MedBiquitous Orientation

1. MedBiquitous Orientation Valerie SmothersMedBiquitous MedBiquitous Annual Conference May 13, 2008

2. Objectives At the conclusion of the workshop, participants will be able to: • Describe the benefits of standards in healthcare education and competence assessment. • Identify opportunities for participating in the standards development process.

3. Before we start • How many are planning to attend Virtual Patients in a Nutshell at 11?

4. Overview • Introductions • What is MedBiquitous? • Why standards? • Major Activities • Summary • How to participate

5. Introductions

6. What is MedBiquitous?

7. MedBiquitous Mission To advance healthcare education through technology standards that promote professional competence, collaboration, and better patient care. Not-for-profit, member-driven, standards development organization

8. The Fragmented Healthcare Industry Industry Universities Societies ? LicensingBoards CertifyingBoards Government Publishers AccreditingBodies

9. MedBiquitous: Technology Standards for Healthcare Education • 74 member organizations • 7 Working Groups • ANSI process • Openness • Transparency • Consensus • Due process • Work with leading organizations that can drive adoption Professional Profile Learning Objects Activity Reporting Metrics Virtual Patients Point of Care Learning Competencies

10. MedBiquitous Goals • Better tracking and evaluation of professional education and certification activities • Easier discovery of relevant education and information resources when and where needed • Interoperability and sharing of high quality online education • Coordination and tracking of competence assessment data

11. MedBiquitous Process Executive committee • Approves new standards projects • Meets via telco, in person • Develops specifications • Consensus body • Votes • Final approval Working groups Standards committee ANSI

12. Working Groups • Professional Profile • Standard for describing a healthcare professional • Credentials verification, administration, identification • Competencies • Standard for describing competency framework • Working with IEEE • Learning Objects • Healthcare LOM (describing learning activities) • SCORM for Healthcare (running e-learning)

13. Working Groups • Virtual Patient • Standards for interactive computer programs that simulate real life clinical scenarios • Activity Report • Tracking CE/MoC activities • Metrics • Aggregate evaluation data • Point of Care Learning • Integration with clinical systems • Tracking needs assessment and inquiry data

14. Activity Report WGThur, 3:30 PM Competency WGThur, 12 PM Learning Objects WG, Thur, 7:30 AM Metrics WG Thur, 12 PM Point of Care Learning WGThur, 7:30 AM Professional ProfileThur, 3:30 PM Virtual Patient WGToday, 3:30 PM Working Group Meetings

15. Why standards?

16. Why standards? Activity You are designing your own searchable cookbook for all of the recipes you download from the internet. Develop a data structure for a cooking recipe. Describe some of the benefits of having this standard.

17. Why standards? • To facilitate exchange of data and resources • To enable collaboration • To create economies and networks of scale

19. Your Challenges Activity What information exchange, coordination, or integration challenges do you have? 5 min

20. Major Activities

21. Coordinating Professional Healthcare • Professional Profile • Coordinating clinician data • Competencies • Coordinating competency data

22. Professional Profile Working Group • Mission: to develop XML standards and Web services descriptions to enable the exchange of clinician profile information across organizations and systems

23. Mike Zarski, American Osteopathic Association, Chair Archana Aida, American Board of Pediatrics Skip Bartolanzo, American Board of Pediatrics Tom Brantigan, TMA Resources Annette Van Veen Gippe, American Osteopathic Association David Hooper, Federation of State Medical Boards Jim Jahrling, American Board of Medical Specialties Paul Jolly, Association of American Medical Colleges Don Jones, American College of Chest Physicians Laura Martin, American Board of Pediatrics Joe O’Conner, Educational Comission for Foreign Medical Graduates Monica Quiroz, American Medical Association Kelly Reddick, American Board of Pediatrics Michael Rowan, Learn Something Pam Shellner, American Association of Critical-Care Nurses Cyndi Streun, Federation of State Medical Boards Howard Tanzman, American College of Surgeons Todd Tischendorf, CECity Toby Vandermark Participants

24. Professional Profile Use Case • Common format for exchanging information about healthcare professionals • Contact • Education • Training • Certification • License • Disciplinary action • Academic appointments • Memberships • Facilitates cross-organization collaboration

25. Benefits • Faster to process standardized data • Faster to develop new applications • Easier to work with partner organizations • Able to automate many business processes • Users: ABMS, AOA for faster credentialing

26. Status of Professional Profile Executive committee • Undergoing Public Review Complete • Ballot complete • Standards Implementation • Clinician credentialing • Data collection • Developing implementation guide and services documentation Working groups Standards committee ANSI

27. Competencies • Competency = any educational objective or educational outcome that results from knowledge, skills, or beliefs.

