domains like healthcare. Health Tech Without Borders (HTWB) developed a TacMed Chatbot for frontline responders in Ukraine. The chatbot provides lifesaving medical information in critical situations. This study describes the steps taken to build this chatbot using a low-code platform, addressing the rationale behind the design choices and the process of deployment. Methods Pre-planning and Research The TacMed Chatbot project began by assessing the needs of Ukrainian frontline responders. The results highlighted the need for a simple, protocol-based tool, as many first responders in conflict zones had limited medical education and worked in high-stress conditions. A decision was made to use a low-code platform to develop the chatbot, focusing on decision tree logic. A low-code platform is a software development approach that requires minimal coding, enabling rapid application development using visual interfaces. This makes it accessible and allows for faster deployment of applications. The TacMed Chatbot was built using a low-code platform to streamline development and localization. Decision tree logic is a structured rule-based model that guides users through predefined steps based on their inputs, ensuring consistency and reliability Chatbot Design The chatbot used vetted information from sources such as Stop the Bleed and Tactical Combat Casualty Care (TCCC) protocols. A low-code platform was selected to facilitate decision tree logic and ensure seamless localization into multiple languages. Key design considerations included adapting the chatbot for Ukrainian medical terminology and integrating visual aids to support understanding. Testing Phase The testing phase involved diverse user groups, including medical professionals and civilians, across the US, EU, Ukraine, and Middle East. The team ran feedback sessions and tested the chatbot’s clarity and usability during a conference in Lutsk, Ukraine and virtually to medical professionals in Sudan. The goal was to ensure the chatbot was simple, effective, and appropriate for both healthcare professionals and non-medical users. Results By the end of July 2023, the TacMed Chatbot had delivered over 32,000 messages to more than 500 users. Its primary use cases involved providing emergency medical protocols for treating war casualties. Feedback from users indicated the chatbot's ease of use and its potential to be a valuable educational tool for frontline workers. Discussion The medical field continues to embrace chatbots, leveraging digital technologies to drive economic growth and improve public services. The TacMed Chatbot is an example of how technology can be harnessed to support healthcare delivery in conflict zones. The development process highlighted the benefits of using a low-code platform [4], which allowed for efficient creation, localization, and easy adjustments. Despite not utilizing AI, the TacMed Chatbot proved effective in delivering critical medical information. It complemented other educational tools and demonstrated the potential for chatbots to enhance long-term memory retention for medical protocols. However, further developments could integrate AI to handle unrecognized queries, enhancing the chatbot's ability to provide broader support. Limitations The TacMed Chatbot, while effective, does not incorporate advanced AI, limiting its ability to handle complex or out-of-scope queries. Moreover, it was designed primarily for frontline workers in Ukraine and Sudan, and its adoption may face challenges in other regions due to language and cultural differences. Additionally, its reliance on decision tree logic may restrict flexibility in responding to unique situations outside the predefined protocols. Conclusion and Future Directions The TacMed Chatbot has demonstrated the potential of simple chatbot technology to support emergency medical care, especially in high-pressure environments like warzones. The success of this tool highlights the need for continued collaboration between medical professionals, NGOs, and technologists to improve healthcare delivery in disaster and conflict settings. In the future, we aim to update the chatbot to incorporate AI to understand questions it doesn't recognize and provide more personalized answers. Future studies can focus on creating chatbots that are adaptable for global use, aiming to build systems that can improve medical education and response during crises around the world. Acknowledgements XR at Yale, Randall Rode, HTWB team

Ahmad Hassan

Marianna Petrea-Imenokhoeva

Stella Nam

+7

Trends in Chronic Kidney Disease–Related Mortality Among Type 2 Diabetes Mellitus Patients in the United States from 1999-2020.

Abstract

Trends in Chronic Kidney Disease–Related Mortality Among Type 2 Diabetes Mellitus Patients in the United States from 1999-2020.

