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Design and preliminary validation of a mobile application-based expert system to facilitate repair of medical equipment in resource-limited health settings

Authors Wong AL, Lacob KM, Wilson MG, Zwolski SM, Acharya S

Received 17 January 2018

Accepted for publication 1 March 2018

Published 16 May 2018 Volume 2018:11 Pages 157—169


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Alison L Wong,1,2 Kelly M Lacob,1 Madeline G Wilson,1 Stacie M Zwolski,1 Soumyadipta Acharya1

1Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA; 2Division of Plastic Surgery, Dalhousie University, Halifax, NS, Canada

Background: One of the greatest barriers to safe surgery is the availability of functional biomedical equipment. Biomedical technicians play a major role in ensuring that equipment is functional. Following in-field observations and an online survey, a mobile application was developed to aid technicians in troubleshooting biomedical equipment. It was hypothesized that this application could be used to aid technicians in equipment repair, as modeled by repair of a pulse oximeter.
Methods: To identify specific barriers to equipment repair and maintenance for biomedical technicians, an online survey was conducted to determine current practices and challenges. These findings were used to guide the development of a mobile application system that guides technicians through maintenance and repair tasks. A convenience sample of technicians in Ethiopia tested the application using a broken pulse oximeter task and following this completed usability and content validity surveys.
Results: Fifty-three technicians from 13 countries responded to the initial survey. The results of the survey showed that technicians find equipment manuals most useful, but these are not easily accessible. Many do not know how to or are uncomfortable reaching out to human resources. Thirty-three technicians completed the broken pulse oximeter task using the application. All were able to appropriately identify and repair the equipment, and post-task surveys of usability and content validity demonstrated highly positive scores (Agree to Strongly Agree) on both scales.
Discussion: This research demonstrates the need for improved access to resources for technicians and shows that a mobile application can be used to address a gap in the access to knowledge and resources in low- and middle-income countries. Further research will include prospective studies to determine the impact of an application on the availability of functional equipment in a hospital and the effect on the provision and safety of surgical care.

Keywords: medical apps, global health, mHealth, repair system, pulse oximeter

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