® MedBiquitous Orientation Valerie Smothers MedBiquitous MedBiquitous Annual Conference May 2,

® Objectives At the conclusion of the workshop, participants will be able to: Describe what a technology standard is and the potential benefits standards afford Describe technology standards developed by MedBiquitous Identify opportunities for collaboration and integration leveraging standards

® Overview Introductions What is MedBiquitous? What advances have been made? Summary How to participate

® Introductions What do you hope to learn today?

® What is MedBiquitous?

® 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

® The Fragmented Healthcare Industry Accrediting Bodies Societies Certifying Boards Licensing Boards Government International Partners Universities ?

® How it all started…

® A note about IP We give it away! No cost, no registration Very open license Download: Specifications XML Schemas Implementation toolkits

® MedBiquitous: Technology Standards for Healthcare Education 47 member organizations 8 Working Groups ANSI process Openness Transparency Consensus Due process Work with leading organizations that can drive adoption Professional Profile Learning Objects Activity Reporting Competencies Virtual Patients Metrics Curriculum Inventory Educational Trajectory

® 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

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

® 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. 10 min

® Why standards? To facilitate exchange of data and resources To enable collaboration To create economies and networks of scale Can you think of any examples?

® The Internet is based on standards HTML (web pages) Jpeg, ping, gif (images) MPEG (movies)

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

® What Standards has MedBiquitous created?

® Discovering and Sharing Educational Resources MedBiquitous Virtual Patient Healthcare LOM

® Mechanism for describing images and learning content in a repository Easier search and discovery, potentially automated Extends IEEE LOM Used by AAMC, HEAL, VA, CECity, many others

® MedEdPORTAL mededportal.org

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

® Healthcare LOM Structure

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® Moving Forward

® Virtual Patients Definition: An interactive computer simulation of real-life clinical scenarios for the purpose of medical training, education, or assessment. Why? Several schools are developing Need a framework that would allow these virtual patients to be shared across systems

® Why Share Virtual Patients? Costly to develop Time consuming to develop Requires significant technical, subject matter, and pedagogical expertise

® How Technology Standards for Virtual Patients Could Work Institution A Institution B Institution C Institution D Etc.

® 3-Year programme involving 6 separate projects 9 European partners and other collaborators Co-funded by the European Commission “To create a shared online bank of virtual patients, adapted for multicultural and multilingual use, for the improved quality and efficiency of medical and healthcare education across the world”

® eViP Partners 1.St George’s, University of London, UK 2.Karolinska Institutet, Sweden 3.Ludwig-Maximilians-University, Munich, Germany 4.University of Warwick, UK 5.Universiteit Maastricht, Netherlands 6.Heidelberg University, Germany 7.University of Medicine Cluj-Napoca, Romania 8.Uniwersytet Jagiellonski, Poland 9.University of Witten Herdecke, Germany

® Outcomes Repository of 320+ collective VPs for multilingual, multicultural access, and integrated into curricula Tried and tested standards Common content licensing model Major resource for medical and healthcare education to be shared by all institutions across the sector

® Why technology standards? Leverage content developed elsewhere (VP banks) Coordinate development efforts across a discipline (ex. Geriatrics Education) Provide flexibility in choosing VP authoring and delivery system (protecting your investment)

® Your Experience Activity Have you shared resources with other organizations? What are the benefits and complications of sharing resources? 5 min

® Tracking the Professional and the Accredited Provider Professional Profile Activity Report Medical Education Metrics

® 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

® Benefits of standardization 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

The Process An app that compiles data reports for the learner and/or other authorized viewers A collection of data repositories that can provide information for the eFolio Connector application Used with permission of AAMC and NBME

® Status of Professional Profile Approved standard Revising standard as part of required maintenance Version 2.0 draft available

® Activity Report Provides a standard XML format for CE/CPD certificates and Maintenance of Certification (MoC) activity reports Allows organizations to centrally track learning and performance improvement

Electronic CME The New Way Used with permission of the AOA and Medscape

® Status of Activity Report Approved standard Maintenance underway Version 2.0 draft available Users include American Board of Pediatrics, American Academy of Pediatrics, American Heart Association, HighWire Press, Mesdcape, AOA, and CECity