15 June 2025

Background Type 2 Diabetes Mellitus (T2DM) affects around 34.2 million people in the U.S., or 10.5% of the population [1], and is the leading cause of chronic kidney disease (CKD) [2,3]. About 40% of adults with T2DM have some degree of CKD [4]. T2DM has unique mechanisms like insulin resistance and metabolic syndrome that speed up CKD progression. Research [5] has shown that diabetic kidney disease (DKD) in T2DM patients causes albuminuria, declining kidney function, and increased cardiovascular risks. CKD in T2DM patients also raises the risk of heart problems and death. Socio-demographic factors, especially in minority populations, affect outcomes, with non-Hispanic Black and Native American groups facing worse results due to healthcare inequities [6]. Most studies focus on advanced CKD or end-stage renal disease (ESRD), but early-to-moderate stages, where intervention can help, are often overlooked. Objective To determine mortality trends for T2DM-associated CKD from 1999 to 2020 among adults in the United States, emphasizing early-to-moderate CKD stages to highlight opportunities for early intervention. Methods In December 2024, data on CKD-related deaths among patients with T2DM in the United States was collected from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research database (CDC WONDER) [7]. Death certificates were used to identify CKD and T2DM with ICD-10-CM codes (E11 for T2DM, N18 for CKD). The data was categorized into two age groups: young (25–64 years) and older (>64 years). Institutional review board approval was not needed as the data was de-identified. Data collected included year, population size, demographics, CKD stage, geographic regions, and urban-rural classification. CKD severity was divided into early (stages 1-2), moderate (stages 3-4), and advanced (stage 5 or ESRD). Demographics included age, race/ethnicity, and gender. Urban and rural areas were classified by the National Center for Health Statistics. Crude and age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were calculated. Trends in AAMRs were assessed using Joinpoint regression, and annual percent changes (APCs) were determined with 95% confidence intervals (CIs). Statistical significance was set at p< 0.05. The inclusion criteria included adults aged 25 years and older with CKD listed as a cause of death and T2DM as an underlying or contributing cause. Only deaths occurring in the United States between 1999 and 2020 were included. Additionally, individuals with complete demographic and geographic information in the dataset were considered. The exclusion criteria comprised patients without documented CKD or T2DM on the death certificate, pediatric populations under 25 years, and cases with missing or incomplete data regarding key variables such as age, sex, or geographic classification. Results There were a total of 90,615 CKD-related deaths among adults with T2DM between 1999 and 2020. The AAMR was 15.0 in 1999, which increased to 26.0 by 2009 (APC: 4.20; 95% CI: 1.98-6.48), after which there was a sharp rise to 56.0 by 2012 (APC: 20.5; 95% CI: -0.03-45.28). It then gradually declined to 3.6 (95% CI: 2.8–4.5) in 2015. By 2020, the AAMR steadily rose to 7.5 (APC: 30.5, 95% CI: 18.91-43.2). The AAMRs for men were higher than those for women throughout the years (23.2 with 95% CI of 22.96–23.39 vs.16.1 with 95% CI of 15.97–16.28). NH American Indian or Alaska Native patients had the highest AAMR (56.2, 95% CI: 53.2–59.2]), followed by NH Black or African American (32.0, 95% CI: 31.5–32.6), Hispanic or Latino (28.7, 95% CI: 28.1–29.3), NH Asian or Pacific Islander (16.6, 95% CI: 16.0–17.2), and NH White populations (16.2, 95% CI: 16.1–16.4). Nonmetropolitan areas experienced a relatively greater mortality burden with higher AAMR (23.3, 95% CI: 23.5–24.2) compared to metropolitan areas (16.9, 95% CI: 17.8–18.1), while the Western region had the highest overall AAMR (22.8, 95% CI: 22.5–23.1), followed by the Midwestern (22.1, 95% CI: 21.8–22.4), Southern (18.0, 95% CI: 17.8–18.2), and Northeastern (12.9, 95% CI: 12.7–13.1) regions. Early CKD stages (Stages 1 and 2) showed lower mortality rates, with age-adjusted mortality rates (AAMR) significantly lower than those for later stages. For example, in 2015, the AAMR for individuals in Stage 1 was 3.6 (95% CI: 2.8-4.4), compared to 56.0 (95% CI: 54.2-57.8) for individuals in later stages (Stages 3-5). CKD stages contributed significantly to overall mortality, particularly among minority populations and non-metropolitan areas, underscoring the importance of early detection and management strategies. Discussion Our study found several key trends in CKD and T2DM mortality: First, advanced CKD stages had the highest mortality rates. Mortality increased from 1999 to 2012, declined until 2015, and then rose again from 2015 to 2020. Although the increase in AAMR from 2009 to 2012 was not statistically significant, it may still have practical relevance, as it aligns with broader public health concerns such as rising comorbidities, healthcare disparities, and changes in diagnostic practices. Future research with larger datasets or alternative analytical approaches could further clarify whether this trend represents a true shift in CKD-related mortality among T2DM patients. Men had higher mortality rates than women. Native American and Alaska Native populations had the highest mortality, and non-metropolitan areas had more deaths than metropolitan ones. Mortality rates varied by state, with the Western U.S. showing the highest and the Northeast the lowest. Mortality trends suggest improvements from 2012 to 2015, possibly due to better management of risk factors like hypertension, particularly with the use of SGLT2 inhibitors, which have been shown to improve kidney outcomes in Type 2 diabetes patients [8]. However, mortality increased after 2015, which may be attributed to factors such as changes in healthcare access, socioeconomic disparities, or a deterioration in the management of risk factors and dietary habits. Early CKD stages showed lower mortality, emphasizing the importance of early intervention. Medications like SGLT2 inhibitors, which help slow CKD progression, are key in these stages [8]. We also found racial disparities, with Native Americans and African Americans facing higher mortality rates, consistent with previous studies [9,10]. This is influenced by increased burden of comorbidities like diabetes mellitus, poorly controlled blood pressure, obesity, and liver diseases [9,11,12], social determinants of health, healthcare access, and genetic predispositions as contributors to these disparities. Early CKD stages offer opportunities for intervention to prevent further progression, highlighting the importance of screening, lifestyle changes, and medication. Limitations include reliance on death certificate data and lack of detailed clinical information. Additionally, unmeasured confounders such as socioeconomic status and healthcare access may impact outcomes. Missing data on key variables like medication use may limit the completeness of the analysis. Lastly, findings may not be generalizable to non-U.S. populations with different healthcare practices. Future research should incorporate cohort-based analyses and explore the impact of emerging therapies, such as finerenone and dual GLP-1 receptor agonists, on CKD outcomes in T2DM. Conclusions The highest mortality was seen in men, American Indians, or Alaska Natives, as well as those living in the Western region and non-metropolitan areas. This study highlights the entire spectrum of CKD in T2DM patients, with disparities in mortality burden based on gender, race, and geographic region. Emphasizing early detection and targeted interventions is critical to improving outcomes in this vulnerable population.

