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Accepted for/Published in: JMIR mHealth and uHealth

Date Submitted: Jul 23, 2021
Open Peer Review Period: Jul 21, 2021 - Aug 2, 2021
Date Accepted: Sep 16, 2021
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Complete and Resilient Documentation for Operational Medical Environments Leveraging Mobile Hands-free Technology in a Systems Approach: Experimental Study

Woo M, Mishra P, Lin J, Kar S, Deas N, Linduff C, Niu S, Yang Y, McClendon J, Smith DH, Shelton SL, Gainey CE, Gerard WC, Smith MC, Griffin SF, Gimbel RW, Wang KC

Complete and Resilient Documentation for Operational Medical Environments Leveraging Mobile Hands-free Technology in a Systems Approach: Experimental Study

JMIR Mhealth Uhealth 2021;9(10):e32301

DOI: 10.2196/32301

PMID: 34636729

PMCID: 8548972

Complete and Resilient Documentation (CARD) for Operational Medical Environments Leveraging Mobile Hands-free Technology in a Systems Approach

  • MinJae Woo; 
  • Prabodh Mishra; 
  • Ju Lin; 
  • Snigdhaswin Kar; 
  • Nicholas Deas; 
  • Caleb Linduff; 
  • Sufeng Niu; 
  • Yuzhe Yang; 
  • Jerome McClendon; 
  • D. Hudson Smith; 
  • Stephen L. Shelton; 
  • Christopher E. Gainey; 
  • William C. Gerard; 
  • Melissa C. Smith; 
  • Sarah F. Griffin; 
  • Ronald W. Gimbel; 
  • Kuang-Ching Wang

ABSTRACT

Background:

Prehospitalization documentation is a challenging task and prone to loss of information, as paramedics operate under disruptive environments requiring their constant attention to the patients.

Objective:

The aim of this study is to develop a mobile platform for hands-free prehospitalization documentation to assist first-responders in operational medical environments.

Methods:

The platform was built to extract meaningful medical information from the real-time audio streaming at the point of injury and transmit complete documentation to a field hospital prior to patient arrival. To this end, the state-of-the-art Automatic Speech Recognition (ASR) solutions with relevant modular improvements were thoroughly explored. Development of the platform was strictly guided by qualitative research and simulation-based evaluation to address the relevant challenges through progressive improvements at every process step of the end-to-end solution. The primary performance metrics included medical Word Error Rate (WER) in machine-transcribed text output and F1 score calculated by comparing the autogenerated documentation to manual documentation by physicians.

Results:

The total number of 15,139 individual words necessary for completing the documentation were identified from all conversations occurred during the physician-supervised simulation drills. While the noise-resilient ASR, multi-style training, and customized lexicon improved the overall performance, not all modular improvements were effective when evaluated in real-world noisy environments. The finalized platform achieved medical WER of 33.3% and F1 score of 0.81 when compared to manual documentation.

Conclusions:

This study presented a fully functional mobile platform for hands-free prehospitalization documentation in operational medical environments and lesson learned from its implementation. Clinical Trial: N/A


 Citation

Please cite as:

Woo M, Mishra P, Lin J, Kar S, Deas N, Linduff C, Niu S, Yang Y, McClendon J, Smith DH, Shelton SL, Gainey CE, Gerard WC, Smith MC, Griffin SF, Gimbel RW, Wang KC

Complete and Resilient Documentation for Operational Medical Environments Leveraging Mobile Hands-free Technology in a Systems Approach: Experimental Study

JMIR Mhealth Uhealth 2021;9(10):e32301

DOI: 10.2196/32301

PMID: 34636729

PMCID: 8548972

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