Smart Trauma App

Team 1: Dato Prof Abdullah Jafri Malin, Universiti Sains Malaysia

Traumatic injuries constitute a significant proportion of cases presenting to healthcare facilities in Malaysia. Statistically it has been found that an average of 19 deaths occur daily due to traumatic injuries particularly from road traffic accidents. Everyday medical practitioners all over the country will encounter and be involved in the management of patients suffering from trauma related injuries. Traumatic injuries involving multiple or critical organ system often require a patient to be transferred to a facility equipped with intensive care units.

Trauma knows no geographic boundaries and may occur in every corner of the country. A typical scenario of trauma in Malaysia is one where a patient sustains injuries and is initially taken to a nearby district hospital where they undergo initially evaluation and resuscitative care. Following this the patient will be investigated and referred to a hospital with the necessary facility to handle the injury based on its type and severity. The task of evaluating such patient often falls on the shoulders of young medical officer who may have limited years of working experience. This triaging process of severely injured patients will significantly influence transfer decision as well as location.

Intensive care units (ICU) can be found in most major healthcare facilities in the country albeit with a limited number beds. When planning to transfer a patient to a tertiary centre, the referring doctor is often faced with the following challenges:-
1. Determining the appropriate Hospital to transfer to – Depends on ICU bed availability and specialized care requirements
2. Accurately determining severity of injury and level of care required – Depends on the experience of the treating doctor as well as availability of investigation facilities.
3. Preplanning for required additional medical support services – Further investigations or need for blood products

The rapid transfer of a patient to a hospital with appropriate care facilities will significantly improve the outcome from injuries. On the other hand, if the availability of intensive care facilities are not known the referring doctor will need to contact all facilities with similar facilities nearby until a place is obtained for a patient. This results in a significant loss of valuable time and resources involved in the transport process. Furthermore at times a patient are transferred to a hospital rapidly for treatment, only to be find out that they lack an empty ICU bed  there. As a result the patient will have to be moved once again to another centre where this facility might be available.
Considering the stated problems, our team from USM  are proposing the development of smart trauma app to be used by medical officers in various district hospital as well as in the emergency departments that will help in the process of severity evaluation as well as suggesting the bed care facility needed. This app will be connected to an online real-time database which will help identify available beds for patients and allow them to book a bed in the referral centre. The app would also enable the referral centre to be aware of the patient needs in advance and help in making prearrangements for further care such as further investigations, operative room availability and blood product needs. Overall this app will pave the way for a more systematic and efficient approach in the management of trauma patients and shorten the time taken for transfer and icu admission. Please refer to the subsequent flow chart regarding how this app will function.

MyLearning App – A Personalized Learning Guide

Team 2:Muhd Al-Aarifin Ismail, Anisa Ahmad, Jamilah Al-Muhammady Mohammad, Mohamad Najib Mat Pa, Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia

Medical curriculum at School of Medical Sciences, USM is one of the medical programs that has been accredited by Malaysian Qualification Agency (MQA). The school has implemented outcome-based education (OBE) in its SPICES curriculum to produce medical doctors that possessed certain competencies or outcomes that have been clearly defined. All the program outcomes (POs) were translated into lists of intended learning outcomes (ILOs). Teaching and learning activities (TLAs) are properly designed to align with the ILOs and all assessment tasks (ATs) are also planned based on the ILOs and the TLAs. This is called constructive alignment. The school has tried its best to keep all these three elements in the curriculum well-aligned to ensure high quality of medical education. Research has found that students in more constructively aligned courses were more likely to adopt deep learning approaches and less likely to use surface learning approaches in their study. This learning approach has been proven to be a good predictor for students’ performance.

Medical students are usually drawn from “the cream of the cream”. Having said that, it is not uncommon to see these brilliant students fail in their exams or even dismissed from medical school because of poor academic performance. Information overload has been recognized as one of the major contributing factors to this problem. Studies have found that among the commonest sources of medical students’ stress are related to the large quantity of contents to be learned, lack of time to review what has been learned, falling behind in reading schedule, heavy workload and difficulty understanding the content. As far as the constructive alignment is concerned, during five years of medical training, each medical students need to cover thousands of ILOs listed by the curriculum developers. Due to large amount of ILOs, the students are unable to do systematic self-assessment and self-reflection of learning based on the ILOs.