Ahmad Hassan

Sana Yameen

Rabia Imtiaz

+3

Demonstration of PinkDetect: A Digital Solution for Breast Health Awareness and Early Detection

Abstract

Demonstration of PinkDetect: A Digital Solution for Breast Health Awareness and Early Detection

25 April 2025

Introduction Breast cancer is a major public health issue in Pakistan, with 1 in 9 women diagnosed in their lifetime and 89% of cases detected at advanced stages. This late detection contributes to approximately 50,000 deaths annually. Key barriers include lack of awareness, social stigma, and limited access to early detection services. PinkDetect addresses these challenges by providing a digital breast health solution that empowers women through education, self-exam tutorials, symptom tracking, and connections to diagnostic services. Technology PinkDetect integrates multiple features to enhance breast health awareness and early detection. It offers culturally sensitive educational content and self-exam tutorials tailored for Pakistani women. A built-in symptom tracker and AI-powered risk assessment tool allow users to monitor their health and receive early evaluations. The app’s diagnostic linkage system, PinkConnect, helps users locate mammography centers and telemedicine services. To ensure data privacy, PinkDetect employs cloud-based storage with encryption. Future advancements include machine learning-driven risk stratification and integration with hospitals for seamless appointment scheduling. Implementation Since its launch in May 2023, PinkDetect has reached over 4,000 women through medical camps, workshops, and focus groups. A pilot program at Jesus and Mary College in India introduced the app to 200 women, while a workshop for visually impaired women in Pakistan emphasized its inclusive approach. Moving forward, PinkDetect aims to expand its reach across Pakistan and South Asia, integrating AI-driven risk assessments and promoting breast cancer awareness at the household level.

Suha Suleman Lalani

Syed Waqas

Solmaz Iranpour

+1

Demonstration of ED Flow Simulation App: Enhancing Emergency Department Efficiency Through Predictive Analytics

Abstract

Demonstration of ED Flow Simulation App: Enhancing Emergency Department Efficiency Through Predictive Analytics

25 April 2025

Introduction Emergency departments (EDs) frequently experience challenges such as overcrowding, long wait times, and inefficient resource allocation, leading to delayed patient care and increased strain on healthcare staff. Addressing these operational inefficiencies requires data-driven solutions that provide real-time insights for hospital administrators. This study introduces the ED Flow Simulation App, a web-based tool designed to optimize patient flow and enhance decision-making in ED settings. Technology The ED Flow Simulation App uses Python for backend processing and Streamlit for frontend visualization, the app provides an interactive and user-friendly experience for hospital administrators. Users can customize key parameters such as patient arrival rates, waiting room capacity, and treatment room capacity to generate real-time visualizations and identify congestion points. The cloud-based storage system ensures data security and enables potential integration with hospital information systems. A live demonstration feature allows users to simulate different hospital scenarios and analyze efficiency metrics. Future enhancements will include machine learning algorithms for more accurate predictions, expanded simulation capabilities for other hospital departments, and an advanced analytics dashboard for deeper insights. Conclusion The ED Flow Simulation App provides a scalable, adaptable solution for managing ED patient flow. With its interactive interface and predictive analytics, it empowers healthcare administrators to make informed decisions, ultimately enhancing efficiency and patient care in emergency settings.

Abdelrahman Mohamed

Olivia Brumfield

Ahmad Hassan

Demonstration of InsureEZ: An AI-Powered Solution to Address Health Insurance Literacy Disparities

Abstract

Demonstration of InsureEZ: An AI-Powered Solution to Address Health Insurance Literacy Disparities

25 April 2025

Health insurance literacy remains a significant barrier for millions of Americans, particularly among vulnerable populations, often leading to poor health outcomes and financial strain. InsureEZ, an AI-driven, web-based platform, aims to address this challenge by simplifying complex health insurance information and empowering users to make informed decisions. Built using Python and large-language models like ChatGPT-4, InsureEZ offers three core features: the Browse Plans Tool for personalized insurance plan comparisons, the Learn About Insurance module for simplified explanations of insurance concepts, and a Resources Page with curated articles and interactive tools. A preliminary study conducted at Rocky Vista University demonstrated the platform’s efficacy, with most participants reporting improved understanding of health insurance and increased confidence in decision-making. InsureEZ’s impact has been recognized through awards at the Rocky Vista University Shark Tank Microgrant Competition and first place at the OMED 24' student poster competition. Future development goals include expanding to mobile platforms, enhancing educational content, and establishing partnerships with healthcare providers and insurers to broaden its reach, especially among underserved populations. By improving accessibility and comprehension of health insurance, InsureEZ has the potential to reduce disparities, improve health outcomes, and promote financial equity nationwide.

