It can make a phone call, serve up email and even locate a place to eat. But can a smartphone prevent medical errors in radiation oncology? A team of Rhode Island Hospital clinicians thinks so and recently won a $23,580 grant to advance the idea.
The project envisions anyone caring for a cancer patient using a smartphone to access the patient’s medical-treatment plan from anywhere on the hospital campus. The electronic information sharing would save time and reduce expenses. Most importantly, the concept holds promise to reduce medical errors by ensuring every member of the treatment team receives an identical treatment checklist and associated information.
“We have too much information coming at us,” said Bruce Curran, the hospital’s associate chief medical physicist and a project leader. “Part of the reason for the checklist is to help sort out … the right information.”
Treatment of cancer patients typically requires an interdisciplinary team of six to eight people. Doctors make the diagnosis and prescribe radiation levels. Physicists like Curran coordinate and deliver the radiation treatment while technicians operate the machines. Others oversee surgical procedures and chemotherapy.
Because the team comes from different departments – located on different floors – they now rely on specially equipped computer stations and face-to-face meetings to coordinate care. Those methods take time and rely on a sort of information relay race, as one clinician hands off information to another. Anytime humans are involved, it opens the door for one to misread the prior report and create a cascade of misinformation.
“The trick is to get that information into the system and make sure everyone agrees,” said Edward Sternick, the hospital’s medical physicist-in-chief and leader of the smartphone project.
Smartphones provide a natural alternative. They are nearly ubiquitous among hospital personnel and wireless, meaning treatment-team members can access medical records just as easily from the cafeteria as their offices.
To create the software necessary to share diagnostic images, dosage instructions and the details of the machine that delivers radiation, Sternick has assembled an eight-person development team, including himself. Guided by a seven-person advisory team, the developers will write software Sternick and Curran are calling ROMPeR, an acronym for Radiation, Oncology and Medical Physics e-Rover.
Initially, the team wants to develop an application that can run on Google’s open-source cellphone operating system, dubbed Android. Sternick and Curran said they selected Android over Apple’s iPhone operating system because Google gives developers more latitude.
The team aims to first deploy the software across the Rhode Island Hospital campus in Providence. A dedicated computer server and layers of encryption will keep the information away from prying eyes. Software could be written by the end of November, though a pilot may take more time to implement.
Eventually, Sternick and Curran see the software as gaining approval from the U.S. Food and Drug Administration and being deployed at hospitals nationwide in partnership with a big-name medical company and Rhode Island Hospital at the helm.
“The future is going to be handhelds and tablets,” Sternick said.
There is a potentially large market for ROMPeR. In 2009, about 1.5 million people in the United States were diagnosed with cancer and about 1.1 million received radiation treatment. The number of new diagnoses is expected to rise to 2 million annually over the next decade.
That likely means more people coming to radiation treatment, which bombards tumors with radioactivity in an attempt to destroy them. But the field came under the microscope after a series of articles in The New York Times highlighted a prevalence of errors. Congress held hearings and the radiation-oncology health care field moved to respond.
Even as far back as 2004 the colleagues of 37 years had mulled using a handheld computer – possibility a personal digital assistant, or PDA – as a mobile tool to trade information. With the explosive popularity of smartphones and their ability to integrate multiple tasks, the pair started graphing their idea to them.
Then in March, they stumbled upon a request for proposals for grants awarded by the Innovation Providence Implementation Council. The grants – backed by the Greater Providence Chamber of Commerce, the city of Providence and The Rhode Island Foundation – are designed to foster innovation based on a knowledge economy.
In May, Sternick and Curran’s proposal received the largest grant. They plan to put a portion of the money toward hiring a research assistant – likely a local college student – and the rest toward buying computers and smartphones.
Sternick and Curran said they likely would have pursued the concept without the grant, but it forced them to hone in on the specifics.
For the pair, it wasn’t much of a stretch to put an application together. An internal hospital panel that awards money for risk-prevention projects had turned down a similar application.
Well aware of a push by President Barack Obama and others to move health records from paper to computers, they also felt compelled to keep refining concepts because they are expected to undertake research as part of their appointments at Brown University’s Warren Alpert Medical School.
“We’ve always been thinking of how computers can improve our practice,” Sternick said. •
