1. Peter Greene, MD Executive Director May 18, 2015
Building the Infrastructure for Continuous Improvement: A MedBiquitous Update
Peter Greene, MD
Executive Director
May 18, 2015

2. MedBiquitous Mission
To develop and promote technology standards for the health professions that advance lifelong learning, continuous improvement, and better patient outcomes.
MedBiquitous has changed, too.

3. Building the Foundation: The MedBiquitous Architecture
* Official ANSI Standards

4. ANSI Reaccreditation
Streamline development process
Ensure balanced representation

5. Performance Framework Standard approved April 17
Technical infrastructure for standardizing performance measurement
“Accelerated” by support from AAMC

6. Performance Framework
An image of the WOMBAT system at the Royal Australasian College of Surgeons. WOMBAT stands for Workplace Oriented MedBiquitous Based Assessment Tools. Surgeons conduct self assessment and then nominate peers to rate their performance using an established framework describing poor and good behaviors. The data structure is built based on MedBiquitous standards.
Used by permission of Ian Graham

7. WOMBAT

8. Draft schema and specification for Financial Interest
Data required for disclosures
Will enable Convey system to centralize updates and dissemination

9. Medical Education Metrics
Enabled compilation of data on CE related to ER/LA Opioids across the CE industry
262 activities reported in 2014

10. Curriculum Inventory
120 Medical Schools uploaded Curriculum data to AAMC Curriculum Inventory in 2014

11. Virtual Patients: Department of VA
Total Simulations: 31,025
Unique Users: 19,856
Published Simulations: 20
Total Decisions: 453,751
Through April 30, 2015

12. VA Simulation Reporting and Analysis
Learner Record Store
Rosalyn Scott completed CPR simulation
Rosalyn Scott demonstrated competency “perform chest compressions” to level 3, mastery.
Rosalyn Scott completed CPR simulation checklist.
Rosalyn Scott demonstrated competency “assessed circulation” to level 3, mastery.
Rosalyn Scott completed CPR virtual patient.
Rosalyn Scott demonstrated competency “Select appropriate medication” to level 3, mastery.
XAPI
Simulation
Checklist
Assessed airway?
Assessed circulation?
XAPI
Learner data may come from several sources. In this example, learner data comes from the mannequin used in simulation, an assessor’s ratings on a computer based checklist, and a virtual patient activity. All of that data can be compiled in a learner record store using the XAPI, allowing the VA to see a more complete picture of a learner’s competencies. Click to see an image of a chart that shows the kinds of graphs that can be produced with this data. The graph shows the learner’s performance related to ACLS Maintain Circulation competencies, and the data is being compiled from multiple sources.
XAPI

13. Emerging Tends and Possible Scope Change for the Consortium
MedBiquitous Technical Steering Committee Emerging Trends and Possible Scope Change for Standards Work
Emerging Tends and Possible Scope Change for the Consortium

14. Application Programming Interface (API)

15. Paradigm Shift Move from data exchange to: Integration
Analytics on aggregate data
Professionals accessing (owning) their data managed by various providers

16. Implications of Shift Implications of Shift
API
API
API
Insights revealed
in aggregate view
Data
Document becomes API payload
Payloads may need finer granularity
May need ways to decompose existing formats

17. Fast Health Interoperable Resources (FHIR)

18. Tin Can API

19. HealthKit and ResearchKit APIs

20. Driving Innovation