Hannah Vedova

Jonathan Scott Wrigley

Sana Khan

+3

NexusGraph: NLP Innovation for Scientific Methodology Replication

Abstract

NexusGraph: NLP Innovation for Scientific Methodology Replication

4 October 2024

Biomedical research emphasizes the reproducibility of scientific research by independent researchers, as the results have direct effects on human health. The increasing complexity of modern research, along with inadequate documentation, equipment and resource limitations, and environmental variability, has contributed to a “reproducibility crisis”. NexusGraph offers an advanced Natural Language Processing (NLP) solution to this crisis. It synthesizes a comprehensive, accessible inventory of reagents, equipment, and other materials to allow for standardization to replicate studies. Furthermore, NexusGraph extracts additional elements, including author and material suppliers, along with synthesizing instructional guidance to increase reproducibility.

Abdul Badih El Ariss

Norawit Kijpaisalratana

Jeffrey Yuan

+2

The Emergency Leadership Dashboard: A Comprehensive System for Visualizing Operations across Educational, Administrative, and Research Sectors

Abstract

The Emergency Leadership Dashboard: A Comprehensive System for Visualizing Operations across Educational, Administrative, and Research Sectors

4 October 2024

Introduction Managing patient care and fulfilling administrative tasks are challenges facing healthcare systems (1). Particularly at university hospitals, emergency departments (EDs) must carry out research and fulfill educational responsibilities. As a result of these responsibilities, educators can develop educator burnout (2). Providers must additionally maintain accreditation by completing continuous education and certification. Using new technology and automation, clinicians can focus on patient care and quality service, reducing administrative burdens. The goal of this study is to introduce an ED leadership dashboard that optimizes ED operational efficiency across the administrative, educational, and research areas. Methodology The digital dashboard was developed with Microsoft Teams, Forms, Excel, and Power BI. The system combines multiple datasets to create a comprehensive visual dashboard. The first database queries information about ED physicians and updates the related datasets, including ED research, administrative tasks, student evaluations, and performance metrics. The real-time updates and visualization on the dynamic Power BI dashboard facilitate the shift from the current paper-based data collection to an electronic workflow. Implementation includes utilizing standardized forms for data inputs about research projects, educational assessments, and administrative tasks, such as complaint management and credential monitoring. These inputs cause updates in the respective datasets and dashboard output in real time, which enhances the decision-making process by providing immediate access to performance metrics such as patient throughput. The dashboard ensures consistency, improves administrative efficiency, and supports a proactive approach to management and educational evaluations within the ED. Results The research dashboard monitors research activities, allows users to select by year and quarter, and displays interactive visualizations. Projects are categorized into "Original Research" and "Case Report," with Original Research being more common. The stages of research (Writing, Analysis, and Data Collection) are depicted in a donut chart, where Data Collection was found to be the most prevalent. The status of the projects is shown as "On Track," "Completed," or "Delayed," with most projects currently on track. An analysis of research types showed that Retrospective studies were the most frequent (Figure 1). The physician's involvement in each project is also tracked to distribute the project load among faculty. The training and certification dashboard shows completion rates for certifications such as Basic Life Support and Advanced Cardiovascular Life Support, with most completion rates near perfect. Safety training showed a low completion rate of 35%. 574 certifications were completed, and 10 were pending, for an overall 98% completion rate. (Figure 2) Figure 1: Research Dashboard Figure 2: Certification Dashboard Conclusion The implementation of an ED leadership dashboard in university hospital emergency departments has markedly enhanced operational efficiency across administrative, educational, and research functions. Utilizing technologies like Microsoft Teams, Forms, Excel, and Power BI, the dashboard has transitioned from paper-based systems to a streamlined electronic workflow, enabling real-time data visualization and updates. This has improved decision-making processes, optimally distributed faculty workloads, and maintained high certification completion rates, while also highlighting areas for improvement such as safety training. Overall, the dashboard has effectively managed patient care and administrative tasks, reducing burdens and supporting proactive management within the emergency department.

Tareq Al Salamah

Abdul Badih El Ariss

Norawit Kijpaisalratana

+3

Persistent Global Health Threats: The Impact of Infectious Diseases in Resource-Limited Regions

Abstract

Persistent Global Health Threats: The Impact of Infectious Diseases in Resource-Limited Regions

