Lessons learned from testing, analyzing and problem solving an online military watchboard medical decision support system (MWMDSS) application: Potential implications for civilian and e-government organizations

The Military Watchboard Medical Decision Support System (MWMDSS) is a new and promising online decision making process, that involves medical informatics technology. Given the present military climate, automated medical surveillance capabilities are valuable tools for medical support of the armed forces. MWMDSS promises to enhance medical support for the military. The development of MWMDSS is consistent with the Department of Defense (DoD) directives, which identified medical surveillance as important for maintaining force readiness. This is one of many major differences between a regular DSS and the MWMDSS. This report documents the results of a Subject Matter Expert (SME) survey conducted to evaluate the MWMDSS software and accompanying dashboard. Thirty Nine SMEs agreed to undergo any necessary training to use the software and to provide feedback on its performance during the simulation. While some users did not require follow-up training, others required some refresher training to perform certain functions. SMEs for this exercise were able to quickly and successfully train to use MWMDSS and were satisfied that it performed most of its functions well. They also felt that it could be a useful tool in understanding the common operational picture and had features that would allow users to obtain and present information more efficiently than previous methods. Overall, participants indicated that MWMDSS had significant potential utility for mobile medical informatics. Some of the SME's reluctance to accept new mobile medical informatics may be viewed through a cognitive perspective. The research draws on Kelly's Personal Construct Theory (PCT) to argue that SME's reluctance to use new mobile medical informatics are influenced by their inability to change their established group personal constructs related to information systems development and delivery (ISDD) activities. This need for real-time information and decision support, has been translated into various new information delivery processes and mechanisms/tools for civilian managers and has e-Government applications. It is important to consider at the very outset that business dashboards hold a unique place in information delivery in e-Government and civilian environs. In addition, MWMDSS uses an e-Government application of new ideas for improving military health efficiency and effectiveness, by addressing the military goals of Information Superiority and Full Spectrum dominance. The recent and continuing emphasis on detection and prevention of chemical and biological attacks has made research and development of medical informatics technologies a pressing need for deployed forces. Such technologies offer medical command the ability to integrate and analyze patient data from widely dispersed forces, permitting early detection and rapid response to disease outbreaks. Previous demonstrations and discussions among product developers and medical users at sites have done much to advance the product. However, no independent test and analysis work has been conducted emphasizing military applications of MWMDSS during extended deployments. Based on the performance of the product during previous demonstrations, the military command believed that MWMDSS would benefit from systematic analysis by a Test and Analysis team independent of the product developer. Such an analysis would also allow the Military Command a base from which to make decisions on the suitability of the product for future deployment.