electronic Community of Practice:Supporting Interprofessional Learning &

Practice

Kendall Ho, Executive Director, TEKTIC

Director, eHealth Strategy Office

Associate Professor of Emergency Medicine

University of British Columbia, Canada

WoHIT eHealth 2010 Barcelona

March 15-18, 2010

Greetings

from

Vancouver,

Canada

What makes a GREAT piano?

• Purity of each note

• Depth/warmth

• Connectivity/Harmony

between notes

Health Professionals & Patient Centred Care

Health Teams

Advantages

• Complementary skills

• Coordinated pt care

• Increase compliance

• Avoid adverse events

• Mutual consultations

• Time saving

Challenges

• Shared understanding?

• Duplication of care

• Conflicting advice

• Care gaps: errors

• “Turf wars”

• Increased time spent

Learning together?

Electronic Community of Practice

(eCOP)?

• Social learning and shared sociocultural practices when people who share common goals interact*

• Newcomers enter and acquire sociocultural practices of a community*

• Enabled by I.T.

*Rogoff, Lave, Wanger

What eCoP is *NOT*…

• Team: structured, tasks (vs informal)

• Task force: timed (vs evolution)

• Board: top down (vs “grassroots”)

• Assembly line: sequenced (vs flexible)

• Orchestra: restricted by size or talents (vs growth

and mentorship)

eCoP: Components

Synchronous:

•Videoconferencing

•Interactive sessions

•Live chats

•WebEx, Elluminate,

Tanberg…

Asynchronous:

•Multimedia posting

•Blogs

•Discussion boards

•Wiki-documents

B.C. Statistics

B.C. Spain

944,736 km2 499,542 km2

4.2 M pop’n 46 M pop’n

~9,000 MDs~175,000

MDs

Challenges: Medications Use

• Large number of new medications

• MDs: keeping up is difficult

• Time to learn: premium

• Commercial detailing: double edge

Useful, new “evidence based information”

Knowledge vs “sell”

Technology Enabled AD

using information and communication technologies (e.g.

Internet, computer, personal digital assistants) to conduct AD.

Key Findings

OVERALL

• Majority:Lack AD experience

• MDs: unbiased, tailored drug info

• PharmDs: Enjoyed MD interactions

TEAD & AD

• MDs:Equally effective

AD: personal interaction

TEAD/AD: 49 vs 81 min

TEAD + webcam 1st

• PharmDsAD: read MDs’ reactions

AD/TEAD: same content

BOTH

• Gain practice insights

• Form eCoPMedication prescribing

Evidence based medicine

Just in time information

Challenge: Emergency

• Best practices vs urban/rural variations

• Complex & dynamic practice contexts

• Interprofessional collaboration vital

Health administrators/policy makers

Health professionals

Translating CPG into Practice: E2E through IHI

*EB

inquiries

*EB order

sets

Agreed

indicators

*EB = Evidence Based

E2E Communities of

Practice

People

IHI Improvement

modelProcess

*EB

CPG

Optimal patient

outcome

Result

E2E: Results

• 40 EDs: MDs, nurses, administrators

• 3 learning forums

• Identify priority topics:

Sepsis

Triage

• Develop joint measurement indicators

• Grant: rigorous evaluation x 3 years

eCoP: Conditions for Success

• Mutual respect of community members

• Flexibility and adaptability

• Accountability

• Ability to table and deal with conflicts

• Sharing successes and mistakes

Communal Learning: eCoP

• Through health vision, togetherness

• Through evaluation, mutual understanding

• Through collaboration, transformative change

Contact Information

eHealth Strategy Office

Faculty of Medicine, UBC, Vancouver, Canada

MISSION: IT to enable education, service,

research and knowledge translation

Kendall Ho: Director & Associate Professor, Emergency Medicine

Kendall.Ho@ubc.ca

www.eHealth.med.ubc.ca

Facebook: Kendall Ho