4 October 2024

Abstract Topic: Global Health Introduction: Global health focuses on improving global health equity, involving interdisciplinary collaboration, addressing transnational health issues, and combining population-based prevention with individual-level clinical care. Problem Statement: Infectious diseases like HIV/AIDS, malaria, tuberculosis, and emerging illnesses such as COVID-19 persist as substantial risks to global health, especially in regions with limited healthcare resources where infrastructure may be lacking. Overview: In an increasingly interconnected world, global health stands as a paramount concern, striving to improve health outcomes and realize health equity for all individuals worldwide. This multifaceted endeavor necessitates a comprehensive strategy, integrating efforts to tackle transnational health issues, their determinants, and potential solutions through collaborative interdisciplinary approaches. Key facets of this approach include robust initiatives in disease prevention and control, ensuring universal access to healthcare services and essential medicines, particularly in underserved regions, and addressing the intricate web of social determinants that shape health outcomes, including poverty, education, and access to basic amenities like clean water and sanitation. Effective governance structures are Central to advancing global health, exemplified by institutions such as the World Health Organization, which play pivotal roles in orchestrating coordinated action and setting strategic priorities. Collaboration among diverse stakeholders, including governments, international organizations, non-governmental organizations, and civil society, forms the bedrock of successful global health initiatives. Technology Stack: The integration of technology emerges as a crucial factor in advancing global health. Technological innovations facilitate the dissemination of healthcare information, enable telemedicine services to reach remote populations, and enhance disease surveillance and monitoring capabilities. Technology plays a transformative role in improving healthcare delivery and outcomes worldwide, from mobile health applications to advanced diagnostic tools. Moreover, sustained investment in research and innovation is imperative, driving progress by deepening our understanding of diseases and fostering the development of innovative treatments and technologies. Equally critical is the prioritization of preparedness for health emergencies, characterized by the strengthening of surveillance systems, rapid response capabilities, and the fostering of international cooperation. Conclusion: The persistence of infectious diseases like HIV/AIDS, malaria, tuberculosis, and emerging illnesses such as COVID-19 underscores the ongoing threat to global health, particularly in regions with limited healthcare resources and inadequate infrastructure. Addressing these challenges requires concerted efforts to strengthen healthcare systems, enhance disease surveillance and prevention measures, and improve access to essential healthcare services worldwide. Only through collaborative and proactive approaches we can effectively mitigate the impact of infectious diseases and safeguard the health and well-being of populations across the globe.

Avani Ghanhasham Juvekar

Anish Hegde

The Healthcare Leadership Program: Assessing the Past, Present, and Future Impact in the Inland Empire

Abstract

The Healthcare Leadership Program: Assessing the Past, Present, and Future Impact in the Inland Empire

4 October 2024

Background Formal leadership training opportunities are limited at many medical schools.2 The Healthcare Leadership Program (HLP) at UCR School of Medicine was an initial solution to this gap in leadership training, and our resulting project provides an innovative solution for assessing the impact of a program of this nature. HLP supports medical students in building a foundation of knowledge rooted in leadership and advocacy to utilize in the community as healthcare leaders. The major foci of the program include: Leadership Lecture Series, Leadership Development (i.e. Strengths Finder Assessments), Mentorship in the Community, and continuous Quality Improvement Projects (resulting in a capstone project).1 Since its inception, it has transitioned from a selective program to a designated emphasis that spans 4 years of medical school. As a result, HLP members have been heavily involved in the community. This project will assess the program’s activities, understand the leadership experiences gained by students, and explore the program’s past, present, and future impact in the Inland Empire utilizing GIS. Methods In an aim to best collect data on current HLP current students, alumni, and faculty, a group of 30 students were divided into the multiple phases of the program. The three teams included: Student Outreach and Community Engagement, Database and Analytics, and GIS mapping and visualization. The Student Outreach and Community Engagement team reached out to all (current and past) members of HLP, gathering information on any projects they participated in as well as current positions in community organizations. Short, 10 to 15-minute interviews were conducted via various modalities to make it as feasible as possible. The modalities included: phone, zoom, in-person and email- based questions. The Database and Analytics group joined in after data collection and organized the data. Themes from interviews were identified and grouped accordingly. The GIS and Visualization team then stepped in and created a map to illustrate the impact of the program as well as to identify areas where future efforts will be targeted. Results A total of 16 students responded and 2 of the founding faculty members. Of the students’ responses, 10 students identified as female and 6 as male. Of the student responses, 5 identified as Asian, 2 as white/ Caucasian, 5 as Middle Eastern, 2 as Indian/Asian Indian and 2 as Hispanic/Mixed. Of faculty responses, both identified as male. One of the faculty members identified as African American/ Black and one as Caucasian. Leadership categories were divided into: Clinical researchers, clinical administrators, clinical teachers and clinical educators. Of the student responses, 2 identified as clinical teachers, 1 as a clinical administrator and 13 as clinical researchers. Of the faculty responses, 1 identified as a clinical administrator and the other as a clinical researcher. Leadership roles among students and alumni included, COO, founders of Unheard cries and breast milk bank projects, chief residents, free clinical managers, and class representatives. Faculty leadership roles included President and Dean of CUSM and Vice Chair of Research for the Psychiatry and Neuroscience Residency Program. After a month of data collection, we found that the highest non- response rates were in third year students, past students, and students on leave. Discussion Our program is based upon a 4-year, up to 20 hours per year requirement, that is largely facilitated via clinical volunteers. HLP scholars partner with clinical volunteers for our guest speaker series, leadership speaker series, and mentorship. Our present project provided a data driven basis for connecting with clinical leaders across the spectrums of clinical researchers, clinical teachers, clinical educators, and clinical administrators to ensure our program has identified past, present and future clinical volunteers central to our success. Ultimately, our HLP Designated Emphasis is not only leadership focused but also community-based. Our network of program participants, HLP Scholars, and clinical volunteers represent our footprint within and across our service communities, and the foundation of our program. Conclusion Through the years, HLP has provided medical students with several community experiences and learning opportunities to develop leadership skills and education. However, there hasn’t been an assessment of the program’s impact on students and the community. Through the utilization of GIS, we demonstrate a “story map” of HLP’s past and current involvement in the community, illustrating student’s commitment to leadership endeavors in the Inland Empire. Additionally, we analyzed areas of improvement and future expansion in order to further support HLP’s goals and sustainability of the program.. Overall, HLP has positively impacted student leadership development and community enrichment. Citations