28. Competencies Working Group • Co-chairs: Rosalyn Scott, MD and Tim Willett, MD • Mission: develop a standardized framework to represent competency data • Existing work: IEEE Learning Technology Standards Committee (LTSC) has convened a Competency study group

29. Uses for a Competency Standard • Allow learners to track their accomplishments against a list of relevant competencies • Enable educators to see how their curriculum fits into a competency framework • Enable content developers to tie educational activities to a competency framework

31. Coordinating in Primary Care Activity Exchanging membership data Promoting a core curriculum 7 min

32. Finding Educational Activities and Content • Healthcare Learning Object Metadata (Healthcare LOM) • Finding learning activities

33. Healthcare Learning Object Metadata (LOM) • Metadata Definition: the data that describes a resource. • Example: card catalog information for a book: author, title, publication date, topic, etc. • Problem: many organizations use completely different metadata schemes. • Example: keyword = “Renal Failure” vs. Topic = “Renal Failure”

34. Healthcare LOM Working Group Mission To develop XML and Web services standards to enable interoperability, accessibility and reusability of Web-based medical learning content.

35. Healthcare LOM Uses Title: Aresenic Toxicity Keyword: Environmental medicine, MeSH D019550 Target audience: Physician, registered nurse Credits:: CME 1.5 AMA PRA Category 1; CNE 1.7 contact hours Title: Preventing sports injuries Target audience: Patient Health Education DatabaseB

36. Healthcare LOM Uses CE Evaluation Interdisciplinary teams

37. Morgan Bantly, Department of Veterans Affairs , Chair Patti Abbott, Johns Hopkins University Trupti Bakrania, St George's University of London Ravi Teja Bhupatiraju, Oregon Health and Sciences University Gabrielle Campbell, Association of American Medical Colleges Chris Candler, M.D., Association of American Medical Colleges Dawn Carroll, Department of Veterans Affairs David Davies, Ph.D., University of Warwick  Nancy Davis, Ph.D., National Institute for Quality Improvement and Education Sharon Dennis, M.S., HEAL Shona Dippie, HEAL Rachel Ellaway, Northern Ontario School of Medicine Nancy Gathany, Centers for Disease Control and Prevention Stuart Gilman, M.D., Department of Veterans Affairs William Hersh, M.D., Oregon Health and Sciences University Lorena Hitchens, HighWire Press Julie Lambla, American Association of Critical-Care Nurses Tao Le, M.D., Johns Hopkins University Joy Leffler, WEMOVE Ross Martin, M.D., Pfizer Jim Martino, Ph.D., Johns Hopkins University Sandra McIntyre, M.Ed., HEAL Don O'Guin, Pfizer Jennifer Ott, Healthstream Beth Powell, Centers for Disease Control and Prevention Andrew Rabin, CECity Mike Rowan, LearnSomething Chris Rueger, Healthstream Deborah Sher, Department of Veterans Affairs Damon Silver, HighWire Press Carl Singer, CECity Sebastian Uijtdehaage, Ph.D., HEAL David Ward, American Association of Critical-Care Nurses Walter Wolyniec, Boehringer Ingelheim Dan Rehak, Ph.D. Jorge Ruiz, M.D., University of Miami Charles Willis, American Gatroenterological Association Learning Objects Working Group

38. Healthcare LOM Structure

39. Healthcare LOM Structure

40. Save money – don’t reinvent, reuse Improve access to content – internally or across organizations Use content in innovative ways Users – HEAL, MedEdPortal, VA Ballot complete - In ANSI review Benefits

41. Break – 10 minutes

42. Sharing and Reuse of Educational Resources • SCORM for Healthcare • Self-directed Web-based learning • Virtual Patients • Web-based simulations of clinical encounters

43. Shareable Content Object Reference Model An e-learning model that enables accessibility, reuse, and interoperability of learning objects and tracking of learner progress. Standards for running, packaging, and describing learning content Broad international adoption SCORM

44. SCORM for Healthcare • Profile of SCORM • Leverages extensions to SCORM metadata called Healthcare Learning Object Metadata (Healthcare LOM) • Developed by MedBiquitous All SCORM for Healthcare content is conformant with SCORM

45. Challenges in Defense Training • Content not portable / interoperable • Content monolithic and not easily updated • Content cannot be shared

46. Goals of SCORM

47. Status of SCORM for Healthcare • Draft specification available • Users – VA co-developing content in conjunctions with other government agencies

48. Virtual Patients Definition:An interactive computer simulation of real-life clinical scenarios for the purpose of medical training, education, or assessment. • Several schools are developing • Very costly to create • No common framework that would allow these virtual patients to be shared across systems

50. Virtual Patient Working Group Mission To develop XML standards and Web services requirements to enable interoperability, accessibility and reusability of Web-based virtual patient learning content.