Haley Hoy, PhD, ACNP Susan Alexander, DNP, CNS, CRNP Manil Maskey, Research Scientist, ITSC

1. Technology for the Transplant Professional: Making it work for you instead of against youDevelopment of a Web-Based Mobile Technology Application for Healthcare Providers in Transplant Care Haley Hoy, PhD, ACNP Susan Alexander, DNP, CNS, CRNP Manil Maskey, Research Scientist, ITSC haley.hoy@uah.edu

2. Where did that come from? Clinical experience Education Opportunity Networking

3. Results- Pre-test

4. Results- Post-Test (p = 0.0045)

5. Results (p = 0.0029) post Pre

6. Next Step • Parallel • Instrument Development • FGCU • VUMC • Mobile Web based application

7. Instrument Development Factor loadings for Maximum Likelihood Factor Analysis for the 23-item TXP-RN Items Factor 1 I would like to work with organ transplant patients 0.896 I would like to participate in transplant research 0.785 Factor 2 I know how to contact procurement services if organ donation is requested 0.001 0.793 I feel comfortable with the paperwork necessary for organ donation 0.046 0.849

8. Factor Analysis • Exploratory factor analysis was undertaken with factor loadings >0.7 determined to be: • Desire to work in transplantation • Confidence in transplantation advocacy • Organ donation advocacy • Procurement 0.6- to be developed

9. Revised instrument An alpha value of greater than 0.7 is generally considered acceptable internal consistency (Nunnally & Bernstein, 1994; Elliott, 2003). Alpha = 0.94

10. URII • UAHuntsville Research Infrastructure Investment Grant • Mobile Application • Web Based Technology for Transplant Nurses • Survey will be administered on the site

11. Web based portal In collaboration with Manil Maskey, Dr. Susan Alexander, and Helen Conover, a prototype of the web-based portal has been developed (http://tpp.uah.edu/).

12. Technological Concerns Michael, S. (2011). Making mobile health work for your medical practice: What is ‘mhealth’ and how to plug into it. Accessed from: Mobilehttp://www.welldoc.com/LinkClick.aspx?fileticket=dN_kaDt8Eco%3D&tabid=104 • Why do I need healthcare technology? • Healthcare providers are busy people and need tools that move with them • How do I choose what to use? • Not all apps are created equal • Is it really all that necessary? • Mobile devices can improve efficiency, coordination of care for the patient, and provider communications

13. Healthcare Apps Raja, Y. Sept. 9, 2011. NJTC TechWire: Best practices and trends in developing mobile healthcare applications. Accessed from http://njtcblog.wordpress.com/2011/09/09/best-practices-and-trends-in-developing-mobile-healthcare-applications-2/ Electronic Health Record is the most important application driving investment above 28% from HealthCare Industry. Next to it, Computerized Physician Order Entry and Medication Administration attracts investment above 13% individually (Source – Motorola)• Mobile Health Care applications will play vital role taking the Health Care systems to next level in future.

14. Raja, Y. Sept. 9, 2011. NJTC TechWire: Best practices and trends in developing mobile healthcare applications. Accessed from http://njtcblog.wordpress.com/2011/09/09/best-practices-and-trends-in-developing-mobile-healthcare-applications-2/ Mobile Health Care market to hit $2.1 billion by end of this year – growth by 17% in each of the past two years (Source – ComputerWorld)• Health Care Application set to become hugely popular and above 500 million consumers will be using the application in next 5 years (Source – Research2guidance)• More than 1/3 of 1.4 billion smartphone users will use atleast one Mobile HealthCare Application by 2015 (Source – Global Mobile Health Market Report 2010-2015)

15. Advantages of Collaborative Environments • Involve people, groups or teams to achieve common goals • Provide more effective ways to share ideas, documents, media, tools • (not just emails, chats) • Allow users to submit or update contents • Improve communication • Control access • Manage and index contents • Categorize contents • Integrate semantics • Provide basis for Mobile App Knowledgebase

16. Technology Basics • Refresher Course • Content Management System • Drupal • Feeds • Resource Aggregation • Forums • Mobile Apps

17. Drupal A popular Web Content Management System (CMS), open source (GPL), ~10 years old (Dries Buytaert) Large user and developer community, thousands of contributed modules, science applications Modular and extensible Framework written in PHP, runs on major OS platforms

18. Core Features • Content management • With admin user interface • Custom content types • Versioning • Taxonomy support • Search support • Template & theme system • Separation of content from view* • Many faces, same content • User management • User authentication and role-based authorization • Many extensions available, e.g., LDAP module

19. Concepts Administration Interface: build and administer a site Node: underline storage units for all types (“base class”) Comments: comments on a node Users and Roles Theme: assembles HTML, scripts to display content Block: information placed on a display location

20. Collaborative Environment for Transplant Professional Mobile App Extension Transplant Cases Tools Calculators Blogs/ Wikis Transplant Professional Extension Pub. workflow Forums/ comments Taxonomy Content Mgmt System Social Software Tools Ratings DRUPAL Search Tagging SEMANTIC LAYER RSS Social Networks Analytics Users Content • UAH developed customizable “software appliance” to build collaborative portals for transplant professionals • Leverages Drupal, an open architecture platform, to provide the core Content Management System capabilities required by an online collaborative portal

21. Collaborative Environment - Web Feed Aggregator Tools Posted Contents Events

22. Features Collaborate Using Forums Resource Aggregation CEU/Other Resources

23. Architecture authentication for add/update Collaborative Environment Services authorize to update CMS Database Report Analysis

24. Mobile App A N D R O I D Calculators Forums/Threaded Discussions I O S Mobile App functionalities

25. Preliminary Resultsprior to beta testing:

26. Preliminary Resultsafter beta testing:

27. Preliminary Resultsprior to beta testing:

28. Preliminary Resultsafter beta testing:

29. Best practices medical applications Reach Compatibility Tech Support Constantly updated Include reliable, valid content ……..TBA

30. Use of Web-based mobile applications to reduce healthcare inefficiency Real patient care and clinical benefits Prevent medication errors Prevent communication errors Avoid Delays/Links ……….- the sky is the limit

31. So what? Importance of nursing research Teams Institutional strengths Next Step- HRSA--$300, 0000

32. Acknowledgements • Grant-North American Transplant Coordinators Association • Grant-UA Huntsville-JFDR • Grant –UAHuntsville-URII • Research Team: • Susan Alexander, DNP • Karen Frith PhD • ManilMaskey, Information Technology & Systems Center

33. Questions ?