Kendrick A. Davis

Aliyah Qurashi

Angela Reyes

+2

Network Analysis in Global Emergency Medicine: Mapping Collaborative Structures and Enhancing Connectivity

Abstract

Network Analysis in Global Emergency Medicine: Mapping Collaborative Structures and Enhancing Connectivity

2 October 2024

Introduction Network analysis, which draws from fields including mathematics, sociology, and public health, is essential for interpreting complex data relationships within healthcare information systems. This approach not only highlights intricate care patterns but also enhances the navigability of systems, making complex healthcare information more accessible [1]. Our study builds on previous applications of network analysis in healthcare, specifically examining its use in structuring academic health center websites in the U.S. to improve user-oriented spaces. Our research explores the digital ecosystem of emergency medicine organizations globally, focusing on the International Federation for Emergency Medicine (IFEM). By employing a systematic, automated approach to network mapping, we aim to uncover collaborative patterns and enhance the online presence of emergency resources. This effort supports greater global collaboration and information sharing among emergency medicine organizations, leveraging the strong networks and insights provided by IFEM to ensure universal access to high-quality emergency services. Methodology We utilized a four-step process for mapping and analyzing the global network of emergency medicine organizations: Web Crawling: We collected data from the IFEM website using the Screaming Frog SEO Spider tool. The crawl depth was set to three to ensure comprehensive data capture from IFEM and its connected links. Content Filtering: BeautifulSoup was used to parse HTML content. We filtered the extracted data for relevance to emergency medicine organizations. The data was further refined using the Gemini 1.0 Pro model to isolate pertinent information about the organizations' names and locations. Geolocation Resolution: Location data extracted from the web pages was converted into geographical coordinates using the Geopy library’s Nominatim tool to accurately map of each organization's position. Network Visualization: We constructed a directed network graph using the NetworkX library, with nodes representing organizations and edges representing their interconnections. This graph was visualized with Matplotlib to illustrate the relationships and distribution patterns among the organizations. Results We identified 4,775 external links on the IFEM website and refined them to 156 unique base URLs for in-depth content analysis. Out of 55 countries listed, there were 41 functional links, 10 non-functional, and 4 missing. We effectively isolated 41 relevant multilingual URLs from the functional links, achieving a 100% accuracy rate in identifying pertinent content. Additionally, our analysis uncovered 30 URLs linked to emergency medicine organizations not listed on the IFEM member page, including the American College of Osteopathic Emergency Physicians and the Swiss Society for Emergency and Rescue Medicine. Discussion Our study highlights the utility of network analysis in understanding the digital networks of emergency medicine organizations globally, revealing essential connectivity patterns and their implications for healthcare systems. The methodology used is adaptable for other healthcare areas, enhancing collaboration and addressing language barriers. Findings indicate dynamic changes in digital connectivity, pointing to evolving collaboration and resource sharing. This research provides a foundation for exploring digital connectivity's broader impacts across various sectors. References Niyirora J, Aragones O. Network analysis of medical care services. Health Informatics J. 2020 Sep;26(3):1631-1658. doi: 10.1177/1460458219887047. Epub 2019 Nov 18. PMID: 31735109.

Norawit Kijpaisalratana

Abdul Badih El Ariss

Prem Menon

+7

MedicAid Disaster Estimator (MADE):
A Digital Tool for Humanitarian Relief Material Demand Estimations

Abstract

MedicAid Disaster Estimator (MADE): A Digital Tool for Humanitarian Relief Material Demand Estimations

2 October 2024

When disaster strikes, relief organizations experience an immediate need to supply necessities such as food, water, and medical supplies. Resource demand calculation is vital for relief organizations to efficiently mitigate the impact of disasters. Although large humanitarian organizations have private demand estimators, a plethora of local organizations that respond to disasters worldwide lack access to a demand calculator. Academic articles have introduced mathematical models for disaster needs analysis, but their findings and resulting calculators have remained largely limited to the academic community due to the lack of applicable technology. To address this gap between research and technology, the MedicAid Disaster Estimator (MADE), a user-friendly and accessible website was created to forecast the demand for water, food, and medicine in a natural disaster. The website utilizes static calculations to scale per person/ per day recommendations of water, food, and medication to the user’s specified number of people and days. The scale factors, or per person/per day recommendations, were informed by credible industry leaders such as the World Health Organization, Sphere, the European Association of Hospital Pharmacists, the World Food Program, and the United Nations International Children's Emergency Fund to ensure that calculations are reliable. HTML and CSS were used for front-end web development, and Python was used for back-end development. Industry experts were interviewed to inform the scope and future directions.