In this 21st century, smartphones are becoming crucial for all walks of life, including medical students. A study has found that majority of medical students possessed their own personal smartphone. Undoubtedly, they have physically and emotionally attached with their smartphone. With the advancement of new technologies, educators should make use of this opportunity to guide and help students to learn. This is how the innovative idea of MyLearning App© comes into the picture. MyLearning App© will help students in any constructively aligned medical programs. By using this app, it will encourage them to study based on the declared ILOs using continuous self-evaluation and self-reflection approach. The app will serve as a guidance for the students to improve their learning. It also acts as a source of motivation for them to study. Perhaps this MyLearning App© can help the students to learn systematically and efficiently, thus assist them in learning.

Fit Family

Team 3: Munisamy Murallitharan, Saravanan
MMPKV Healthcare Sdn Bhd

The prevalence of non-communicable diseases (NCDs) and NCD risk factors in Malaysia have risen substantially in the last two decades. The Malaysian Adult Nutrition Survey (MANS) conducted in 2003 showed that only one out of six adults had adequate exercise. This goes to show that sedentary behaviour has become a norm in Malaysian society.
According to the survey, sedentary activities take up the biggest chunk of our daily routine. Malaysian adults spend 10 hours of the day sitting down, and eight hours of the day either lying down or sleeping. Low-intensity activities such as standing and personal care activities take up about four hours of the day. Moderate to vigorous intensity activities such as walking, stair-climbing and sports account for only two hours of the day.

The mode of transportation used also affects the frequency and intensity of daily physical activity. The MANS revealed that three out of four Malaysian adults used passive transportation such as a car or a motorcycle to move around. The National Health and Morbidity Survey (NHMS) 2011 found that women were more physically inactive than men. Urban adults were found to be more inactive compared to rural adults. Physical activity also decreased as people got older, especially senior citizens.

A major finding of this survey was that obesity in adults increased three-fold from 4.4% in 1996 to 15.1%, while overweight in adults increased two-fold from 16.6% to 29.4%. This increasing obesity and inactivity arc continues to drive the worsening diabetes mellitus, hypertension and cardiovascular epidemics in Malaysia, creating a growing burden on both the health system and the economic system, making them increasingly unable to cope with the huge increased burden of these diseases.

a) There are many ways to motivate and get people to engage in physical activity these days, right from the traditional gym memberships and personal trainings till the virtual runs where you compete in races, but you run alone. But very few of these methods last long and most does not turn into a habit. The question is why? What does it take to make exercise a sustainable habit ?

b) We think that there are few factors which makes long-term physical activity sustainable. These are:
i) Group physical activity is more sustainable in the long-term .
ii) Physical activity which is monitored and measured drives long-term sustainability.
iii) Competition and reward as an underlying psychological motivational force for engaging in physical activity
iv) Economic incentives for driving motivational and behavioural change

c) Our Hypothesis is that a developed family-based physical activity ecosystem underlain by health information technology systems will be highly successful at:
i) increasing and subsequently maintaining group and individual behaviour of engaging in physical activity and weight-loss
ii) increasing and subsequently maintaining sustainable individual and group-driven physical activity
iii) increasing and subsequently maintaining sustainable individual and group weight loss

d) Our solution is called ‘Fit Family’- a family-based physical activity ecosystem. The solution features a number of interlocked components:
i) a cloud-based registry of member households which manages health information data for the member households including collating evolving data input from wearables or other phone-based apps.
ii) a physical activity ecosystem app based on a smartphone/tablet . Besides incorporating features that enable measurement of physical activity, the app will also act as a ‘virtual’ meeting place to organise, schedule and monitor planned physical activity events/programmes. Another ability of the app will be that it will monitor, make available and enable individual and family ‘unlocking’ of ‘rewards’ based on their performance of physical activity tasks/achievements. The app will also be used to deliver evolving health-driven content and act as a passive motivator to drive physical activity participation. In an effort to increase economic sustainability of this ecosystem, it can also act as an advertising platform as well as a ‘virtual marketplace’ for sales of health-related products.
iii) individual wearables- made available to members of participating households to monitor their individual and family-based physical activity
iv) ‘activity coaches’ – geographically-divided individuals who formulate, plan and drive activities for their designated ‘cluster’ or area; bringing together households to engage in the group physical activities. These ‘activity coaches’ can also be household members or stand-alone community individuals who have a leadership function.

The Fit Family thus is a platform to engage urban families to indulge in physical activity together, motivated to to do so as a ‘family unit’ while building on strong psychological behavioural concepts to enhance and sustain their participation; supported by robust, cost-effective health technology.

Fit Family will feature in the primary care/health prevention space, and it is hoped that it will become the first such ecosystem to successfully drive these sustained behaviour changes for better health in Asia!