INNOVATIVE APPLICATIONS OF TECHNOLOGY IN

EMERGENCY MEDICINE
AMY DUNKLEE, INDEPENDENT STUDY MENTORSHIP- FALL 2018, MRS. CLICK

Source: Creative Commons

DISCLAIMER

Some of the information within this presentation came from

outside sources and will be cited at the end.
MENTOR INTRODUCTION SLIDE

Mentor: Dr. Wayne Rutledge, M.D.

Mentor’s Place of Business: UTMB Victory Lakes

Mentor’s Profession: Emergency Medicine

Physician

UTMB Health Brand

Management Team. UTMB
Health Logo: Full-Color Logo.
 ALL ABOUT INDEPENDENT STUDY MENTORSHIP

Independent Study Mentorship is a year long course

study in either Health Science or Multidisciplinary tracts
 Allows students to study a career area of interests
Classwork involves designing projects and completing
assignments related to their mentorship.
Students also observe their chosen profession a
minimum of 3 hours per week.
Students are also expected to perform all classwork at
the collegiate/ professional level.

Image Sources: Creative Commons

PROJECT TOPIC SLIDE

My project topic is geared toward the many technological

innovations that Emergency Medicine Physicians utilize.
I chose this topic because on the first day of mentorship I
observed my mentor use a medical calculator.
At the ER they use medical apps such as MDCalc to help assist
doctors with narrowing down their diagnosis.
The app itself is geared toward Emergency Medicine Physicians as a
reference for clinical decision tools and content.
MDCalc is used by over a million medical professionals worldwide.
Seeing the application first-hand in a professional setting really
contributed to my understanding of this topic.

Swaminathan, Anand. MDCalc Fellowship Program. 12 Peer, Ishaan. CHADS2

Sept. 2017. Score and Stroke Risk.
 1. Research what is MDCalc, and how Medical Calculators
are being used in general.
2. Explain what EBM (Evidence-Based Medicine) is and
how it correlates to medical calculators.
3. Identify how a physician would incorporate Medical
Calculators into there work.
4. Recognize other forms of technology that are being
incorporated, such as Online ER Check-ins.
KEY POINTS
5. Research laceration closure techniques, specifically for
interrupted suture.

UTMB Health Brand

UTMB Health Locations:
Management Team. UTMB League City Campus.
Health Logo: Full-Color Logo. League City.
RESEARCH SLIDE

1. Research examples of application in

motion, such as “CHADS2 Stroke Score”.
2. Research statistics associated of Medical
Calculators, such as how above scores
have become incorporated over the
following decade.
3. Include research of the incorporation of
EBM (Evidence-Based Medicine) alongside
“Frequently Asked Questions.” MDCalc,
MDCalc.
www.mdcalc.com/faq.
 CURRENT EVENTS SLIDE

 Many Emergency Departments and

Physicians alike are incorporating
Evidence-Based Medicine (EBM) more
commonly into practice.
 EBM integrates clinical experience,
patient values, and best available
research evidence when making
decisions for patient care.
 MDCalc is one of the leading apps used
in the research/evidence factor for
Masic, Izet, et al. “Evidence Based Medicine – New Approaches and Challenges.” Current
Neurology and Neuroscience Reports., U.S. National Library of Medicine, Dec. 2008,
Evidence-Based Medicine.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3789163/.
 WHAT IS MDCALC?
 MDCalc is a medical calculator/reference that can be applied
through websites and through a mobile app that allows medical
professions to process algorithms and scores.
 MDCalc began from the idea that physicians shouldn’t have to
waste time trying to memorize scores and algorithms.
 Scores utilize an evidence base, and when combined with a
physician’s judgement improve the care of patients.
 Clinical decision tools have grown since 2005, when MDCalc was
first developed contained only 70 scores. Use of Evidence Based
Medicine (EBM) has grown in recent years, back then there were
few scores available. MDCalc has over 370 scores and are used
by “65% of all U.S. docs every week”. (Ferng 1) Lee, Jarone, and Graham
Walker. MDCalc Apps.
MDCALC RESEARCH (CONTINUED)
 Dr. Jarone Lee, MDCalc editorial board
member refers MDCalc as “the modern
‘electronic textbook’ when you only have 5+
minutes to read up on a topic.” (Ferng 3)
 MDCalc is not designed for “point-of-care us.”
(Lee 3)
 Medical Calculators were never designed to
replace clinical judgment, but to be used
alongside EBM.
 Scores originate from medical journals and
academic researchers who will publish their
work supports the creation of new calculators.
Johnson, Sam W. Mdcalc Reviews – Calculate Heart Score, Creatinine Clearance or Anything

