| dc.description.abstract | This summer I have worked with IWK Health Centre and their Informatics Department in
a novel position titled ‘Student Innovator in Health Informatics’, seeking to bring a health
informatics based solution of my design to reality. The position is the result of Dr Brett Taylor, a
graduate of the Master of Health Informatics at Dalhousie, and hospital administrators,
recognizing the growing importance of bringing technology to healthcare, hope to foster
innovation and provide support to health informatics students with a vision. I was fortunate
enough to be the first student in this position.
This position is unique in that, while there is ample clinical and technical support, the
majority of the work is selfdirected.
I designed, planned, adapted, and taught myself that which
was necessary for the project. With the help and feedback of my advisors, supervisor and
clinical consultants, the project nears completion.
The goal is to create a system that would enable diabetic patients to record, display,
analyze and understand data from their lives, including blood sugar, insulin doses, carbohydrate
consumption and exercise sessions. As well, to prepare this data for transfer to their care team
in a clinically meaningful way. At present, this data is addressed with their care team, but it is
often presented incomplete or recorded with pen and paper. The project is ongoing and will
continue after the internship comes to a close, but together we have built a near complete
application for iOS mobile devices that accomplishes most of these goals.
Design decisions were deeply informed by clinical observation in hospital with Dr Arati
Mokashi and the diabetes team at the Pediatric Endocrinology Department at IWK. Many
aspects of health informatics are involved in bringing an information technology solution like this
to a health care problem. Fitting seamlessly into existing clinical workflow, technical system
design choices, statistical analysis, and creating a clinically meaningful tool that can also
operate as a patient teaching tool are all aspects that I addressed in the design and
implementation of this project. This report will detail many facets of these informatics associated
topics, and will seek to justify the continuation of this substantial position for future students.
Discussed herein are two specific informatics topics that were among the more complex
addressed this summer. The first is a visual data representation of blood glucose, carbohydrate
consumption and insulin action relative to time of day. This is a chart adapted from observations
of patientcaregiver
discussions about their blood sugar readings at home. The second is a
novel algorithm for calculating a specific measure of glycemic variability, the mean amplitude of
glycemic excursions. This is a well studied and validated measure of blood glucose swings that
has been noted to be difficult to compute. (Marics et al., 2015) Both these challenges were
solved using personal research, support from my advisors, knowledge taken from my course
work and experimentation. The chart will visually support and improve the conversation between
caregiver and patient about blood sugar at specific times of days. The algorithm demonstrates
taking a clinical concept and translating it to computer understandable code.
The project as a whole has been challenging as well as deeply rewarding. Entrusting a
student that seeks to bring informatics solutions to healthcare, and having project success be
contingent on their ability is extremely motivating. The volume of information and technical skills
I have acquired to see this project through are ample evidence of how important a position like
this can be. Certainly, this experience should contribute greatly to future opportunities in the
health informatics field. I also have a great deal of gratitude to the institution for giving me this
opportunity and intend to contribute to the continuation of the Student Innovator position as well
as the Informatics Department at IWK in the future in any way I can. Beyond what I personally
have taken from this position, we also have a patientcentered
data recording and analysis tool
prototype that compares very favorably to existing products. I feel it will improve the experience
of recording blood sugar for patients and of dissecting the data for physicians
The unique elements of this position allowed me to see informatics from a both a top
down and bottom up perspective. Mapping clinical context to technical choices and then
implementing those technical choices allowed me to apply everything I have learned in health
informatics to a real world project. The position required confidence, humility, curiosity and
implicit motivation to accomplish what I set out to. I sincerely hope that future students have this
opportunity and that my advisors and the institution see the value that this position has had for
me. Health informatics is a field that is evolving quickly. That evolution and the extent to which
we can transform healthcare with technology will depend on the sort of support to bring an idea
from concept to reality that I have had this summer. | en_US |
