Oral Health SymposiumFriday 9th November 2012

Dr. Ambica DattakumarHealth & Biomedical Informatics Research UnitUniversity of Melbourne

Are We Educating the Future Clinical Health Professional Workforce Adequately for eHealth Competence? Current Australian Context and Data

A national effort

Team:Kathleen Gray & Ambica Dattakumar, University of

MelbourneHelen Chenery, University of Queensland

Anthony Maeder, University of Western SydneyKerryn Butler-Henderson, Curtin University, WA

Aiming to initiate and encourage... A Coordinated Interprofessional Approach To Curriculum Renewal For eHealth Capability In Clinical Health Professional Degrees

With support from DEEWR OLT 2011-2012 2

An interprofessional approach

All Australian tertiary degrees for entry into clinical practice:

Medicine Nursing Dentistry Allied Health & Complementary Therapies + a few more from the Australian and New

Zealand Standard Classification of Occupations in medicine, nursing and other health professions.

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Project Activities http://clinicalinformaticseducation.pbworks.comGoogle: Clinical Informatics Education PBworks

Literature review Accreditation guidelines review Degree coordinator survey & interviews Degree coordinator workshops Health workforce planning Educational resources inventory__________________________________ eHealth in clinical job description analysis

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Can we use the peer reviewed literature as a starting point for curriculum renewal for ehealth?

Educating future clinicians about clinical informatics:

A review of implementation and evaluation cases.

European Journal of Biomedical Informatics, 2011.

There are very few accounts of learning, teaching or assessment that use externally validated instruments or processes.

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Accreditation guidelines 1

21 Accreditation Documents from health professions including allied health, medicine and nursing, were reviewed over the course of 2 months.

The documents were searched for IT related terms, for example, technology, computers, electronic etc. The relevant sections were also read.

Quotes were sorted by search terms and professions.

Quotes were grouped under themes such as e-health, technology etc. and analysed.

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Accreditation Guidelines 2

Evidence based practice is widely used in all documents.

Computers, Information Technology/ICT are specified more often as physical resources/facilities.

As a topic for study, ICT related terminology is vague.

‘Electronic communication’ is not a widely used term.

The term eHealth is not present in any of the documents.

8/21documents were last updated in 2010. The oldest document dates back to 2001.

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National survey & interviews

400 invitations; 105 completed surveys and 35 interviews

~40 different health professions in all States and Territories

What are they doing about ehealth in the degrees for which they are responsible?

What matters about ehealth to degree coordinators of health profession degrees?

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“Our students would be required to know how to use patient records, how to access and undertake reviews of the literature”. Dietitian /Nutritionist, P29 graduates to be able to conduct research to any great degree, and do not wish for us to teach them electronic patient care records as this is done once they are in their grad year”. Paramedic, P77

“It is required that students demonstrate an awareness of electronic record storage - in the competency based outcome standards”. Speech Pathologist, P104

“Not one of their criteria, but it is expressed in discussion”. Medical Practitioner, P24 10

“Our assessment strategies are always aligned with our learning objectives and so yes some of our strategies will address some aspects of ehealth”. Medical Imaging Professional/Radiographer, P88 “Our assessment strategies do not address anything related to ehealth”. Psychologist, P4 11

“Yes we use info from NEHTA [National eHealth Transition Authority]”. Dietitian, P100

“Curriculum design and implementation is always a balance between the needs of the program overall and the apparent needs of a discipline. It is generally not possible to access, assess and implement all external curricula in our curricula. We do however use them (at times) to bench mark our curriculum”. Medical Practitioner, P91

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Workshops

February 2012: Brisbane, Sydney, Perth, Melbourne / 52 participants

Interactive, interprofessional, invited panellists from govt, industry, peak bodies.engagement with and feedback on findings

from lit review and survey.contribution of ‘local’ institutional and

disciplinary perspectives, practices and needs.

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Top 10 Priorities 1.14: Apply ethical and security issues.

