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

Kendall Ho, MD FRCPCAssociate Professor, Emergency MedicineDirector, eHealth Strategy OfficeFaculty of Medicine, University of British Columbia

The University of Georgia

Institute for Evidence Based

Health Professions Education Conference

March 30th, 2012

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?

Health System & Academia

How can we (students, faculty,

universities) contribute?

STUDY & SERVICE

Advantage: eHealth

Definition

Using Information Technologies:• Health service delivery• Education• Research• Knowledge Translation

Agenda

Learning in practice: Context

Technology Enabled Learning considerations

UBC eHealth journey

Questions, comments

Life Long Learning Continuum

Undergraduate (4 yrs)

Post-graduate (4-6 yrs)

Professional (20+ yrs)

Learning in Practice: Challenges

Knowledge/skills

New Knowledge

Knowledge deterioration

9

Stages of Change

Pre-contemplative

Contemplative

PreparationAction

Maintenance

of change

LIFE

LONG

LEARNING

From Knowledge to Competence

Knows

Shows how

Knows how

Does

Learning Dynamics

Individual System

HP Education Context: Summary

Volume of knowledge/evidence

Stages of learning & reflection

From knowledge to competence

Tied to health system (& work)

K Ho Technology Enabled Learning 11.2009

13

ADVANTAGE: Information & Communication Technologies

• Accessibility & Portability

• Multimedia

• Reproducibility

• Automaticity (data processing)

• Rule based decision branching

• Repository

Technology Enabled Learning?

TEL Archetypes/Models:

1. Videoconferencing, webinars

2. Automated CE, learning objects

3. Cased Based: Web cases, simulations

4. Facilitation: electronic Community of Practice

5. Self assessment: learning portfolios

6. System reflection: public health data

Dynamic Case Audits

• Tonsillar Abscess Mx

Simulators

• Resuscitation

• EHR implementation

Disease Surveillance Dashboard

http://www.hc-sc.gc.ca/pphb-dgspsp/dsol-smed/

Example:

TEL Archetypes/Models:

1. Videoconferencing, webinars

2. Automated CE, learning objects

3. Cased Based: Web cases, simulations

4. Facilitation: electronic Community of Practice

5. Self assessment: learning portfolios

6. System reflection: public health data

DATA/HI INTENSITY

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

Stages of Change & TEL

Pre-contemplative

videoconferencing, webinars

Contemplative Automated CE, learning objects

Preparation Case based learning, simulations

Action Discussion, eCOP, self audit

Habit Formation

Learning portfolio, systems reflection

DATA/HI INTENSITY

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?

UBC eHealth Strategy Office Journey…

“ICT to enable academic mission:

Education, Research, Knowledge Translation”

Technology Enabled

Knowledge Translation

Decision Support

TEKT @ UBC eHealth: 5 Directions

Telehealth

Emergency telehealth

Tele-dermatology

Tele-pathology

Tele-mental health

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:

AsthmaCardiovascular DiseaseChronic Kidney Disease

COPDDiabetes

Depression

Heart Failure CareHepatitis BHepatitis C

HypertensionOsteoarthritis

Rheumatoid Arthritis

Biometrics Monitoring

ECG

Microscopy

Retinal screening

Nano-technologies

Decision Support

Team Based Care

TEKT @ UBC eHealth: 5 Directions

Technology Enabled AD

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

Evidence 2 Excellence: E2E for EM

BC Emerg. Depts.

MoH, HAs

Standard of careTriaging, clinical,

operations

Care Mapping: IP

Electronic community (eCoP)

http://www.evidence2excellence.ca/

Decision Support

Team Based Care

Patient Engagement

TEKT @ UBC eHealth: 5 Directions

31Health Forum, Vancouver

www.iconproject.org

Other Possiblities

Text messaging

Apps

Biometrics monitoringBlood pressure

Pedometer

Weight

Oxygen saturation

…

Decision Support

Team Based Care

Patient Engagement

Evidence Based Policy

TEKT @ UBC eHealth: 5 Directions

Evidence Based PolicyProvincial

Tele-mental healthPublic engagement in eHealth

NationalEHR training in academiaAboriginal eHealth benefits evaluation

International Telehealth for the underservedMobility of eHealth professionals

WHO Global eHealth Observatory

Rural telemedicine literature review

09/10 country surveys

Key telemedicine trends

Recommendations

www.who.int/goe/publications/ehealth_series_vol2/en/index.html

1/14/2011

Published

Decision Support

Team Based Care

Patient Engagement

Evidence Based Policy

Evaluation

TEKT @ UBC eHealth: 5 Directions

5 Evaluation Areas

Quality of Care

Health Access

Cost Effectiveness

End user satisfaction

Usability

HI Capacity: Blueprint

Medicine, Nursing, Pharmacy, …

K-12 Pre-HP Health SystemClinician

Health Informatician

Health Consumer

HI, Comp Sc, Engineering, Library science…

Min. of Education, Schools, …

Govt., NGOs

Translational informatics

Genomics

Metabolomics

Proteomics

Pharmaconomics

Populomics

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

e H e a l t h S t r a t e g y O f f i c e

Web: www.eHealth.med.ubc.ca

Facebook: on.fb.me/ehealthstrategy

Twitter: www.twitter.com/ehealhtstrategy

Collaboration Welcome!