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 GeorgiaInstitute for Evidence BasedHealth Professions Education ConferenceMarch 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

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

AgendaLearning in practice: ContextTechnology Enabled Learning considerationsUBC eHealth journeyQuestions, 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

Maintenanceof change

LIFELONG

LEARNING

From Knowledge to Competence

Knows

Shows how

Knows how

Does

Learning Dynamics

Individual System

HP Education Context: SummaryVolume of knowledge/evidenceStages of learning & reflectionFrom knowledge to competenceTied to health system (& work)

K Ho Technology Enabled Learning 11.2009

13ADVANTAGE: Information & Communication Technologies

• Accessibility & Portability• Multimedia• Reproducibility• Automaticity (data processing)• Rule based decision branching• Repository

Technology Enabled Learning?

TEL Archetypes/Models:1. Videoconferencing, webinars2. Automated CE, learning objects 3. Cased Based: Web cases, simulations4. Facilitation: electronic Community of

Practice5. Self assessment: learning portfolios6. 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, webinars2. Automated CE, learning objects 3. Cased Based: Web cases, simulations4. Facilitation: electronic Community of

Practice5. Self assessment: learning portfolios6. 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, contextsStage of learners

Stages of Change & TELPre-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

TelehealthEmergency telehealthTele-dermatologyTele-pathologyTele-mental health

Clinical Practice GuidelinesClinical practice guidelines on PDA!Condensed Guidelines are viewable on both

Windows PocketPC (mobile) and Palm24 guidelines available on PDA. Including:

AsthmaCardiovascular DiseaseChronic Kidney Disease

COPDDiabetes

Depression

Heart Failure CareHepatitis BHepatitis C

HypertensionOsteoarthritis

Rheumatoid Arthritis

Biometrics Monitoring

ECGMicroscopyRetinal screeningNano-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 EMBC Emerg. Depts.MoH, HAsStandard of careTriaging, clinical,

operationsCare Mapping: IPElectronic 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 PossiblitiesText messagingAppsBiometrics monitoring

Blood pressurePedometerWeightOxygen 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 ObservatoryRural telemedicine literature review09/10 country surveysKey telemedicine trendsRecommendations

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 AreasQuality of CareHealth AccessCost EffectivenessEnd user satisfactionUsability

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 informaticsGenomicsMetabolomicsProteomicsPharmaconomicsPopulomics

eHealth in Learning & Practice

Integrate TEL to learning and self reflectionIntegrate EHR to practice and self auditMonitoring & surveillance for system changePortable computing & mobile HealthSocial 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.caFacebook: on.fb.me/ehealthstrategyTwitter: www.twitter.com/ehealhtstrategy

Collaboration Welcome!