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Group Communication & Point of Care Learning

Group Communication & Point of Care Learning. David Topps Medbiq 2009. Who are we?. Academic Family Health Team Northern Ontario New service delivery model Removes fee-for-service pressures Collaborative practice Collaborative learning. Key messages. Small changes make progress

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Group Communication & Point of Care Learning

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  1. Group Communication & Point of Care Learning David Topps Medbiq 2009

  2. Who are we? • Academic Family Health Team • Northern Ontario • New service delivery model • Removes fee-for-service pressures • Collaborative practice • Collaborative learning

  3. Key messages • Small changes make progress • Information overload Health care is a Team Pursuit

  4. Change Fatigue The remedy, say the experts, flies in the face of the revolutionary approach to change… be less preoccupied with large-scale transformation, and focus instead on small improvements. Nick Morgan, Harvard Business School, 2001 http://hbswk.hbs.edu/item/2485.html

  5. Group calendaring

  6. Team Sites and wikis • Clinical Practice Guidelines • Care pathways • Lots out there • Whose do you use? • Allowing for customisation • Optimised for local factors

  7. Team Sites and wikis

  8. Email vs. RSS • FHT for Practice blog • portal or wiki as a separate daily task? • Email overload vs. email as your life organiser

  9. Dashboards & Widgets • Associated with Business Intelligence • Another oxymoron? • Heavily oriented towards financial • Expensive • Be careful what you measure • Sad example of NOSM metrics • GIGO collection • Dreadful display axes – actually misleading

  10. Widgets

  11. Widgets Dim stand_alone as Boolean Dim useful as Boolean IF stand_alone = True THEN NOT useful END IF

  12. Widgets • IF standalone THEN NOT useful • Need to integrate with EMR • Who wants to type in parameters again into a Creatinine Clearance calculator? – the data is already there in the EMR • Same challenge for PDA tools • Classic case call handover utility • Often sought • Sometimes downloaded • Seldom used

  13. Widget standards • PoC group InfoButtons • Have defined some standards • Will this help? • Integrate with other programs • Which will require an interface standard • But problems for EMR vendors

  14. Problems for EMR vendors • Add-ins • Tend to be clunky • Expensive to maintain • Not much influence on purchasing decision • So why put in the investment? • Same challenge with the promises from most EMR vendors about having a PDA interface • So… don’t reinvent the interface • Think what data you need to use/send/receive

  15. Gadget Inspector • Just being a Google Gadget is fashionable • But is not enough in itself to be other than just cute • For many things that are created, you would be better off with a link to a web page

  16. Dashboard click-through • Information fatigue • Irrelevant information…

  17. Annoying as hell…

  18. Dashboard click-through • Information fatigue • Irrelevant information… • users quickly learn to ignore the messages • Finding the optimum level • MS has been trying to find this for years • Remember Clippit the paper clip?

  19. Ticklers & Reminders • Same click-through problem • Story from Sarasota • removal of all warnings

  20. Ticklers for needed actions Find the right level of intrusiveness

  21. Surprise Tickler

  22. Screensaver

  23. A Surprise Tickler • Odd effect of Windows screensaver • Reminder that I am behind schedule • Educational slide shows for patients

  24. Instant Messaging

  25. Instant Messaging • In-house system • Useful IF you are watching the screen • Staff still mostly knock on the door • Odd, since this is more intrusive • Explore the psych barriers here?

  26. IM Presence

  27. Presence systems • Great for close-knit developer team • Extreme example in Learning Commons • real-time video 24/7 • Physicians more independent • resistant to being “watched”

  28. Electronic Learning Prescriptions • Reminders better than paper system • PDA version not integrated to patient • Now using the EMR to do this

  29. Learning Rx in the EMR

  30. Learning Rx in the EMR

  31. Learning Rx in the EMR

  32. Wrap-up • Small changes • Info overload • Sorry, that’s what I’ve just done to you!

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