As previously mentioned, we are here in the Hospital de Câncer de Barretos (HCB) to run an evaluation of our Melacap system. Originally a combined effort between Bioengineering master’s student team UVFree and Global Health undegraduate Team Teledermatology, the Barretos team renamed it Melacap. Its primary function is improve the efficiency of the extant teledermatology system I described earlier.
The Melacap system is comprised of both a mobile attachment and a mobile application. The application guides the user, in this case nurses in the field, in acquiring patient information and accompanying images of suspect skin lesions for diagnosis. The mobile attachment, in turn, features a scope equipped with a small magnifying lens and a white LED in order to improve image quality, as well as a physical extension to ensure a standardized distance for images.
The mobile application stands as the focus of this post. The main idea driving its design was to facilitate the acquisition of patient information and images and the communication of this information to the doctors at HCB for remote diagnosis. Currently, it only exists for Android, but that is due to the fact that it is the primary operating system of the target regions in Brazil.
Its use is relatively simple:
1. Login to access the app. Every user must create a user login that is stored on their own phone. This, in addition to the necessary REDCap key (explained later), adds necessary security barriers for the use of this app.
2. Access important functions from the Home screen. The home screen presents four possible options for the user: Add patient, Photo queue, Settings, About this App. Additionally, the user can also log out from this screen.
3. Click “Add patient” to begin collecting data. Arguably the most important function, initiating this function takes the user through the necessary steps needed to send patient data to the main HCB.
3.1. First, add personal patient information. In this screen, the user must enter the necessary patient information as needed by the doctors at HCB for the medical records.
3.2. Second, add lesion images. This is the most complex part of the app, as it requires the user to select a body area and subsequently capture two images of the lesion. The first image is a close-range image, for which the mobile attachment’s scope is used. The second is a mid-range image, for which the attachment’s extension is used. In addition, the user has the possibility of adding comments for each particular lesion, a feature in which every doctor thus far has expressed strong interest.
3.3. Upload images. The app needs an Internet connection in order to be able to upload the images onto the REDCap database. However, should Internet connection be unavailable, the images are saved on the phone for later upload, allowing the nurses to continue to process patients without losing data. At this point, the user returns to the Home screen.
4. Check the “Photo queue” for uploads. From the home screen, the user can access the photo queue to verify that all images have been uploaded, or to select which ones to upload in the desired order.
5. Add REDCap key and change language in “Settings.” The app communicates with a database server called “REDCap,” but in order to access the HCB REDCap database for teledermatology the user must enter the correct REDCap key. In addition to providing the app the communicative functionality, it also adds another level of security. Additionally, the app comes in both English and Brazilian Portuguese, and these can be selected from the Settings page.
In summary, Melacap aims to add efficiency, organization, and accessibility to the teledermatology system in HCB. By providing a centralized communication system as well as standardized patient information, we hope to eliminate the time-consuming e-mail usage and possibly expand the reach of teledermatology.
Though we are still awaiting for approval to begin the study, we are still improving the app from some feedback we received from Dr. Carlos Gourlat, the main doctor heading the teledermatology system at HCB. In particular, he asked us to further update the patient information fields to match those used in HCB, as that will expedite the scheduling process for patient appointments. He also expressed concern that the app needs to be as easy to use as possible, since he does not want to hinder its adoption and use amongst the intended users.
Though I am just starting out on learning Android development, I have managed to update some of the user interface (UI) to improve its usability and user experience — being a graphic designer as well, I jumped on that opportunity first. In practicing with that, I’m learning more about how the app works in order to be able to update the patient information fields. To be honest, app development was always something I was interested in but daunted by, and now that I have such a clear opportunity I’m very excited to be working on this.
I will be adding images of the updated UI as I continue to work on it!
Até mais, a gente —