1. Technology vision

At Campus Bio-Medico University of Rome we introduced at the beginning of 2003 wireless networks and portable devices starting a number of projects for assessing the use of this technology. Since then, many laurea thesis and research activities have been focused on mobile technology and the use of handheld devices for clinical records. Some of them were concerned with new scenarios, such as vertical handoff performance in heterogeneous networks [1]; others dealt with applications [2,3,4]. A first project, carried out during an engineering laurea thesis between January and June 2003, focused on the electronic patient record for nurses. A further development was the HISS (Hospital System for Students) project, carried out from September 2003 to July 2004 at Campus Bio-Medico University of Rome, under the financial support of HP mobility grant: students of medicine, nursing and dietetics practising in the ward were trained to use handheld devices connected through a WLAN to record patients’ data. Besides learning this new technology and applying it for free access to teaching resources from any place in the Campus, the students were able to design new user interfaces for accomplishing daily tasks. This was a predicted positive effect: instead of involving in the interface design actual nurses and physicians, always busy in their daily tasks (and whose time is costly), we used feedback from the students to develop new approaches in view of a real operational Hospital Information System for handheld computers. Another student, Andrea Riccio, designed and developed the database for HISS and wrote most of the software; he produced his laurea thesis with the results of the project. Communication or presentations about the HISS project were conducted at conferences or printed in Conference Proceedings [5,6,7,8,9]. One of them, presented at the IADIS International Conference on Mobile Learning (Malta 28-30 June 2005) was given an award as “more outstanding paper” [10].

A further step in the achievement of our technology vision was represented by an application for handheld devices supporting the activity of the surgical ward, where daily documentation and maintenance of medial record quality is a crucial issue [12].
This software was developed by a very young employer of Campus Bio-Medico, Roberto Valenti, who also designed, together with Campus Bio-Medico engineers, a mobile application for the dieticians, which is fully operational now.

On the basis of this experience, we can affirm that the degree of technological deployment of mobile technologies in our University is quite advanced but still on the road to fully achieving our vision, especially for what concerns services delivered to the end users. We focus on two main educational issues: improving mobile technology at University can prepare our students to their future; enhance the level of both hardware and software technology in the hospital can help students in their training activity and can improve the quality of service to the patients.

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PROJECT DETAILS

2. Project executive summary

HP technology will help to achieve a fundamental goal of this course: immediate interaction for faster problem solving. Students equipped with Tablet PCs can participate in periodical briefings held in the classroom, then go to the hospital for observation, taking notes and images of the problems, and sending them to the tutors when needed.  

The recipients of MoPS (Mobile Problem Solving) will be the Bioengineering students who follow the still on-going activities of HISS. Keeping in touch with their tutors, they can better help other students using the HISS Information System and other computer-based systems in the Hospital and can gather suggestions improving interfaces and databases. They will also be able to help physicians and nurses in their daily activities, observing and reporting problems.

3. Teaching and learning issues

Problem solving is considered a core course since it involves all the knowledge that students have so far acquired, representing the first chance to test all their theoretic formation ‘on the field’ and to get in touch with the Hospital reality at various level: physicians, nurses, trainees, IT department, etc. The main stress is on interdisciplinary and communication: the students learn to interview users or to observe directly problems and to find and communicate solutions. Instructors can test students’ ability to solve problems and to react to users’ difficulties. If they can constantly keep in touch with students equipped mobile devices, they could better monitor students’ behaviour and help them troubleshooting.

The fundamental learning and teaching issues that the project addresses are both ethical and technological. The course main tutor, prof. Victor Tambone, is a member of the Hospital Ethical Committee. The focus is on teaching the students something which is useful for the entire Hospital community (physicians, nurses, other hospital workers, patients). We want them to test their ability to understand users’ need and to explain technicalities in a friendly way, making practical their theoretical knowledge.

Furthermore we want the students to learn what does really mean ‘users’ centered technology’, bringing usability into the design process, enhancing the interaction between IT department and users (physicians, nurses etc.) through engineering students’ cooperation.

4. Goals, objectives and outcomes

First of all we aim at preparing Bioengineering students to their future profession, not only giving them the opportunity to play an active role in the hospital, but also giving them the instruments which they will encounter in their future profession. Using mobile devices they will be able, in future, to develop better solutions for this kind of instruments and to create new ways of interaction among users.

Access to the Hospital Information System will be improved. Students of Bioengineering will access the system as trainees/doctors’ assistants. The advantage of mobile devices is that this task can be performed everywhere, not only in the medical cabinet, always crowded with people and where there is normally only one desktop PC for both nurses and physicians.

