Jam Analysis Brief

Part 1 of 2

Presented by Knowledge in the Public Interest

This work is licensed under a Creative Commons Attribution 4.0 International License.

Imagine a world where a Vision Portal support(s) open-source, device-independent capture, transmission and advice from global VF. !J. Scollard

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Members of the global vision community came together for a Jam on the concept of a shared “vision portal.” The object was to discuss the role such a portal might play and how it might be structured if it were to meet the needs of a broad and diverse community of potential users.

183Individuals Registered

73 registered in advance 112 registered on the day

77

Top 5 Countries

Countries Registrants came from

USA, Ethiopia, India, Bangladesh, China

32 people posted in the Jam

US 11 China 5 Ethiopia 3 South Africa 2

Bangladesh 1 Canada 1 Ecuador 1 Germany 1

Ghana 1 India 1 Ireland 1 Mongolia 1

Nigeria 1 Palau 1 Switzerland 1 United Kingdom 1

11

5

3

11

11 1111

1

2

1 11

Most Jam posters are associated with ORBIS International as program managers or consultants/doctors. Those not associated with Orbis are heads of programs, medical institutions and companies.

Who Participated?

23 2 5ORBIS Private Company Hospital / Eye care clinic

1University

1Other

• How to serve all of the different roles in the field?

• How to respond to those with robust and affordable internet access and those without?

• How to be a trusted resource in a “real time” environment?

• How to serve the global eye care field but respond to local needs in terms of language, context and timeliness?

The concept of a global vision portal that supports all eye care professionals is both

tantalizing and overwhelming.

Jam participants acknowledged these concerns while embracing the goal of a global vision portal and charting a potential path towards realizing it.

A shared vision of a shared vision portal

Begin by thinking broadly about the potential audience of users of a vision portal

…A global portal should have wide() coverage -include paramedics, managers and other eye health/development professionals globally and have relevant content to serve them. I feel such a global portal should be open to all and encompass as many healthcare providers as possible to help them serve their communities better. !M.Kumar

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Avoid duplicating what others are doing. Learn from the best of their techniques but do not

compete by providing similar training or content.

Maintaining controls is a huge challenge on the web. There must be other sectors who have dealt with these challenges and maybe we in eye care should look at their successes etc. !K.Naidoo

“ “(A vision portal) should complement what's already out there and not become redundant. I think maintaining the quality of and confidence in information is a really important part of this. !M.Hanbidge

“e-learning tools are being developed by several institutions… as (they) can cover many regions, including rural participants… and that has lower cost involved. !N.Awal

Recognize the reality (limits) of internet access, hardware availability and language proficiency

on the ground today and respond to it

I had a conversation with 2 gents from COECSA yesterday who reported that mobile internet in Kenya (well, Nairobi...) is now faster than they experience when traveling to the UK or US as a result of the new east Africa undersea fibre optic connection. !J. Scollard

“ “In the Indian context, real time would be the best solution with the advanced IT infra available. With the advancements available in country, people expect quick answers. !M. Kumar

Recently in Ethiopia we used cell phone technology to gather and transmit data to a central location. !Alexmita !

(For) a global vision portal, important points are usability; especially in cross-cultural and multi-lingual contexts, and importantly, balancing usability and attractiveness with accessibility for everyone. !N.Awal

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– but, also recognize that the landscape is shifting rapidly and it will be important to be agile as opportunities and

expectations change.

I have seen some of our partners in Zambia, with reference material on their tablets, on their person while doing clinics. !P.Ramson !

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If the goal of the portal is leverage – effectively supporting as many professionals as possible as they work to deliver care to as many people as possible

Telemedicine can mean many things. It can mean virtual surgical demonstration, where we broadcast surgeries live with audio communication. It could be virtual grand rounds, or flipping demonstration on its head and having a mentor watch as a trainee is performing surgery thousands of miles away and offering support during a case. It can also mean telemedicine in the traditional sense, instant consultation. !J. Brown

“- then a broad view of “tele-medicine professional

development” may be the most compelling design frame.

Content-driven sites have proven to be underutilized in the web environment. Building

vibrant communities of practice is a more fruitful way to begin and to “drive usage.”

Great content (is terrific). But, it is a PUSH approach. Today, website and learning platforms are more collaborative - sharing oriented. !K.Youngstein

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Identifying a group of local champions in a particular role (nurses or bio-meds for example) and giving them the forum and structure to discuss issues of shared interest can create

connection and trust, allow for peer learning and the targeted inclusion of experts on particular issues. Content is identified in

response to questions and issues and linked to users.

I think the first thing we need is a clear champion for a community - someone for ophthalmic nursing, someone for biomed, etc. - from there we can build content and engagement strategies. If we had a handful of really engaged leaders for certain professions we could set them up as community leaders on the vision portal - they could moderate, advise etc. There may also be some geographic affinity - it might be interesting to have a nursing lead for India, one for Africa or southern Africa', etc. !J.Scollard

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Surround a group of active communities with vetted resources, structured training options and use

technology creatively to demonstrate or model, observe and give feedback.

