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An app today keeps the doctor’s forms away

November 8, 2019

Phoenix Children’s Hospital and ASU students partner to create an app that replaces outdated medical history forms

Stressed, exhausted and sitting in a hospital waiting room, the last thing anyone wants to do is spend half an hour filling out paperwork. Yet that is the first task patients and caregivers are saddled with during a hospital visit.

This not only takes away precious time that could be spent with the physician, it creates a burden for the doctor as well. She has to scramble to read through forms moments before she walks in the room. After the visit, she must enter them into the electronic medical record along with her own notes.

Currently, doctors spend around two hours of their time on electronic medical records for every one hour of face time with patients, according to a study by the Annals of Family Medicine.

To improve this process, Phoenix Children’s Hospital — one of the largest pediatric health care systems in the U.S. — partnered with Arizona State University to form a Practice Lab. Practice Labs bring together interdisciplinary teams of students to help companies creatively solve pressing issues.

The Phoenix Children’s team is creating a dynamic web app that allows patients to submit their information before an appointment and then enters that information directly into the health system’s records.

“We're reducing time that providers spend on collecting data, which means they can serve more patients, which means that people get more access to health care. There's some noble pursuit that we are achieving here,” said Chase Adams, co-principal investigator on the project and assistant director of the ASU Luminosity Lab, which develops student teams for Practice Labs.

“It was undoubtedly a great opportunity to bring new energy and new insight,” said David Higginson, the executive vice president and chief operating officer of Phoenix Children’s. “It was time to come up with a solution to an old, ongoing pain point that most health care systems face.”

“It’s an exposure to the outside world,” said Nikhil Agarwal, a computer science master’s degree student with the project. “We get to interact with professionals and understand what problems they are facing and whether we could make their lives easier.”

Diagnosing the problem

The medical staff at Phoenix Children’s have long struggled with issues related to physical patient forms. Typically, the health system needs to collect three types of information from a patient: past history, such as prior surgeries or illnesses; family history, such as hereditary diseases; and social history, such as education and income.

“We felt that the patient family should have the opportunity to input this kind of background data when they have time at home, rather than in their doctor's office,” said Vinay Vaidya, senior vice president and chief medical information officer at Phoenix Children’s, who collaborated with the Practice Lab.

The hospital and Practice Lab team decided to focus on collecting family history as the first step in developing their app.

To better understand how health care professionals go about doing that, the students met with genetic counselors, who evaluate and advise families on genetic disorders. The counselors conducted mock interview sessions that allowed the students to see how they might improve the process and learn where patients typically have questions.

One of the team’s biggest takeaways was gaining experience working in an interdisciplinary group, much like they would in an industry setting. Communication has been key, they say, to ensuring that their individual work comes together cohesively.

Prescribing a simpler solution

The Practice Lab’s web app is a serious upgrade to the typical paper form. One of the main differences is that it only asks patients for information relevant to their hospital visit. For example, if a patient is at the hospital for a heart-related problem, the app will not ask questions about a family history of vision problems.

The app also saves the patient’s information for future visits, so there is no need to answer the same questions over and over. Instead, the patient can update information that has changed, which will allow the doctor to track the patient’s health over time.

“This benefits both the doctor and the patient,” Agarwal said. “The patient doesn't spend time filling data that he has actually already filled, and the doctor doesn't waste time looking at excess data.”

The app will work like this: A few weeks before an appointment, patients will get a text message from Phoenix Children’s with a link that will prompt them for authentication before taking them to the web form.

Once in the app, patients will be asked questions related to their appointment. Answers are in a simple “yes, no, unsure” format. Depending on how patients answer, the app will customize the questions that follow.

Patients can also leave and return to the form if, for example, they need to ask family members about their medical history.

The project team hopes that the ease of use will free patients to fill in more complete information than a paper form, or doctors’ notes, would allow.

“A lot of the patients that come in aren't necessarily tech savvy, so to make sure that it was as simple as possible was the biggest priority,” said Kusum Ijari, a human systems engineering master’s degree student.

