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 The University of Georgia Institute for Evidence Based Health Professions Education Conference March 30 th, 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 IndividualSystem

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 ADVANTAGE: Information & Communication Technologies Accessibility & Portability Multimedia Reproducibility Automaticity (data processing) Rule based decision branching Repository

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 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 UBC eHealth: 5 Directions

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

Clinical Practice Guidelines Clinical practice guidelines on PDA! C ondensed 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

Biometrics Monitoring ECG Microscopy Retinal screening Nano-technologies

Decision Support Team Based Care 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 care Triaging, clinical, operations Care Mapping: IP Electronic community (eCoP)

Decision Support Team Based Care Patient Engagement UBC eHealth: 5 Directions

31 Health Forum, Vancouver

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

Decision Support Team Based Care Patient Engagement Evidence Based Policy UBC eHealth: 5 Directions

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

WHO Global eHealth Observatory Rural telemedicine literature review 09/10 country surveys Key telemedicine trends Recommendations 1/14/2011 Published

Decision Support Team Based Care Patient Engagement Evidence Based Policy Evaluation 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-12Pre-HP Health System Clinician 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

eHealth Strategy Office Web: Facebook: on.fb.me/ehealthstrategy Twitter: Collaboration Welcome!