Navy prescription: Use handheld app to place med students

Navy prescription: Use handheld app to place med students


A test of handheld devices has demonstrated how the Navy's Graduate Medical Selection Board can shrink by 75 percent the time it takes to complete an arduous annual appointment process.

The Joint Service Graduate Medical Selection Board reviews the applications of military medical students for residency training and assigns them an internship, residency or fellowship according to their preferences and the services' needs.

The selection board convenes under the authority of the assistant secretary of Defense for health affairs and the surgeons general of the Army, Navy and Air Force. Each November, the board reviews the available graduate medical education (GME) positions for all three service branches to maximize selection opportunities for applicants, placing the graduates in open slots at various training hospitals.

Using a paper-based system, the Navy's GME Selection Board hands over a stack of documents recording the final selections. Program administrators spend more than 20 hours deciphering sometimes illegible notes and entering the choices into the database. By introducing handhelds, however, the process has been reduced to five hours, said Cliff Taylor, Navy GME database information manager.

As you requested

The Navy GME Selection Board comprises approximately 100 naval officers, led and managed by a captain who sits on 22 specialty committees. That board meets annually in a weeklong conference to review the placement requests and match as many candidates as possible with their preferred assignments.

But with those requests, the board must select and assign physicians in GME training for specialty internships according to the Navy's needs. The Navy board's process was mired by paper records, files and handwritten notes.

'The Navy was committed to a faster way to complete the selection process and eliminate the extensive paperwork associated with the annual task,' Gordon said.

'There is a hard copy file for every applicant,' said Harriet Gordon, deputy director of Navy graduate medical education. 'These files contain the application and 10 supporting documents sorted by specialty.'

Each committee member received hard-copy printouts to track graduate selections, determine how many candidates requested each specialty and location, and recommend assignments. Board members would come to their decisions and manually mark each grid to indicate the final selections.

Navy GME office staff would examine the completed paperwork and enter the information into the database. Data entry took more than 20 hours to complete.

In November 1999, the Navy began a pilot for 10 of its 22 committees of Palm VII handheld devices from Palm Inc. of Santa Clara, Calif. 'The Navy was committed to a faster, more efficient way to complete the selection process and eliminate the extensive paperwork associated with the annual task,' Gordon said.

In the online pilot, the graduates indicate their placement preferences by filling out an application at the GME Web site. When the committees record final selections, board members enter data in the handhelds. The Palm application consists of drop-down menus that let the user read a placement file and modify it on the fly.

Syncing feeling

When placements are complete, the board members put the device into a synchronization cradle connected to a PC. The data is uploaded into a central Microsoft SQL Server 6.5 database. The 20-plus-hour data entry task is shortened to five hours.

To develop the new process, the Navy GME Office hired Impact Innovations Group Inc. of Columbia, Md., as the systems integrator. The company designed and implemented a Palm application based on Code Warrior, a forms application from MetroWerks of Austin, Texas. The customized application makes the GME database accessible on the handhelds.

The software is menu-driven and lets a user read the placement file and make modifications that are later synchronized with the main database. Board members enter a user ID and medical specialty to generate a query to the server. The appropriate files are downloaded to the handheld.

'With these devices, we eliminate an inefficient, and sometimes inaccurate, manual data entry process,' Gordon said. 'Our old data entry system was quite arduous as confusing notes and illegible scribbles had to be deciphered and keyed into the database. Now we quickly update the database at the conclusion of the board meeting.'


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