Student Kusum Ijari presents the app's design to team members

ASU student Kusum Ijari (center) goes over the app’s design with fellow team members Nikhil Agarwal (left), Rakshith Subramanyam (bottom right) and Siddarth Madan Kumar (upper right). Photo credit: Andy DeLisle

A positive prognosis for the future

The Practice Lab’s user testing suggests they were successful. The team asked parents who worked in the Luminosity Lab to fill out the web form with their children’s family medical history. The test subjects were able to complete the form in an average of just three minutes.

The team also made an effort to keep the coding for this app clean and modular, like Lego blocks, to enable add-ons of other potential features in the future. Those could include graphs or medical family trees using patient data; a Spanish version; or expansion of the app to gather patients’ past and social histories.

The project entered a new phase at the end of October, when the team handed their code over to Phoenix Children’s for further testing and refining.

The health system will ensure that the app meets the industry’s rigorous security standards and offers a seamless user experience before launch. Higginson says he hopes to begin pilot testing in the first or second quarter of 2020.

The app represents the latest wave in a growing trend of integrating technology in health care. Now that doctors can interact through electronic medical records, the industry is ready for better virtual communication with patients.

People on both ends of the stethoscope will likely be more than happy to leave the clipboards, flower pens and lengthy forms behind in exchange for a few taps on the screens in their pockets.

If your organization is interested in forming a Practice Lab with ASU, please contact ASU’s Business Concierge at corporate@asu.edu for more information. Learn more about ways companies can partner with ASU.

Top photo: ASU students Rakshith Subramanyam (left) and Nikhil Agarwal (right) work on the web app. Photo credit: Andy DeLisle

Mikala Kass

Communications Specialist , ASU Knowledge Enterprise

480-965-0610

Robot coworkers: How AI impacts the future of work


November 8, 2019

What happens when technology advancements threaten to automate people’s jobs?

That question is on the minds of many as research and development in artificial intelligence and machine learning rapidly advances. man working with a robot in a lab Pulkit Verma, a graduate student member of Siddharth Srivastava’s research team, helps with efforts to reprogram autonomous robots using artificial intelligence. The new robots will not only be more adaptable to the manufacturing industry as it evolves, but they will also be equipped with intelligent tutoring systems to train factory workers to operate the robots. Photo by Erika Gronek/ASU Download Full Image

A new project led by Siddharth Srivastava, an assistant professor in the School of Computing, Informatics, and Decision Systems Engineering at Arizona State University, aims to help alleviate this concern.

Srivastava and his multidisciplinary team are creating autonomous systems that are not only more adaptable and efficient in manufacturing environments, but also have built-in intelligent tutoring systems that will cooperate with factory workers and retrain them to use AI technology so they are not displaced from their jobs.

Funded by a $1 million grant from the National Science Foundation as one of its Convergence Accelerator awards, the project is highly focused on using AI to augment the workplace rather than replace workers.

“Suppose you have this new robot, it’s very efficient, but you need to hire five computer science graduates to operate and maintain it instead of five current factory workers,” Srivastava said. “That’s not feasible, first of all because we don’t have that many computer science graduates in society. Our idea is that instead of getting people to enroll in a new college program again, what we can do instead is design our AI systems, our robots, in a way that will help people to come on board.”

Srivastava is collaborating with ASU faculty members in the Ira A. Fulton Schools of Engineering and the School for the Future of Innovation in Society to bring the project to life.

“We have 10 team members, including experts in robot control, tutoring systems and human systems engineering — a field that involves thinking about how the robot and the human would interact and how you would build a situation where the human trusts the robot,” Srivastava said. “We also have experts in law to help solve the sociotechnical aspects of the problem.”

How artificial intelligence can preserve jobs

Traditionally, AI has mostly been developed with a mind to automate human-performed tasks — that is, to perform tasks in place of a human. For example, machines play chess better than humans do and are also faster at distinguishing patterns and performing calculations. One example of AI working to augment human-performed tasks rather than replace them can be found in intelligent tutoring systems.

The ASU team is focusing on this interaction, particularly in implementing the intelligent training systems for factory workers. This eliminates the concern about driving up the demand for highly educated workers to unsustainable levels and also empowers human workers to incorporate AI into their work.

