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How can digital technology improve patient safety?

You get a page—a patient is in distress. You must respond within two minutes. The catch? It’s a test to prevent medical errors.

On this episode of BoldlyDr. Nada Gawad, speaks with her mentor from the Joule Innovation Council, Dr. Joshua Liu. Dr. Gawad is a medical resident and creator of the My On Call (MOC) Pager App. The MOC Pager App helps train medical learners and doctors by using hypothetical medical situations to gauge their decision-making skills in real-time and prevent medical errors.

She shares her inspiration for the app, the value of teamwork in turning her vision into reality and tackling some obstacles in innovation. Dr. Gawad then voices her vision for the future and where she hopes to take the app.

tweetable: “Having the tools isn’t necessarily a prerequisite. You can…develop those as you go.”

Key takeaways

What is Dr. Gawad’s background?

  • One summer in medical school, she went on a trip to ponder her career options.
  • Looking to further develop her career in Canada, she participated in the Surgical Exploration and Discovery (SEAD) program.
  • She describes SEAD as a two-week medical student summer camp with workshops to discover different surgical specialties.

tweetable: “There isn’t much early exposure to surgery and there isn’t much early exposure to surgeons in the pre-clerkship curriculum.”

What inspired the MOC Pager App?

  • Innovation comes from recognizing an unmet need. For her, it was a gap in medical training.
  • In hindsight, she was working to build the tools she wished she’d had.

tweetable: “I think innovation has always come from recognizing a need and then having the tools to be able to address it.”

How does the app work?

  • Learners answer ‘pages’ on a mobile phone the same way they would in a hospital ward.
  • The phone vibrates to alert the learner know there’s a new page. Once they open the app, the learner has two minutes to respond.
  • Pages include access to their (hypothetical) patient’s relevant medical information and then asks the learner how they would like to respond.
  • Response options could include giving phone orders, seeing the patient immediately, seeing the patient when they have time, calling the senior doctor for help or calling the appropriate service for help (anesthesia, ICU, etc.).
  • It forces the learner to evaluate their own level of confidence, patient safety and when to ask for help.
  • Their responses are scored, and everything is customizable to meet different program needs.


Who helped her get this project off the ground?

  • She found Dr. Fraser Rubens, who told her about a grant opportunity he found through a Google search.
  • They interviewed students and selected Dr. Heather McDonald to help champion the project.
  • They reached out to high school students who had won awards for app creation to help them design the app. Her mom also helped her connect with engineers to assist with its creation.
  • Her supervisor in Ottawa helped further ground the app in medical education.
  • As the idea started to snowball, they applied for a Joule Innovation grant.

tweetable: “It really comes down to finding someone who’s willing to give you a chance.”

How does Dr. Gawad persevere in the face of adversity?

  • She didn’t initially think of herself as tenacious.
  • For every grant they’ve received, there are others that won’t come through. It’s important to stick with it.

tweetable: “It’s one thing to be interested…and to say “oh that’s a great idea!”- and it’s another thing to champion it and bring it to your program.”

What is the status of the app?

  • The pilot version of the app is available and there’s a new version is being re-built.
  • They are currently working to create new virtual patients and questions.


What are the most unexpected and difficult parts of her journey?

  • Initially, the goal was to inspire people to have a dynamic conversation.
  • Over time, the goal changed to make a safe decision the greatest number of times, rather than ‘correct’.
  • The greatest challenge has been the time investment and finding committed teammates who are willing to put in the work.


How could other doctors help with this innovation?

  • Helping them create new virtual patients and questions through information-sharing.


What is the most exciting development on the horizon?

  • They’re adding administrative platforms and two other interfaces.
  • Soon, they’ll be able to measure and analyze some of the outcomes as well as determine how to improve using all the user information they’ve gathered.

tweetable: “It really allows it to meet the needs of more programs.”


Recommended resources

MedsOnCall Pager App: A pilot project for practicing safe clinical decision-making, an NCBI article (note: the app changed name)

Physician innovators: Technology driven solutions, a Hospital News article featuring Dr. Gawad and the My On Call Pager App

Meet emerging physician innovator Dr. Nada Gawad, a Boldly video

The Surgical Spotlight: Medical students are learning early about surgery, a University of Toronto article highlighting Dr. Gawad’s work creating SEAD



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The opinions stated by podcast participants are made in a personal capacity and do not reflect those of the Canadian Medical Association and its subsidiaries, including Joule. Joule does not endorse any views, product, service, association, company or industry mentioned in this podcast.