Computer-Supported Collaborative Design of Standardized Clinical Cases.

Abstract

The creation of computer-supported collaborative clinical cases is an area of research in teaching that has been widely studied. However, the reuse of cases and their sharing with other platforms is a problem that encapsulates knowledge in isolated platforms without interoperability. This paper proposes a workflow ecosystem for the collaborative design and distribution of clinical cases through online computing platforms that (i) allow medical students to create clinical cases collaboratively in a dedicated environment; (ii) make it possible to export these clinical cases in terms of the HL7 FHIR interoperability standard; (iii) provide support to transform imported cases into learning object repositories, and (iv) use e-learning standards (e.g., IMS CP, SCORM) to incorporate this content into widely-used learning management systems, letting medical students democratize a valuable knowledge that would otherwise be confined within proprietary platforms. To demonstrate the feasibility of developing a workflow ecosystem based on IT platforms to enable collaborative creation, export, and deployment of clinical cases. The ecosystem infrastructure for computer-supported collaborative design of standardized clinical cases consists of three platforms: (i) Mosaico, a platform used in the design of clinical cases; (ii) Clavy, a tool for the flexible management of learning object repositories, which is used to orchestrate the transformation and processing of these clinical cases; and (iii) Moodle, a Learning Management System (LMS) that is geared towards publishing the processed clinical cases and delivering their course deployment stages in IMS CP/SCORM format. The generation of cases in Mosaico is exported in the HL7 FHIR interoperability standard to Clavy, responsible for creating and deploying a learning object in Moodle. The main result is an interoperable ecosystem that demonstrates the feasibility of automating the stages of collaborative clinical case creation, export through HL7 FHIR, and deployment in an LMS, enabling the generation of IMS Content Packages associated with the original Mosaico clinical cases that can be deployed in conventional third-party LMSs. This allows the democratization and sharing of clinical cases to different platforms in standard and interoperable formats. In this article, we have proposed, implemented, and demonstrated the feasibility of developing a standards-based workflow that interoperates multiple platforms with heterogeneous technologies to create, transform and deploy clinical cases online. This achieves the objective of transforming the created cases into a platform for online deployment in a learning management system.