1. 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

2. 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?

3. Health System & Academia How can we (students, faculty, universities) contribute? STUDY & SERVICE

4. Advantage: eHealth Definition Using Information Technologies: Health service delivery Education Research Knowledge Translation

5. Agenda Learning in practice: Context Technology Enabled Learning considerations UBC eHealth journey Questions, comments

6. Life Long Learning Continuum Undergraduate (4 yrs) Post-graduate (4-6 yrs) Professional (20+ yrs)

7. Learning in Practice: Challenges

8. Knowledge/skills New Knowledge Knowledge deterioration

9. 9 Stages of Change Pre-contemplative Contemplative PreparationAction Maintenance of change LIFE LONG LEARNING

10. From Knowledge to Competence Knows Shows how Knows how Does

11. Learning Dynamics IndividualSystem

12. HP Education Context: Summary Volume of knowledge/evidence Stages of learning & reflection From knowledge to competence Tied to health system (& work)

13. K Ho Technology Enabled Learning 11.200913 ADVANTAGE: Information & Communication Technologies Accessibility & Portability Multimedia Reproducibility Automaticity (data processing) Rule based decision branching Repository

14. 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

15. Dynamic Case Audits Tonsillar Abscess Mx

16. Simulators Resuscitation EHR implementation

17. Disease Surveillance Dashboard http://www.hc-sc.gc.ca/pphb-dgspsp/dsol-smed/ Example:

18. 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

19. 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

20. 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

21. 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?

22. UBC eHealth Strategy Office Journey… “ICT to enable academic mission: Education, Research, Knowledge Translation” Technology Enabled Knowledge Translation

23. Decision Support TEKT @ UBC eHealth: 5 Directions

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

25. 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

26. Biometrics Monitoring ECG Microscopy Retinal screening Nano-technologies

27. Decision Support Team Based Care TEKT @ UBC eHealth: 5 Directions

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

29. Evidence 2 Excellence: E2E for EM BC Emerg. Depts. MoH, HAs Standard of care Triaging, clinical, operations Care Mapping: IP Electronic community (eCoP) http://www.evidence2excellence.ca/

30. Decision Support Team Based Care Patient Engagement TEKT @ UBC eHealth: 5 Directions

31. 31 Health Forum, Vancouver

33. www.iconproject.org

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

35. Decision Support Team Based Care Patient Engagement Evidence Based Policy TEKT @ UBC eHealth: 5 Directions

36. 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

37. 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

38. Decision Support Team Based Care Patient Engagement Evidence Based Policy Evaluation TEKT @ UBC eHealth: 5 Directions

39. 5 Evaluation Areas Quality of Care Health Access Cost Effectiveness End user satisfaction Usability

40. 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

41. Translational informatics Genomics Metabolomics Proteomics Pharmaconomics Populomics

42. 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

43. eHealth Strategy Office Web: www.eHealth.med.ubc.ca Facebook: on.fb.me/ehealthstrategy Twitter: www.twitter.com/ehealhtstrategy Collaboration Welcome!