Verda Rose Annan

Lauren Kim

Omolivie Eboreime

+7

An Innovative Integrated Geospatial Information Systems & Quality Improvement Residency Research Training Program

Abstract

An Innovative Integrated Geospatial Information Systems & Quality Improvement Residency Research Training Program

2 October 2024

Introduction Participation in scholarly activity during residency has posed barriers to departments that include: research mentorship, an active and supportive research community, formal research infrastructure and programming, and diverse and accessible opportunities for scholarly activity with faculty, staff and communities in our service region. In response to these barriers our team has created a formal QI research training program for psychiatry residents.2 Our solutions include: assembling a dedicated team, which contains both department leadership and a GIS faculty expert, an expanded interdisciplinary team which includes research librarians and grant support, GIS as a tool and science to best orient residents to the regional landscape and needs of our service populations, formal research training covering GIS, Cultural Psychiatry, and Psychometrics in Psychiatry as curricular themes, and a Chief Resident for Research role to facilitate bridges between residents and faculty and to promote a continuous research community. Methods An inquiry-based approach is applied to our formal research curriculum. Year 1 is an inquiry theme focused on basing resident QI research on the needs of our service region. Year 2 is themed research wherein literature reviews, dashboards and Storymaps are the emphasized outputs. Year 3 is themed implementation and residents are supported to use their dashboards with community to aid community organizations in making decisions for and with populations they serve. Lastly, year 4 is themed construct wherein residents are supported to complete and submit manuscripts and grants. Results Our pre-pilot phase was underway as of July 1st, 2023. To begin integrating within the Psychiatry & Neuroscience department as a formal program our team targeted core departmental programming; Grand Rounds, Journal Club, and didactics. We presented our curriculum to department staff, faculty, leadership and some residents during Grand Rounds in a detailed PowerPoint presentation. We worked with the faculty and staff directors of Journal Club to have our 2nd year deliverable of a StoryMap or Dashboard become the presentation for each PGY2. We presented it to all residents at a didactic session. As a follow-up to the didactic presentation we sent residents a QI attitudes and interest survey, which was an adaptation from the BASiC-QI. An estimated 20% of residents responded to the survey. From the residents who responded to the survey, the majority have followed-up with starting regular research mentor meetings with the Vice Chair for Research and advancing their projects. Findings/Conclusions Our pre-pilot year is nearing an end. Our full pilot year will begin on July 1st 2024. Thus far we have accomplished increasing buy-in for the program, and selecting a Chief Resident for Research and Wellness. We have also invited our new cohort of residents to our first annual QI/GIS conference showcase enabling a group of interns to begin a new year within our formal curriculum. We will also formalize the tracking of our increases in scholarly activities and our effectiveness with promoting and supporting scholarly activities within our department. Results from the integration of this program into the department and residency training program will be more evident in phases to come.

Angela Reyes

Kendrick A. Davis

The Development of Urgent Care Telemedicine in Pakistan

Abstract

The Development of Urgent Care Telemedicine in Pakistan

2 October 2024

While 61% of Pakistan’s population lives in rural areas, per the 2023 Pakistan Census Report, there remains a deficiency in access to healthcare in these rural areas (Figure 1) 1. There are only 3.6 physicians per 10,000 people in rural areas when compared to 14.5 physicians per 10,000 people in urban areas 2. Challenges such as violence against healthcare workers, poor infrastructure, lack of employment opportunities, and inadequate facilities deter urban healthcare workers from practicing in rural areas 3. Many rural healthcare centers lack hygiene, infrastructure, and equipment. This results in limited access to care, especially for time-sensitive illnesses 3,4. This is compounded by a shortage of emergency medicine-trained physicians in Pakistan as there are only thirteen emergency medicine residency programs in the country 5. More recently, multiple asynchronous and synchronous telemedicine initiatives have been implemented in Pakistan, with several focusing on care for rural areas. However, there is no current initiative to close the gap between the need for emergency medical services and the lack of providers in rural areas. Our mission at Health Tech Without Borders (HTWB) is to close this gap by connecting urban providers to rural patients requiring urgent care. Given the lack of emergency medicine-trained providers, we created a telemedicine curriculum targeted to train Pakistan-based physicians of all backgrounds and specialties on practicing urgent care. Our telemedicine course consists of a twenty-question pre-test, an introduction to telemedicine primer video including how to set up for a telemedicine visit, and videos focused on four common chief complaints that are appropriate for telemedicine, including diarrhea, cough and respiratory tract infections, fever, and back pain. The course concludes with a twenty question post-test followed by a course survey (Figure 2). Course participants have to score 80% or higher on the post-test to pass the course and receive their certificate. Our course is located on the platform Teachable, and is free for all participants. Our organization, Health Tech Without Borders, is a non-profit organization dedicated to expanding the reach of healthcare globally through innovative and digital means. We partnered with a local Pakistani telemedicine company, Oladoc, to distribute our course with their physician employees. Oladoc is providing HTWB with an encrypted telemedicine platform through which we can provide synchronous video and audio telemedicine. This company operates in all major cities in Pakistan. There are three parts to our project. The first step of our project is to distribute our course through Oladoc to physicians interested in learning more about/ practicing urgent care telemedicine. The second step of our project is to pilot encounters between physicians and patients in medium to large city settings. Once this phase is complete, we plan to expand our reach to connect urban providers with patients in rural settings. Our goal is to provide a mode of healthcare for rural populations, focusing on those who do not currently have any access to care in their geographical regions. We hope to allow for a robust yet efficient and more standardized method of providing urgent care while promoting digital approaches to medicine in Pakistan. As of May 4, 2024, 157 physicians are actively enrolled in the curriculum. Initial findings indicate that while the majority are general practitioners, the participant pool has a diverse array of backgrounds. Remarkably, 72% of them have never received formal training in telemedicine. Feedback from the participants has been overwhelmingly positive: 96% reported that the course met their expectations, 92% acknowledged its role in enhancing their comprehension of virtual healthcare delivery, and all respondents agreed that it deepened their understanding of urgent care principles (Figure 3). Considering that most participants lack specialized training in urgent care, these findings are promising, suggesting the efficacy of standardized telemedicine education for future practitioners. In conclusion, the current telemedicine initiatives mark just the beginning of our journey towards equitable healthcare access in rural Pakistan. Moving forward, we are committed to expanding our reach, refining our curriculum, and fostering partnerships to ensure timely and quality access to healthcare.

