Constraints of List Based Knowledge Interaction on an Android App for Emergency Medicine
Background: The "AGN Notfallfibel Medikamente Richtwerte in der Notfallmedizin" is a standard quick reference guide for emergency doctors and paramedics in the German speaking area. It has been sold approximately 60,000 times. The paper based booklet has been subsequently developed, tested in the field and constantly improved for 20 years by Dr. med. Ralf Muller, emergency doctor at Graz LKH University Hospital and is practically in the pocket of every emergency and family doctor and paramedics in the German speaking area. Due to the enormous success, availability and performance of Smartphones, the time was ripe to develop an electronic version providing faster access and better search facilities. Objective: We designed and development an electronic version and hypothesized that the electronic version of the handbook allows more efficient and more reliable work than the printed handbook. However, certain design aspects which make sense on printed paper must be revised for mobile applications and adapted to the mobile app paradigm. In this paper we report on the challenges and lessons learned during the development and the tests. Methods: The application's design emphasizes extensibility and modularity, which is supported by Android's Activity paradigm in which single activity classes, usually representing one view or "window" are only loosely connected via so called Intents. The final implementation of the working app consists of more than 100 custom Java classes. All parts of the application were tested, either manually or using automated tools. Unit tests were created for certain parts of the implementation, however, not all parts of the application are easily testable using unit tests or using tools performing black box testing. Robotium for Android, a powerful JUnit based testing framework for user interfaces on Android was used for some user interface tests. The tests were partly executed on emulator devices running different Android versions and on three different physical devices (Samsung Nexus S, ASUS Nexus 7, and Samsung Galaxy Xcover) Results and Conclusion: The current version of the application is a result of continuous improvement of the back and frontend. During the development of the app new requirements for the XML data language arose, as well as for the user interface. During the tests we realized that list based interactions with medical data sets have serious limitations. This is vital when using such applications within a medical context, especially in the context of emergency medicine, since list based interactions do not make use of the power that modern multi touch devices offer.