Sims Max H, Bigham Jeffrey, Kautz Henry, Halterman Marc W
Department of Neurology, University of Rochester Medical Center, Rochester, New York.
J Hosp Med. 2014 Jul;9(7):451-6. doi: 10.1002/jhm.2204. Epub 2014 Apr 17.
Given the pace of discovery in medicine, accessing the literature to make informed decisions at the point of care has become increasingly difficult. Although the Internet creates unprecedented access to information, gaps in the medical literature and inefficient searches often leave healthcare providers' questions unanswered. Advances in social computation and human computer interactions offer a potential solution to this problem. We developed and piloted the mobile application DocCHIRP, which uses a system of point-to-multipoint push notifications designed to help providers problem solve by crowdsourcing from their peers. Over the 244-day pilot period, 85 registered users logged 1544 page views and sent 45 consult questions. The median initial first response from the crowd occurred within 19 minutes. Review of the transcripts revealed several dominant themes, including complex medical decision making and inquiries related to prescription medication use. Feedback from the post-trial survey identified potential hurdles related to medical crowdsourcing, including a reluctance to expose personal knowledge gaps and the potential risk for "distracted doctoring." Users also suggested program modifications that could support future adoption, including changes to the mobile interface and mechanisms that could expand the crowd of participating healthcare providers.
鉴于医学领域的发现速度，在医疗现场获取文献以做出明智决策变得越来越困难。尽管互联网为获取信息创造了前所未有的便利，但医学文献的空白以及低效的搜索往往使医疗服务提供者的问题得不到解答。社会计算和人机交互的进展为解决这一问题提供了一个潜在的方案。我们开发并试运行了移动应用程序DocCHIRP，它使用一种点对多点推送通知系统，旨在通过向同行众包来帮助医疗服务提供者解决问题。在为期244天的试运行期间，85名注册用户记录了1544次页面浏览量，并提出了45个咨询问题。人群的初始首次回复中位数在19分钟内出现。对记录的审查揭示了几个主要主题，包括复杂的医疗决策以及与处方药使用相关的询问。试验后调查的反馈确定了与医疗众包相关的潜在障碍，包括不愿暴露个人知识差距以及“分心行医”的潜在风险。用户还建议了可以支持未来采用的程序修改，包括对移动界面的更改以及可以扩大参与医疗服务提供者群体的机制。