In this way they will be able to overcome one of the main obstacles in the diffusion of new technologies in our Campus University: users’ resistance. More enthusiastic users can change the attitude of the more reluctant ones, by showing them how easy and helpful is, for example, to use mobile devices for recording patients’ data or to retrieve useful information at bedside. In this way we think we could persuade even health care professionals, excluded from the previous project, which was specifically addressed to students. The access the Hospital Information System will be warranted not only for problem solving, but also to give explanations on the interface, to perform presentations of new applications etc.

Another future scenario can be patient information. Patients can have diagnostic, treatment and educational (such as diet habits) data displayed in their own room, so that they can get more consciousness of their health situation.

5. Measures

We will examine the effects of introducing a mobile computing data-acquisition and analysis tool into problem-solving laboratory. To determine the effects of the computer tool, two groups will be selected: the test group will use a computer tool to collect and analyze data in the hospital , while the control group will use traditional equipment (pen, paper, telephone). The curriculum will be kept as similar as possible for the two groups. The groups will be examined for effects on performance on conceptual tests and grades, attitudes towards the laboratory and the laboratory tools, and behaviours within cooperative groups.

6. Project timeline

The project will be developed between October 2005 and September 2006.

Milestones:

October 2005: start of the activities and selection of the two groups;
November 2005: preliminary lessons on methodology and training of the students to the use of Tablet PC;
December 2005: end of performance tests;
March 2006: end of the first active phase; analysis of the first results of the students and feedback;
April 2006: First report;
May-July 2006: Revision of the methodology and new active phase;
September 2006: Final report

7. Technology integration

We choose this course since the Problem Solving laboratory methodology includes both briefing in the classroom and observation and intervention on the field. The granted HP technology will contribute to resolving the fundamental problem or opportunity this project addresses: immediate interaction for faster problem solving. The use of wireless technology will ensure fast localization (with VoIP on the WLAN, or by instant messaging) and immediate access to useful information.

Both tutors and students will work in Moodle, a course management system that allows different kind of interaction: chat, forum, newsletter, video lessons, on-line resources, virtual interaction. It is basically a software package designed to help educators create quality online courses. One of the main advantages of Moodle over other systems is a strong grounding in social constructionist pedagogy.

8. Courses impacted

Besides the Problem Solving laboratory, many other courses will be impacted both in Bioengineering Department (courses of Informatics and Telematics) and in Medicine Department (students of the 3^rd, 4^th, 5^th and 6^th year of Medicine practising in the wards; students of Nursing and of Dietetics). Problem Solving laboratory is a course for Graduates. The other ones are courses for Undergraduates.

Problem Solving course, which is a core course in the Bioengineering Department, will be redesigned with the use of new technologies in/outside the classroom. The scenario we imagine is the following. The students meet for the initial training on mobile devices and lessons concerning Problem Solving methodology. This activity will be performed in classroom directly on Tablet PC. After the first month, they begin to go in the wards to observe and report the problems taking written notes on the Tablet, by images or recording interviews with the hospital professionals. They meet again in classroom to show the materials they have gathered and to discuss problems and solutions. In this context they will use projector for presentation. They go again in the wards to perform active intervention. They monitor users’ feedback and other problems or difficulty. During this phase they can also provide a service of help-desk for IT department, giving instructions to the users or solving technical problems directly when they are signalled.

The professors directly involved in this project will be eight, of both Bioengineering and Medicine Department (see principal investigators and team members). The students impacted during the first full year of this pilot project implementation will be 150: 30 in Bioengineering Department and 120 in Medicine Department. When this course design is fully implemented, the students impacted will be over 250: 50 in Bioengineering Department and 200 in Medicine Department

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PROJECT SUPPORT AND VISIBILITY

9. Campus involvement

The campus educational technology and many instructional leaders will be involved in this project. The Bioengineering department will coordinate the students’ involvement in the project. The Medical, Nursing and Dietetics department will provide support to the project, ensuring that the project could fit with the daily activity in the wards of both professionals and trainees. The Campus Intranet will be constantly reporting the advancements and accepting proposals by the students using the system and all the other ones.

The environment where the project will be deployed has an IT infrastructure with Internet access that can accommodate an 802.11b/g Access Point. The Information Technology department of "Campus Bio-Medico" University is already deeply involved in the development of wireless technology. It will be in charge of coordinating both the hardware installation and software development of the project. It will also give other kind of support such as Table PC hard-drive imaging, onsite help etc.