According to Subbarao Kambhampati, a professor of computer science, this education-based relationship is the key to successful collaboration between AI and humans. In particular, the AI systems need to learn to model the mental states of the humans they collaborate with, and use those models to guide their interactions with the humans.

“We are now considering scenarios in which the AI system teaches humans on the job,” Kambhampati said. “If you are using one machine, and there is a big technological advancement, then the question is what is the best way to get people to come up to speed in using these new machines?”

This retraining process is essential to helping factory workers in the evolving manufacturing industry keep their jobs. It’s a necessary transition into a future when machines can augment human activities without replacing the people who have traditionally performed them.

In that scenario, workers would be able to assign robots a wider variety of tasks while the robots teach workers how to use the robots and why robots are making the decisions they do.

“(Robots) are more adaptable in that their behavior adapts to the changes in their environment, they adapt to the tasks that you give them and at the same time they can answer your questions,” Srivastava said. “A worker who doesn’t know the internals of the robot can ask it, ‘Why did you go along this path when I think you should have just gone straight?’ And the robot can answer, ‘If I go this way then my hand might collide with that table.’ So, in that process, the worker learns about the robot’s constraints and how to operate it.”

Moving toward a more robotic future

Could machines ever replace humans? Is it cheaper to have an all-robotic workforce?

The answer is complicated, said Katina Michael, a professor jointly appointed in the School for the Future of Innovation in Society and the School of Computing, Informatics and Decision Systems Engineering, one of the six Fulton Schools.

“At face value, initially it seems that robots would do better than the operational expenditure of the human labor force,” she said, “but when you look at this quite clinically, you’re almost shifting costs from the human labor force to the robotic labor force. It’s quite debatable as to whether costs will be reduced.”

While robots can operate 24/7, people need breaks, time off, insurance coverage and compensation. However, robots must be updated and maintained, and they also need power to operate — human workers are still extremely necessary in the workplace.

Although the research project is focused on AI development, it is ultimately centered around training human workers and ensuring job security. The team wants to enhance communication between both humans and robots to obtain the best of both worlds in the manufacturing industry.

“Sadly, training diminishes with the increased cost of the capital investment,” Michael said. “Many corporations are trying to save money somewhere, but training is where we need to invest more money in order to have a successful integration of workers and autonomous systems so we can minimize safety risks. If we don’t have adequate training, we don’t have adequate responses to reducing the incidence of on-the-job disasters.”

An interdisciplinary interaction

In highly multidisciplinary projects involving diverse skill sets and expertise in multiple areas, there are many factors to consider when humans team up with robots.

“We’re interested primarily in how humans and robots work together,” Michael said. “With the humans doing their bit and the robots doing their bit, we want to see if there is any incongruousness or congruousness that can be observed. I’m also looking not only at the economic impact but also the societal impact, seeing if the workers who are interacting with these robots are receiving adequate training.”

Erin Chiou, an assistant professor of human systems engineering at The Polytechnic School, one of the six Fulton Schools, is studying the interactions of humans and machines for data to guide the design of systems that prioritize the collaboration of humans and robots.

“Ultimately, it’s getting that multidisciplinary conversation going between people who actually build the machines and people who think very critically about job design and human workers,” Chiou said. “It is relatively easy to optimize technology when you aren't thinking too deeply about how to involve people, because once you involve people, you introduce variation into the system. This makes the problem much more difficult. At the same time, this variation — or the ability for a system to adapt to different situations — is crucial for technology acceptance and for overall system performance.”

The ASU team also has experts looking at the legal, social and economic implications of implementing such technology in the workplace, all of which will be considered when designing the new systems.

“It’s not about changing the hardware, it’s about how to change the software,” Srivastava said. “We’re thinking about how it should act and what it should do. We are rethinking how a robot’s ‘mind’ should work in order to make it more amenable to providing on-the-job training and collaborating with humans.”

Karishma Albal

Student Science/Technology Writer, Ira A. Fulton Schools of Engineering

480-283-5304