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

Alison L Wong1 Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA;2 Division of Plastic Surgery, Dalhousie University, Halifax, NS, CanadaCorrespondence[email protected]

Kelly M Lacob1 Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA

Madeline G Wilson1 Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA

Stacie M Zwolski1 Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA

Soumyadipta Acharya1 Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USACorrespondence[email protected]

Abstract

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:

Supplementary materials

Figure S1 Surveys used in this research.

Notes: (A) Biomedical technician practices and resources; (B) usability of application; and (C) content validity of application.

Acknowledgments

The authors thank Dr. Tigistu Adamu and colleagues from Jhpiego and Jhpiego Ethiopia; Felege Hiwot, Debre Markos; Finot Selam, St. Paul’s, Black Lion, and Menelik Hospitals; Debre Markos Biomedical College and Addis Ababa Institute of Technology; the Ethiopian Federal Ministry of Health; Engineering World Health; Katie Kloss; Dr. James Cobey; Dr. Lew Schon; and Dr. Barclay Stewart.

This research was funded in part by GE foundation (“Base of Pyramid Technology for Saving Mothers and Children” #116873).

Disclosure

The authors report no conflicts of interest in this work.