Rmaah Memon

Stella Nam

Mary Showstark

+3

Project VITAL: Telehealth Innovation for Healthcare Equity in Africa

Abstract

Project VITAL: Telehealth Innovation for Healthcare Equity in Africa

2 October 2024

Globally, an estimated 148.4 million people require humanitarian aid due to conflict and climate-related disasters, with approximately 89.3 million displaced individuals lacking access to essential healthcare services 1,2. Heightened attacks on healthcare facilities and workers exacerbate these challenges, particularly in Africa, where a severe shortage of health workers is anticipated to reach 6.1 million by 2030 3,4. In 2015, the region faced significant deficits, with only 1.30 health workers per 1000 people compared to the 4.5 needed to meet UN Sustainable Development Goals (SDGs) 5,6. Conflict-ridden areas like Cameroon/Sahel, home to over 30 million people in need of humanitarian assistance and mental health support, grapple with the highest maternal mortality rates globally amidst climate change impacts and security concerns 7. West and Central African regions have the highest maternal mortality rates globally while suffering from the effects of climate change, including extreme heat, droughts, degradation of agriculture, and security challenges 8,9. Overall, this leads to displaced populations with poor and worsening access to healthcare. In response, Project VITAL pledges to establish a sustainable, culturally sensitive telehealth program for the Cameroon/Sahel region, anchored in the 3S pillars model: sustainability, safety, and security. Sustainability involves forming a steering committee, conducting needs assessments, and empowering local programmers and healthcare providers with technology-focused training and resources. Collaborations with local entities like iDocta, Pasteur Institute of Bangui, and Reach Out Cameroon aim to ensure contextual understanding and long-term viability, supported by a revenue model and governmental compliance. Safety will prioritize safe, quality care, Project VITAL will implement robust review systems aligned with best practices and WHO guidelines. Security means partnering with technology experts, the initiative will ensure secure platforms and devices, adhering to cybersecurity protocols and local regulations. In a closely coordinated effort, Health Tech Without Borders, iDocta, and VSee established a steering committee in the fourth quarter of 2023. Early in 2024, iDocta and the team in Yaoundé, Cameroon, successfully conducted a targeted pilot program using the VSee telehealth platform. Insights gleaned from this pilot are now being meticulously applied to refine and tailor the VSee platform, customizing it to meet the specific needs of local clinicians and patients (Figure 1). Additionally, the Project VITAL team is expanding its workforce, hiring new staff, including clinicians and technical experts, to support project growth and implementation. Strategic outreach efforts have been outlined, engaging key community stakeholders to expand the platform's capabilities, encompassing telehealth, home health visits, laboratory scheduling, prescription refills, and pharmacy requests. Project VITAL is currently on schedule to commence a larger pilot later this year. Presently, the team consists of 4 innovators, including 6 full-time staff (2 female), 1 temporary employee, 3 doctors, 5 developers (1 female), 2 pharmacists, 1 lab technician, and an estimated 50-100 nurses. Additionally, 10 patients are currently participating in the trial phase. After a pilot in Yaoundé, expansion to remote North/Northwest regions will follow, addressing legal, financial, technological, and cultural barriers. Telehealth emerges as a promising solution, offering specialist access, peer consultations, education, triage, and epidemic monitoring, aligning with WHO's vision of equitable, efficient healthcare. With a focus on sustainable partnerships and adherence to equity principles like the Douala Equity Checklist, Project VITAL aims to advance healthcare access, bolster health systems, foster innovation, and empower communities in line with UN SDGs and African Union 2063 Agenda (Figure 2).

Mary Showstark

Yap Boum

Martin Joseph Lubowa

+12

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