Else Medical .
 MEDICAL CALCULATOR EXAMPLE

 CHADS score stands for Congestive

(heart failure), Hypertension, Diabetes,
and Stroke, all of which are risk
factors for stoke, or when supply of
blood to brain is reduced.
 CHADS score is used for stroke risk
assessment in atrial fibrillation.
 Atrial fibrillation is the irregularity of a
person’s heart beat.
 It may result in poor blood flow and is
more prone to have heart failure.
Peer, Ishaan. CHADS2 Score and Stroke Risk.
 CURRENT EVENTS: ONLINE ER-CHECKINS
 Scheduling Technology allows patients the ability to
schedule appointments online for their local urgent
care of ED’s.
 System of scheduling even from mobile phone allows
patients and physicians to have greater flexibility and
avoid long wait times.
 Administrators at Loma Lind University Medical
Center derived that they needed some change due
to the facility’s high “I left without being seen rate.”
(Page 1)
 LLUMD settled with “ER EXPRESS” (Page 1) “a
scheduling platform that allows patients to go online,
fill out short questionnaire about their medical
issues, and book a time slot for later in the day.”
(Page 1)
“Houston Hospitals, Institutes
& Centers.” Memorialhermann,
www.memorialhermann.org/.
Pros:
They concluded the “I left without being seen rate”
dropped over “29%,” and over several months the patient
satisfaction “went up 17 %” (Page 2).
Cons:
The new system defeats the purpose or devalues the use
of triage, or the assessment to the degree of urgency for
an incoming patient.
David Farcy, M.D., argues “some patients could be putting
themselves in danger by self-triaging.” (Page 3)
 PHOTOS OF MENTORSHIP SITE/ARTIFACTS:
CONTACT DERMATITIS, FINGER LACERATIONS,
AND SAMPLE INTERRUPTED SUTURE

Source: Dr. Wayne Rutledge

CONTINUED ARTIFACTS: LARYNGOSCOPY, ISOLATION ROOM, AND
HAZMAT SUITS

Source: Dr. Wayne Rutledge

 CONTINUED ARTIFACTS: LACERATION, CODE CART, AND
Source: Dr. Wayne Rutledge MENTOR’S SCHEDULE
PRODUCT SLIDE
Product: Video demonstration of closing laceration on pigs’ feet.
1. Research lacerations and suturing techniques/procedures, practice
procedure- done no later Wednesday October 31st

2. Video demonstration of common suturing technique in ED for laceration on

Pigs feet either at UTMB or at CSHS Between Wednesday
October 31 and November 16th

3. Edit Video and allow for rehearsal of presentation and video, due right after
thanksgiving break (November 26 th, Monday)

Source: Creative Commons

PRODUCT VIDEO
IF VIDEO FAILS…
 CONCLUSION SLIDE

In conclusion, I’m glad to have learned what a real

ER is like, as well as gain experience with medical
calculators and laceration techniques.
I think the best thing about my mentorship was
seeing so many different patients. From drug
overdoses to finger lacerations, I love how exciting
the ED can be, and how no two cases are the same.
You may have the same symptoms and diagnosis,
but the severity and treatment may differ between
patient to patient, and I love seeing such different
range of cases every week!
Source: Creative Commons
THANK YOU SLIDE

Thank you to my mentor, graders/evaluators, Mrs. Click, teachers, and

parents!!!

Source: Creative Commons

WORKS CITED

Masic, Izet, et al. “Evidence Based Medicine – New Approaches and Challenges.” Current Neurology and
Neuroscience Reports., U.S. National Library of Medicine, Dec. 2008,
www.ncbi.nlm.nih.gov/pmc/articles/PMC3789163/.

“Medical Calculators, Equations, Algorithms, and Scores.” MDCalc, www.mdcalc.com/. (LOGO)

“Patient Care at UTMB Health.” UTMB Health Volunteer Services, www.utmbhealth.com/. (LOGO)

Ferng, Alice. “Understanding and Creating Calculators for Medical Diagnoses: Exclusive Interview with MDCalc
|.” Medgadget, MDCalc, 15 June 2018, www.medgadget.com/2018/06/understanding-and-creating-new-
calculators-for-medical-diagnoses-exclusive-interview-with-mdcalc.html.

Muoio, Dave. “Wolters Kluwer Releases New UpToDate Advanced with Interactive Decision- Making
Capabilities.” Wolters Kluwer Releases New UpToDate Advanced with Interactive Decision-Making Capabilities,
HealthCare IT News, 1 Mar. 2018, www.healthcareitnews.com/news/wolters-kluwer-releases-new-uptodate-
advanced-interactive-decision-making-capabilities.
WORKS CITED (CONTINUED)

Manning, Allison. “Tackling Urgent Care Wait Times with Technology.” AthenaInsight, AthenaInsight, 24 Nov. 2017,
www.athenahealth.com/insight/tackling-urgent-care-wait-times-technology.
“What Is Evidence-Based Medicine?” Informed Health Online [Internet]., U.S. National Library of Medicine, 8 Sept.
2016, www.ncbi.nlm.nih.gov/books/NBK279348/.
Ferng, Alice. “Understanding and Creating Calculators for Medical Diagnoses: Exclusive Interview with MDCalc
|.” Understanding and Creating Calculators for Medical Diagnoses: Exclusive Interview with MDCalc, MedGadget, 15
June 2018, www.medgadget.com/2018/06/understanding-and-creating-new-calculators-for-medical-diagnoses
-exclusive-interview-with-mdcalc.html.