The "Army Knowledge Online (AKO) electronic e-mail system has a “tele-consultation service" that uses both clinical champions and project managers for quality assurance and to ensure that responses are timely. It could be interesting to explore their methods further. !A.Chamberlain

“ “In the CREST project in China, we now have cameras in all ten rural centers connected with our Grading Center at ZOC, and also have an electronic medical record system which connects all the centers. We have used photos from this system for HBPs. We also have an automated SMS system which, sends reminders to patients 1 day and 1 week prior to their appointments. In the future, will also send them health care messaging in this way. 95%+ of our patients have cell phones, and in pilot testing we found this system tripled long-term follow-up. !N.Congdon

Today, website and learning platforms are more collaborative - sharing oriented. I propose that, along side formal high level content, there is a platform for users to share videos, images, information. It is key that each user retains ownership of the content - like YouTube. Giving up ownership is often a barrier to sharing. This less formal approach will result in local language content being uploaded. !K Youngstein

In the private sector the program "Second life" is being used to create virtual training centers that are accessed by employees all over the world – (and) not just restricted to those with special knowledge of computer technology and software. !A.Chamberlain

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Consider incentives for participation in formal training and accessing portal content

(It is important to provide) local credit that speaks to country or sub-regional accreditation standards or CPD points. !C.Robinson

“ “(I agree that) monetary incentives need careful consideration - but if you are a poor medical student in a developing country, the cost of accessing our content may be a barrier to uptake !J.Scollard

A way of incentivising would be to make (portal participants) members of an elite club of some kind, which would allow them to share/exchange ideas with the big-wigs of eye care, business, etc.... some kind of special privilege. (Or give the) gift of a book of choice, one year free subscription to some portal, journals, attend conferences...If we can decipher the value add that the user is looking for it can be done and it is only an operational matter. !M.Kumar

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Supplement asynchronous consultation with creative real time inputs.

What if the forum for such a real-time consultation were to be text/image based? Or maybe, further down the line, what if a virtual "call center" group were formed with approved mentors, etc. where mentors had designated "office hours"? That way no matter what time you login and seek consultation, someone is there to answer? The time for a resource/technology like that might not be so far off. It exists for so many other private-sector organizations…Real time consultation could work on a local level where schedules and time zones might be more synchronized. This would be an interesting development of a regionalized approach. !D. Neely

“ “If we can provide a smart phone platform to users it will increase the rate of using online resources. !Q.Lu

Young generation (in China), whether they are living in rural or urban, are using smart phones. (They use a) domestic brand, cheap and reliable, about 100usd, android system. !P.Xu

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Most doctors in Mongolia use smart phones. !C.Chuluunkhuu

“Doctors rarely have time to sit at a computer or laptop, but mobile makes access easier. !P. Ramson

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Think “mobile”

Consider a revenue model – perhaps a combination of ophthalmic company ads and global NGO contributions.

I would think that ophthalmic companies would jump at the chance to have inexpensive ads that reach a global audience of users. !D.Neely

“ “I think a direct revenue model would be difficult in developing countries - both because of the cost and also logistics (how would revenue be collected where credit cards or services like Paypal don't exist?). I think the idea of the portal partners bearing some responsibility warrants discussion - if it removes a barrier to access and there is a return on investment I think it is feasible. !J.Scollard

Work towards standards and protocols for participation and contributions. Match to metrics to assess the value of the portal.

“…An open group forum would of course still need to have regulations, standards and procedures. It would not make sense to allow just anyone to give advice on such a forum. But perhaps making (a) case more open would allow for more collaboration and a better response on a more global scale than a closed, private exchange in a singular organization. I think standards and protocols should be developed in tandem to a global vision portal. In my mind assessing needs goes hand in hand with assessing standards. !J.Daguna

Pair community champions with local/regional project management and technology support.

“The article about the use of IT/TeleHealth in the US Army speaks of the use of dedicated management/managers for IT/Telehealth. In Africa we have Childhood Blindness and Low Vision Coordinators attached to partner hospitals. Apart from their regular work, they can be supported to take on some IT duties if needed. Also, having that good relationship with local Government one can engage them on trying to find HR to assist. !P.Ramson

What an amazing rich discussion we've had over these past 7 hours. Our goal was to

hear from the field, what is needed in an online tool. We wanted to answer the

question- how can we build on our past success, expand our user base, engage a

broader community and provide a tool that allows them to engage one another. We

wanted to know whether this was useful and something those in the field were

interested. Now that we understand your global perspective on experiences and

challenges, I hope to share this with our global ophthalmic community and rally the

group to develop a Vision Portal that will offer high quality content, mentor ship and

build community within ophthalmology and all its associated clinical disciplines.

!

J.Brown

For questions about this Brief or the Vision Portal Jam please contact  Susan Restler srestler@kpublic.com

Presented by Knowledge in the Public Interest

This work is licensed under a Creative Commons Attribution 4.0 International License.