® MEMS: Medical Education Metrics Technology standard for core evaluation data Users Educators want best practices, ability to compare Funders want to measure reach and efficacy Accreditors want to measure success of activity and provider

® MEMS Data Activity Description What’s being evaluated Participant Activity Evaluation What did participants think Participation Metrics How many people participated Learner Demographics

® MEMS Use Case CE provider ACCME PARS CE provider

® Status of MEMS Approved standard Used by ACCME for Program Activity Reporting System (PARS) CECity, Rievent Technologies, DLC Solutions have implemented

® Tracking professionals Activity Exchanging certification activity data 10 min

® Break – 15 minutes

® Tracking and Measuring Competence Competency Framework Curriculum Inventory Educational Trajectory Performance Framework Educational Achievement

® Competency Framework An organized and structured representation of a set of interrelated and purposeful competency objects.

® 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

® Competency Object Any abstract statement of learning or performance expectations, and information related to the statement. ID Title Description Category

® Competency Framework.xml Professionalism.xml A competency object... Relates to other competency objects... xml Which can relate to external resources... Learning Object Educational activity Performance data/ assessment Current Specifications

® Status of Competency Framework Candidate drafts of schema and specification available; public review and ballot pending Draft of competency object schema and specification available, too. Working groups Standards committee ANSI Executive committee

® Curriculum Inventory Common XML format for Curriculum data for benchmarking and educational research Sponsored by the AAMC Enable local curriculum management systems to upload data to a central Curriculum Inventory Portal Identify curricular trends for benchmarking and reform

® Curriculum Inventory A E B F C G DH I J K L A 1 M E O N C G SH I J P R Q Competency framework Expectations Events Sequence blocks Integration blocks

® Curriculum Inventory Program A Program B Program C Curriculum Inventory What instructional methods are used to teach patient safety? AAMC Curriculum Inventory Portal

® Educational Trajectory Provides common format to support the tracking, planning, and audit of learners’ educational trajectory across medical schools and national organizations “the path of an individual learner through one or more programs of study…”

YearQuarter 1 (Jun - Aug) Quarter 2 (Sep - Nov) Quarter 3 (Dec – Feb) Quarter 4 (Mar – May) 05 – – – – Coursework leading to MD/primary degree Coursework beyond MD/primary degree Enrichment, priority Enrichment John Doe’s Educational Trajectory John Doe, December 8,

® Status of Educational Trajectory Schema and specification available on MedBiquitous website Profile of LEAP2A specification

® Performance Framework Use cases in development Enable reporting and documentation of performance levels in relation to specific competencies

® Example: Pediatrics Milestones

® Educational Achievement Documentation of competence and achievement of milestones Draft specification in development

My Activities and Responsibilities StatusActivitySummary Arterial puncture for blood gas analysis Entrustment Details Intravenous catheter insertionEntrustment Details... Manage patients with common, single system diagnoses who require a hospital setting In progress Details Care of a healthy newbornEntrustment Details Date of report: Oct 5, 2011 Date of achievement: Various Source: Various

® How do you know a trainee is qualified and what supervision is required? Trainee Is competent in At what level Professional profile Competency Framework Performance Framework Educational Achievement

The eFolio Connector An App that will sit “on top” of the Data Commons to compile & display an individual’s information The individual can: ▫view their own educational & assessment info ▫choose pieces of data to share with others (mentor, team member, authorized viewer) ▫add reflections, comments or personal thoughts on any piece of data ▫connect with classmates, colleagues, study partners, etc. Used with permission of the AAMC and the NBME

® Tracking professionals Activity Competency Implementation 15 min

® Summary

® Building the Foundation

® MedBiquitous Goals Better tracking and evaluation of professional education and certification activities Activity Report Medical Education Metrics Educational Trajectory Curriculum Inventory

® MedBiquitous Goals Easier discovery of relevant education and information resources when and where needed Healthcare LOM Interoperability and sharing of high quality online education MedBiquitous Virtual Patient

® MedBiquitous Goals Coordination and tracking of competence assessment data Professional Profile Competency Framework Educational Achievement Performance Framework

® Back to your challenges Can existing standards address any of the challenges you face? Are there needs for other standards? Are there potential benefits to using standards for your organization?

® How to Participate Become a member and sign up for working groups Become a member of the Standards Committee and vote on standards proposals Participate in meetings and share your work

® Contact Valerie Smothers