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Mile Marker software streamlines surgical residency evaluations

Aimee Martin, the CEO of Mile Marker. (Maximilian Franz)

Aimee Martin, the CEO of Mile Marker. (Maximilian Franz)

Where medical residents once used index cards to track how well they handled their cases, a Baltimore startup wants its software to help change medical education through a data-driven approach.

Mile Marker produces software allowing surgical residents and their attending physicians to rate their performance post-procedure providing more instant feedback and significantly reducing the amount of time spent evaluating residents each year.

The software tracks how residents do on a series of milestone competencies set by the Accreditation Council for Graduate Medical Education (ACGME) in 2013 and 2014.

“We’re focused on trying to deploy the software in every single specialty in every teaching hospital in the world,” said Aimee Martin, Mile Marker’s CEO. “It’s a captive market. Everybody needs this because of regulatory changes that are going to competency training.”

Mile Marker, which participated in the M-1 Ventures accelerator last year, is based on technology developed by doctors in the Johns Hopkins/University of Maryland plastic surgery residency program as a response to the ACGME milestone competencies.

Under the competency program, residents rate their performance on a scale of one to five in a variety of areas and surgeries post-procedure. Attending physicians also make evaluations. Residents must achieve mastery in the milestones in order to graduate.

Using Mile Marker, residents and attending physicians can make their evaluations on their smartphone, tablet or computer.

It represents a more regimented process than the one that previously existed. Martin said her husband, a plastic surgeon, carried index cards with him during his residency to keep track of cases.

But even under the new competency system, case tracking and evaluation could still leave more room for opinion. And evaluations took a long time. When the doctors at Hopkins first evaluated their residents, it took an hour for each resident. With up to 31 residents at a time, the evaluation period could take up multiple work days.


The Mile Marker technology allows residents and attending physicians to enter data in a matter of minutes. (Maximilian Franz)

“That would be very disruptive for a practice as busy as ours,” said Dr. Scott Lifchez, the Johns Hopkins/University of Maryland plastic surgery residency program director and a co-inventor of the Mile Marker system. “We said we need to figure out a way to have the information to make a fair and accurate assessment of our learners.”

Lifchez and other physicians created a tool they called the operative and trustability assessment. It allowed residents to enter their evaluation in as little as 60 seconds and attending physicians to enter their evaluations in just 15 seconds.

The change significantly reduced the amount of time on those resident evaluation meetings. Instead of an hour, they now average 5.6 minutes per resident, Martin said. She estimated cost savings to departments at $500,000.

The system also allows the residency program to cater to its student demographic — millennials.

“They like a lot of feedback,” Lifchez said. “How did you do? What was good about it? What was bad about it? What do I need to do better next time?”

The Mile Marker tool provides a simple way for evaluators to provide that feedback, whether it ranges from tips for holding a scalpel to insight on a procedure. Feedback was rare when Lifchez completed his residency.

“I trained in the environment where you would get these scantily required assessments,” he said. “Rarely would you get those great nuggets of a comment, where someone would say here is something I want you to work on.”

Mile Marker hopes to use its utility and connection to Johns Hopkins as it looks to make deals with more teaching hospitals.

Martin was brought in as the CEO with a business background to help the company figure out that part of its future. She has experience as an investment banker with an MBA from Harvard and experience with education technology at Educate Inc.

She hopes to use the software in a broad variety of areas. The first expansion will include medical specialties beyond plastic surgery. But the possibilities could include any area that requires training and evaluation.

“Our system is designed to be able to assess anything that somebody can observe,” Lifchez said.

The possibilities also go beyond evaluation. The system will create a wealth of data for educators to use. So far, the system has accumulated about 10,000 points of data.

 “We also are very excited about the prospect of the largest longitudinal dataset of its kind to show how medical training really is done,” Martin said.

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