2.3 Apply principles of clinical decision making.

3.3: Apply ability to communicate electronically.

1.3: Apply efficient responsible use of information process tools.

2.6: Apply principles of evidence-based clinical practice.

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Top 10 Continued... 3.11: Understand methods of decision support.

1.2: Understand needs for systematic information processing.

1.16: Understand informatics methods and tools.

2.15: Apply identity management in healthcare.

2.8: Remember quality assessment and performance in healthcare.

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Job Description Analysis 1

Over 100 job descriptions were analysed over the past 2 months.

From this, over 60 jobs were shortlisted as a result of searching for ehealth/IT skills across the clinical health professions job descriptions.

Search terms included ehealth, Information Technology, Information Management, Electronic Record, Document Management.

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Job Description Analysis 2

Computer was the most widely used term in job descriptions.

The skills required of a potential employee with respect to ehealth were not well described.

For instance, “basic computer skills”, “Tech savvy - able to operate various computer systems.”

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Conclusions

Current teaching and assessment don’t do what they need to do.

Current students won’t learn ehealth competence by chance.

Current teaching and learning resources aren’t adequate.

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Final Thought

The Department of Health and Ageing Report (2011):

Researched ehealth readiness in allied health sector.

Dentists are “proactive pioneers” (pg. 14), and will act as role models for eHealth adoption. Dentists were very well represented in this cluster.

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Links and sourcesACHI Australasian College of Health Informatics www.achi.org.au

AIPPEN Australasian Interprofessional Practice & Education Network www.aippen.net

ATHS Australasian Telehealth Society www.aths.org.au

ACS Australian Computer Society www.acs.org.au

ACPDHS Australian Council of PVCs and Deans of Health Sciences www.universitiesaustralia.edu.au/page/about-us/committees---contacts/key-contacts/deans-groups/

AHIEC Australian Health Informatics Education Council www.ahiec.org.au

AQF Australian Qualifications Framework www.aqf.edu.au

COACH Canada's Health Informatics Association http://coachorg.com

DEEWR OLT Department of Education, Employment and Workplace Relations Office for Learning and Teaching www.deewr.gov.au/HigherEducation/Programs/Quality/Pages/OLT.aspx

DOHA Department of Health and Ageing. (2011). The eHealth readiness of Australia’s allied health sector. http://www.health.gov.au/internet/publications/publishing.nsf/Content/CA2578620005D57ACA2579090014230A/$File/Allied%20Health%20ehealth%20readiness%20survey%20report.pdf

Gray, K., Dattakumar, A., Maeder, A., Chenery, H. (2011). Educating future clinicians about clinical informatics: A review of implementation and evaluation cases, European Journal of Biomedical Informatics, 7(2), 48-57.

HIMAA Health Information Management Association of Australia www.himaa.org.au

HISA Health Informatics Society of Australia www.hisa.org.au

HL7A Health Level 7 Australia www.hl7.org.au

HWA Health Workforce Australia www.hwa.gov.au

IMIA International Medical Informatics Association http://imia-medinfo.org

NEHTA National Ehealth Transition Authority www.nehta.gov.au

Oh, H., Rizo, C., Enkin, M., & Jadad, A. (2005). What is eHealth (3): A systematic review of published definitions. Journal of Medical Internet Research. 7(1):e1, doi:10.2196/jmr.7.1.e1

O’Neill G.: Initiating Curriculum Revision: Exploring The Practices Of Educational Developers. International Journal for Academic Development 2010; 15(1), pp. 61-71.

UK eICE Embedding Informatics in Clinical Education www.cln.nhs.uk/eice/

US ONCHIT Office of the National Coordinator forHealth Information Technology http://healthit.hhs.gov

Wikipedia http://en.wikipedia.org/wiki/EHealth

WHO World Health Organization Global Observatory for eHealth http://www.who.int/goe/publications/atlas/en/index.html

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