Question

Design an alert system for doctors

Answer 1

Clarifying the goal: Doctors are often needed at a moment's notice to attend to those who need help. I assume the goal of this system is to provide a way for doctors to get alerted and attend to urgent situati…See more

Answer 2

Clarifying the goal:

Doctors are often needed at a moment's notice to attend to those who need help. I assume the goal of this system is to provide a way for doctors to get alerted and attend to urgent situations. This can arise in many different situations - such as in a hospital, or in public places where someone needs help immediately in a park or movie hall, or for example in places like a train or a hike, etc.

Existing alternatives include calls to 911 in countries like USA, getting emergency response to bring back a person to a medical facility before treatment. However, this may take time in certain areas where it is either overburdened or remote.

We need to design something better than current alternatives.

Target Users

Doctors - who can attend to trauma, or react to time sensitive situation s such as cardiac arrests

Patients - who are in a hospital setting, who are in public places or in remote areas

Emergency services - who might be dispatched

User Journey

Doctors need to add themselves and their contact info, need to make themselves available, need to accept a call, need to attend the call, complete the request for assistance, get reimbursed or get paid as a paid employee or contract employee.

Patients need to ask for assistance, need to know how, need assurance that help is coming, need to have proper care for their situation, need to pay doctors if needed.

For this question, focusing on doctors only:

Needs

- As a doctor, I need to help those in distress and provide availability (time,  area)for assistance.

- As a doctor,  need to get calls and respond with confidence

- As a doctor, reach the patient asap

-As a doctor, provide help and coordinate with other agencies

- As a doctor, I want to be clear about when I can handoff.

 

Solution:

Roadside medical assistance provided as part of medical insurance:

Registry of doctors, contact information, availability

For non-emergency situations, a well known phone number to call for assistance.

For emergency, 911 dispatch to include calls to doctors to verify availability to handle request given location.

System matches doctor expertise to reported situation and confirmation of response.

Doctor updates case and receives/provides updates from emergency crew

For emergency, 911 provides situation brief to attending doctor and receives confirmation.

Doctor provides treatment continuity till physician takes over at medical facility.

Prioritizing:

If I were to consider myself as building a new product, the first step would be to make sure I have this need. Current 911 system already handled life threatening emergencies with an established process and Salad. To get started, I would focus efforts on non- life threatening emergencies which need medical advice on the road. This would be provided via telephone so that it is available wherever there is cell phone coverage. If needed, doctor is dispatched for roadside assistance.

I envision this solution to be built on tried and tested solutions, that are robust and somewhat independent of phone capability.

Metrics

Success is when every potential patient is using this system and being satisfied with the results. However, it takes time to see the users return to the system due to past positive experiences.

A good way to measure success would be to use Net Promoter Score surveys after every assistance event.

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Answer 3

First, to clarify the scope of the question:Doctors can need alerts for several reasons:- When they are physically needed at an hospital- When their input/knowledge is needed for a call or decision - When…See more

Answer 4

First, to clarify the scope of the question:

Doctors can need alerts for several reasons:
- When they are physically needed at an hospital
- When their input/knowledge is needed for a call or decision 
- When they need a reminder to reach out to a patient or follow up on a treatment

As well there can be different kind of alerts:
- Triggered by other doctors or nurses (generally high priority)
- Triggered by patients (might or not be high priority)
- Automatically triggered by a system.

Finally we can need alerts for doctors in different contexts:
- When they are working at an hospital
- When they are performing a surgery
- When they are not working but they are needed

We'll assume that we need an alarm system for when doctors are physically required by other doctors or nurses for an emergency in a hospital, no matter if the doctor is at the hospital or not.

Secondly, identify potential users and use cases:

- Doctors for whom the alarm is targeted- There are different kind of doctors, depending on their specialization (surgeons, pediatricians, traumathologysts, neurologysts, cardiologysts, etc.)  and roles (private doctors who are generally at home or at their private office when an emergency comes in, on-site doctors who are already in the hospital).  
- Other doctors or nurses who trigger the alarm- They are the ones who are requesting the assistance/input of the alerted doctor. 
- Specialists who would need to also be involved /informed when an alarm is sent. This could be ambulance drivers, hospital directors, other medical specialists, hospital janitors, etc. Depending on the alarm, several people would need to be informed as well.
- Patients- Who even if they would not be trigerring the alarm, they can ask for assistance if they are experiencing a complication that might end up in the triggering of an alarm.

Thirdly, we'll focus only on the needs and use cases of the doctor for whom the alarm is sent.
A doctor who is requested physically at an hospital because of an emergency needs to (in order of priorization):
- Be able to receive the alarm immediately no matter the in which they are.
- Be able to request additional assistance if he/she can't answer the alarm.
- Be able to receive a brief summary of the emergency (cause, patient, location, priority, time)
- Be able to provide an initial answer with relevant information (alarm received, start certain procedure, provide ETA) 
- Be able to ask for additional information, follow up questions to clarify the emergency


 Fourthly we evaluate how are doctors currently solving these needs and where are the possible gaps in currently available products.

As far as I understand, there are currently no doctors-only alarm systems. Hospitals and doctors generally use common means of communications such as text messaging, phone calls and internal hospital communicators. Some gaps of these solutions are:
- They need the doctor to have a charged smartphone of device with them. 
- This messages and calls are delivered with the same priority as the ones made by family, friends etc.
- If the doctor is unreachable (do not disturb, mute, no signal) there are no alternate ways to reach them.

Proposed solution features:
-  Cross device web based system that triggers alarm simultaneously in as many channels as possible:app push notification, wearable vibrating notification, e-mail, sms, online text messaging & phone call.
- Doctor can confirm of received alarm.
- Installed system app rings, flashes and vibrates until alarm is confirmed of received
- Alarm provides an initial summary of the emergency to give context to the doctor.
- Doctor's information previously logged in to reach him out by different channels and match his expertise to the emergency
- Every doctor has a "backup" doctor to be reached out if the alarm is not confirmed of received after 5 minutes
- Doctor can make a follow up call/text that goes directly to the person who triggered the alarm with teh objective of providing initial indications or asking for more context.
- System automatically provides doctor's ETA based on their location if they are located outside of the hospital
- Doctor can input if any additional people need to be contacted with the summary of the alarm eg: anesthesiologist needs to start preparing, nurses should start preparing surgery room, ambulances should get set to transport patient etc.

Prioritization: The most important feature of an alarm system in an emergency context is to make sure the alarm is delivered as soon as possible to the right person. Everything else can be solved with current means of communication. The first feature would be the guarantee of alarm delivered by triggering the alarm in multiple channels. Secondly, to guarantee that the doctor can establish a communication with the hospital if there's the need of exchanging more information. Lastly, the more relevant information provided in a simple clear way, the better in order to simplify the decision making process for the doctor and the hospital.

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