10. Project visibility

The project description and results will be publicly available at http://research.unicampus.it/MOPS. The site will be updated with ongoing achievements. The project will be announced before the end of the academic year and the students will be able to apply for participating in it. At the beginning of next academic year (October 2005) we'll have a general meeting explaining the immediate and future goals of the MOPS project.

A number of laurea thesis will be produced on the topics arising during the project. A number of scientific papers will be proposed to congresses and journals, in the educational and technical fields.

11 Principal investigators

- Prof. Giulio Iannello,full professor of Informatics, Faculty of Engineering, tel. +39-06.22.54.12.61, fax (+39) 06.22.54.17.51, g.iannello@unicampus.it

- Prof. Michele Crudele, professor of Medical Informatics in Campus Bio-Medico University, fax (+39) 06.22.54.17.51, +39-06.22.54.12.60, m.crudele@unicampus.it

Team members

Prof. Paola Binetti, head of Medical education department, p.binetti@unicampus.it;

Eng. Filippo Cacace, professor of Informatics, f.cacace@unicampus.it;

Eng. Paolo Casorati, head of the Hospital Information System Department, p.casorati@unicampus.it;

Prof. Laura Ceni, coordinator of the Dieticians Laurea, l.ceni@unicampus.it;

Prof. Maria Grazia De Marinis, associate professor of Nursing, m.demarinis@unicampus.it;

Prof. Sergio Silvestri (Problem Solving Laboratory in Bioengineering Department), s.silvestri@unicampus.i ;

Prof. Victor Tambone (Problem Solving Laboratory in Bioengineering Department), v.tambone@unicampus.it;

Mr. Roberto Valenti, Software Programmer, r.valenti@unicampus.it;

Mr. Marco Venditti, Hospital Information System manager, m.venditti@unicampus.it

Institution Name: Legal name, mailing addess, phone, fax

Università Campus Bio-Medico

Via Emilio Longoni, 83 - 00155 Roma - tel. (+39) 06.22.54.11 fax (+39) 06.22.54.17.51

VAT Exempt: No VAT number: 04802051005

Shipping instructions

Mr. Roberto Valenti, Software Programmer, +39-06.22.54.12.60

e.mail address: r.valenti@unicampus.it

Università Campus Bio-Medico di Roma,

via E. Longoni 83, 00155 Roma, Italy.

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Publications and Conference Proceedings

[1] Massimo Bernaschi, Filippo Cacace, and Giulio Iannello, ‘Vertical Handoff Performances in Heterogeneous Networks', 2004 International Workshop on Mobile and Wireless Networking, Montreal (Canada) 2004;

[2] Francesca Bellardini, Progettazione e sviluppo della cartella infermieristica digitale con gestione tramite dispositivo palmare in ambiente wireless, Laurea thesis, Roma, Terza Università, March 2003;

[3] Andrea Riccio,  Progettazione e sviluppo di un sistema informativo ospedaliero basato su dispositivi mobili, Laurea thesis, Roma, Terza Università, March 2004;

[4] Roberto Valenti, I sistemi informativi ospedalieri tra sperimentazione e innovazione, Finale Paper for Multimedia Languages and Technologies Course, Roma, ELIS, July 2005.

[5] Michele Crudele, Giuio Iannello, HISS - Hospital Information System for Students, Workshop on Ubiquitous and mobile computing for educational communities: enriching and enlarging community spaces - Amsterdam, 19 Sept. 2003;

[6] Giulio Iannello, Guaranteed services in heterogeneous wireless access networks, Workshop su Qualità del Servizio nei sistemi geograficamente distribuiti, 9-10 June 2004;

[7] Filippo Cacace, Maria Cinque, Michele Crudele, Giulio Iannello, Marco Venditti, The impact of innovation in medical and nursing training: a Hospital Information System for Students accessible through mobile devices, Bracciano, Proceedings of MLEARN 2004, Bracciano - Italy, 5-6 July, 2004;

[8] Michele Crudele, The impact of innovation in medical and nursing training: a Hospital Information System for Students accessible through mobile devices, Povo, Seminari di Matematica, 14 July 2004

[9] Massimo Bernaschi, Filippo Cacace, Maria Cinque, Michele Crudele, Giulio Iannello, Marco Venditti, Interface design and mobility in ubiquitous access to HIS, Proceedings of Medicon 2004, Ischia - Italy, July 31-August 5, 2004;

[10] Maria Cinque, Filippo Cacace, Michele Crudele, Giulio Iannello and Massimo Bernaschi, Mobile Learning in a Hospital Environment', Proceedings of Mobile Learning 2005, Malta, 2005;

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