Leveraging eHealth in Education and Practice: Opportunities, Challenges, Lessons Learned (so far…)

1. The University of Georgia Institute for Evidence Based Health Professions Education Conference March 30th, 2012 Leveraging eHealth in Education and Practice:Opportunities, Challenges, Lessons Learned (so far…) Kendall Ho, MD FRCPC Associate Professor, Emergency Medicine Director, eHealth Strategy Office Faculty of Medicine, University of British Columbia

2. Health System pressures… Evidence based care models? Increase service capacity? Health access for the underserved? Improve cost effectiveness? Patient satisfaction, engagement, & safety? Hospital/health system management? Anticipating future transformative care?

3. Health System & Academia How can we (students, faculty, universities) contribute? STUDY & SERVICE

4. Definition Using Information Technologies: Health service delivery Education Research Knowledge Translation Advantage: eHealth

5. Agenda Learning in practice: Context Technology Enabled Learning considerations UBC eHealth journey Questions, comments

6. Post-graduate (4-6 yrs) Undergraduate (4 yrs) Professional (20+ yrs) Life Long Learning Continuum

7. Learning in Practice: Challenges

8. New Knowledge Knowledge deterioration Knowledge/skills

9. Stages of Change Pre-contemplative LIFE LONG LEARNING Maintenance of change Contemplative Action Preparation

10. Does Shows how Knows how Knows From Knowledge to Competence

11. Learning Dynamics Individual System

12. HP Education Context: Summary • Volume of knowledge/evidence • Stages of learning & reflection • From knowledge to competence • Tied to health system (& work)

13. Accessibility & Portability • Multimedia • Reproducibility • Automaticity (data processing) • Rule based decision branching • Repository Technology Enabled Learning? ADVANTAGE: Information & Communication Technologies K Ho Technology Enabled Learning 11.2009

14. TEL Archetypes/Models: • Videoconferencing, webinars • Automated CE, learning objects • Cased Based: Web cases, simulations • Facilitation: electronic Community of Practice • Self assessment: learning portfolios • System reflection: public health data

15. Dynamic Case Audits • Tonsillar Abscess Mx

16. Simulators • Resuscitation • EHR implementation

17. Disease Surveillance Dashboard http://www.hc-sc.gc.ca/pphb-dgspsp/dsol-smed/ Example:

18. TEL Archetypes/Models: • Videoconferencing, webinars • Automated CE, learning objects • Cased Based: Web cases, simulations • Facilitation: electronic Community of Practice • Self assessment: learning portfolios • System reflection: public health data DATA/HI INTENSITY

19. Making TEL Stick, Consider… • Media (VC, Internet, computer, podcasting, tablets, smart phones, Web 2.0, …) • Engagement: push, pull, interactivity, facilitation, co-creation, "lurkers" • Practice integration: workflow, habits, contexts • Stage of learners

20. Stages of Change & TEL DATA/HI INTENSITY

21. TEL: What if…. • The system crashes? • Data loss? • The capacity does not suffice? • Security breach? • Student technical difficulties? • Student technical literacy? • Technology access is limited?

22. Technology Enabled Knowledge Translation UBC eHealth Strategy Office Journey… “ICT to enable academic mission: Education, Research, Knowledge Translation”

23. Decision Support TEKT @ UBC eHealth: 5 Directions

24. Telehealth Emergency telehealth Tele-dermatology Tele-pathology Tele-mental health

25. Clinical Practice Guidelines Clinical practice guidelines on PDA! Condensed Guidelines are viewable on both Windows PocketPC (mobile) and Palm • 24 guidelines available on PDA. Including: • Asthma • Cardiovascular Disease • Chronic Kidney Disease • COPD • Diabetes • Depression • Heart Failure Care • Hepatitis B • Hepatitis C • Hypertension • Osteoarthritis • Rheumatoid Arthritis

26. Biometrics Monitoring ECG Microscopy Retinal screening Nano-technologies

27. Decision Support Team Based Care TEKT @ UBC eHealth: 5 Directions

28. Technology Enabled AD using IT technologies (e.g. Internet, computer, PDAs) to conduct AD.

29. BC Emerg. Depts. MoH, HAs Standard of care Triaging, clinical, operations Care Mapping: IP Electronic community (eCoP) Evidence 2 Excellence: E2E for EM http://www.evidence2excellence.ca/

30. Patient Engagement Decision Support Team Based Care TEKT @ UBC eHealth: 5 Directions

31. Health Forum, Vancouver 31

33. www.iconproject.org

34. Other Possiblities • Text messaging • Apps • Biometrics monitoring • Blood pressure • Pedometer • Weight • Oxygen saturation • …

35. Patient Engagement Evidence Based Policy Decision Support Team Based Care TEKT @ UBC eHealth: 5 Directions

36. Evidence Based Policy • Provincial • Tele-mental health • Public engagement in eHealth • National • EHR training in academia • Aboriginal eHealth benefits evaluation • International • Telehealth for the underserved • Mobility of eHealth professionals

37. WHO Global eHealth Observatory • Rural telemedicine literature review • 09/10 country surveys • Key telemedicine trends • Recommendations 1/14/2011 Published www.who.int/goe/publications/ehealth_series_vol2/en/index.html

38. Patient Engagement Evidence Based Policy Decision Support Team Based Care Evaluation TEKT @ UBC eHealth: 5 Directions

39. 5 Evaluation Areas Quality of Care Health Access Cost Effectiveness End user satisfaction Usability

40. Clinician K-12 Pre-HP Health System Health Informatician Health Consumer HI Capacity: Blueprint • Medicine, Nursing, Pharmacy, … HI, Comp Sc, Engineering, Library science… Govt., NGOs Min. of Education, Schools, …

41. Translational informatics Genomics Metabolomics Proteomics Pharmaconomics Populomics

42. eHealth in Learning & Practice • Integrate TEL to learning and self reflection • Integrate EHR to practice and self audit • Monitoring & surveillance for system change • Portable computing & mobile Health • Social media & Web 2.0

43. Collaboration Welcome! Web: www.eHealth.med.ubc.ca Facebook: on.fb.me/ehealthstrategy Twitter: www.twitter.com/ehealhtstrategy